health business 14.4

AMBULANCES

PLUS: DESIGN & BUILD • ENERGY • FLEET MANAGEMENT • HEALTHCARE EVENTS • TRANSLATION

HEALTHCARE ITLITIGATION

VOLUME 14.4www.healthbusinessuk.net

Making sure healthcare waste does not pose a risk to public health or the environment

WASTE MANAGEMENT

BINNING CLINICAL WASTE

Using technology to deliver savings and increase transparency

E-PROCUREMENT STRATEGY

PURCHASING

The first line of defence for infection control

HAND HYGIENE

INFECTION CONTROL

Comm

entHEALTH BUSINESS MAGAZINE ISSUE 14.4

AMBULANCES

PLUS: DESIGN & BUILD • ENERGY • FLEET MANAGEMENT • HEALTHCARE EVENTS • TRANSLATION

HEALTHCARE ITLITIGATION


Making sure healthcare waste does not pose a risk to public health or the environment

WASTE MANAGEMENT

BINNING CLINICAL WASTE

Using technology to deliver savings and increase transparency

E-PROCUREMENT STRATEGY

PURCHASING

The first line of defence for infection control

HAND HYGIENE

INFECTION CONTROL

© 2014 Public Sector Information Limited. No part of this publication can be reproduced, stored in a retrieval system or transmitted in any form or by any other means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of the publisher. Whilst every care has been taken to ensure the accuracy of the editorial content the publisher cannot be held responsible for errors or omissions. The views expressed are not necessarily those of the publisher. ISSN 1362 - 2541

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PUBLISHED BY PUBLIC SECTOR INFORMATION LIMITED226 High Rd, Loughton, Essex IG10 1ET. Tel: 020 8532 0055 Fax: 020 8532 0066 Web: www.psi-media.co.ukEDITOR Angela Pisanu EDITORIAL ASSISTANT Arthur Walsh EDITORIAL DIRECTOR Danny Wright PRODUCTION EDITOR Richard Gooding PRODUCTION CONTROL Jacqueline Lawford, Jo Golding WEBSITE PRODUCTION Reiss Malone ADVERTISEMENT SALES Patrick Dunne, Jeremy Cox, Tomas Lee, Ben Plummer, Lucy Rowland ADMINISTRATION Victoria Leftwich PUBLISHER Karen Hopps REPRODUCTION & PRINT Argent Media

Bridging the gap between GP surgeries and A&EA group of medical Royal Colleges have called for all emergency departments to have co-located out of hours GP services to ease the burden on urgent care services. They say that patients should not be expected to be able to determine the seriousness of their illness or injury, but at the same time, A&E departments should not be responsible for “anything and everything”.

The group – made up of the College of Emergency Medicine, the Royal College of Paediatrics and Child Health, the Royal College of Physicians and the Royal College of Surgeons – states that as well as out-of-hours family doctors, there should also be other health and social care workers located in emergency departments to bridge the gap between GP, hospital and social care services. The group also said that community care and social care should be available seven days a week to support urgent and emergency care services, which would mean patients could be safely discharged outside of normal working hours.

The issue of GP access is examined in this edition of Health Business, with page 54 looking at the current state of play of GP provision and how the Prime Minister’s Challenge Fund is helping surgeries across the country pilot innovative ways to meet patient demand for out-of-hours care.

This Health Business also looks into the current regulation concerning clinical waste disposal, which is sizeable and multi-faceted. On page 26, Sam Corp, head of regulation at the Environmental Services Association, highlights the key areas and legal obligations that producers of healthcare waste should know. We also re-examine the role that hand hygiene has in infection control on page 15, and how nursing is being transformed and modernised by technology on page 41. Angela Pisanu, editor

BUSINESS INFORMATION FOR HEALTHCARE PROFESSIONALS – www.healthbusinessuk.net

3 Volume 14.4 | HEALTH BUSINESS MAGAZINE

Contents

ENERGY

PLUS: MEDICINES & MEDICAL DEVICES • FACILITIES MANAGEMENT • LEADERSHIP

FLEET MANAGEMENT

Using information to make care better, safer and more affordable

THE POWER OF BIG DATA

HEALTHCARE IT

How a design-led solution can reduce aggression and improve safety

TAMING EMOTIONS IN A&E

DESIGN & BUILD

INFECTION CONTROL


Implementing the government’s recommendations following the Francis Report

PATIENT SAFETY

A FINAL RESPONSE TO FRANCIS

CLEANING

VOLUME 13.6


PLUS: FIRE SAFETY • HEALTHCARE IT • PARKING • FACILITIES MANAGEMENT

INFECTION CONTROL

How properly managed agency

staff can help an NHS under pressure

RECRUITMENT

The Government’s scheme to help

the NHS slash its energy bills

GREENING THE

UK’S HOSPITALS

ENERGY

A FLEXIBLE WORKFORCE

Patient safety reporting

to be overhauled

2m visit A&E due to lack

of GP appointments

Six per cent rise in

reported NHS staff

assaults

LATEST

NEWS

How better reporting of problems can

play a vital role in patient care

REGULATING

MEDICAL DEVICES

PATIENT SAFETY

SECURITY


PLUS: MARKET RESEARCH • ENERGY • HEALTH & SAFETY • FACILITIES MANAGEMENT

EHI LIVE 2013

Just a vision or an achievable reality?

HEALTHCARE IT

How the Department of Health’s procurement strategy aims to improve buying

BUYING BEST PRACTICE

PROCUREMENT

CREATING A PAPERLESS NHS

£50m for weekend and

evening GP opening hours

‘Statutory independence’

for CQC

NHS 111 future

uncertain

LATEST NEWS

HOSPITAL MANAGEMENT

VOLUME 13.3


PARKING

HB NEWS: SIR DAVID NICHOLSON TO EXIT NEXT YEAR | CSC SECURES NEW LORENZO DEAL

HEALTH & SAFETY

Ofsted-style ratings planned

FRANCIS ENQUIRY

PATIENT SAFETY

Keeping the blues and twos green

FLEETMANAGEMENT

AMBULANCES

Who or what is protecting those under secrutiny?

SECURITYBACKGROUND CHECKS

DIGITAL HEALTHCARE

VOLUME 13.4


NHS FLEETS

HB NEWS: Professor Berwick reports on safety • North East and Cumbria CCGs form collaborative hub

LEGIONELLA CONTROL

Patient safety: mastering healthcare on mannequins

TRAINING

Equipment to deal with

bariatric patients OBESITYSPECIALIST EQUIPMENTWhat should good governance and

decision-making processes look like?

CLINICAL

COMMISSIONING

GROUPS

BEST PRACTICE

SIMULATION

TRAINING

Health Business www.healthbusinessuk.net

CONTENTS15



26

41

67

07 NEWS Government introduces special measures for care homes; Safe staffing guidance for nurse care; Social media behind rise in complaints 10 PROCUREMENT The NHS Supply Chain’s Jennie Brice-Boutard examines how the new eProcurement Strategy aims to make savings and increase transparency 15 INFECTION CONTROL: HAND HYGIENE Hand hygiene is widely recognised as a vital tool in combating healthcare associated infection 21 INFECTION CONTROL: EVENT PREVIEW Infection Prevention 2014 takes place in Glasgow from 29 September to 1 October 26 CLINICAL WASTE Sam Corp, head of regulation at the Environmental Services Association highlights the legal obligations that producers of clinical waste should know 31 LITIGATION The NHS needs to make better use of negligence information to improve patient safety and halt the rise in patient claims 34 TRANSLATION Geoffrey Bowden of the Association of Translation Companies discusses the importance of using translation services in the NHS to communicate to patients of all nationalities 37 OBESITY MANAGEMENT The British Dietetic Association’s Linda Hindle examines the obesity crisis facing Britain and comments on strategic approaches to curb this worrying trend 41 HEALTHCARE IT 74 NHS Trusts have received funding to invest in technologies such as digital pens, tablets and clinical software to help nurses and midwives work more efficiently

49 INFORMATION SECURITY Careless disposal of confidential information can be detrimental if the information finds its way into the wrong hands, says the BSIA’s James Kelly 53 IP EXPO EUROPE IP EXPO Europe, on 8-9 October at London’s ExCel, informs healthcare professionals on how they can best use data 54 GP SURGERIES The Prime Minister’s Challenge Fund aims to raise standards of patient access throughout the UK. Health Business reports 57 ENERGY Kevin Thoy talks about an ambitious biomass project rolled out in Boston’s Pilgrim Hospital 61 DESIGN & BUILD The MPBA’s Jackie Maginnis writes about the trend of using modular buildings as pop-up hospitals during times of peak healthcare demand 64 IFSEC REVIEW Those tasked with security made up the delegates at this year’s IFSEC event 67 HEALTH + CARE REVIEW Health Secretary Jeremy Hunt spoke of a “completely new vision for integrated healthcare” at June’s Health + Care 2014 event 71 HOSPITAL SIGNAGE Jim Creak of the Health and Safety Sign Association shares his views on the introduction of ISO7010 as the standard for fire safety signage in hospitals throughout Europe 73 FLEET MANAGEMENT Laura Woods of road safety charity Brake sums up revised Health & Safety Executive advice on work-related road safety 77 AMBULANCES David Davis examines how the independent ambulance sector is a vital resource for an oversubscribed NHS

available in a

Sundeala_HB14.4 - FP.indd 1 17/07/2014 15:14

available in a

Sundeala_HB14.4 - FP.indd 1 17/07/2014 15:14

New

s

PATIENT COMPLAINTS

Social media behind rise in complaints, GMC reportsSocial media and negative press coverage are behind an increase in patient complaints in recent years, with complaints against doctors almost doubling between 2007 and 2012, according to a report commissioned by the General Medical Council (GMC) and carried out at Plymouth University. The GMC claims that there is no evidence for falling standards in medical care over this period, and explains the rise by arguing that patients are now better informed of health matters, have higher expectations of doctors and have more avenues to discuss their healthcare experiences than in the past. The GMC also says that negative coverage in the media could be affecting the public’s confidence in the medical profession, and that this trend could lead to complaints being made that are not strictly relevant to the doctors’ regulatory body. Dr Julian Archer of Plymouth University said that the report indicates that “the forces behind a rise in complaints

against doctors are hugely complex and reflect a combination of increased public awareness, media influence, the role of social media technology and wider changes in society. “The report also indicated that there is much to do to improve the wider complaint handling system, so that complaints made by the general public about their doctors are directed to the appropriate authorities.”

EMERGENCY CARE

NHS England: A&E waiting time targets missed ‘for whole year’Official figures from NHS England show that major A&E departments have failed to meet waiting time targets for 52 weeks in a row, leading to concerns that staffing issues in the NHS are growing more serious and that the country’s ageing population are posing difficulties on health demand.

Guidelines dictate that 95 per cent of patients at A&E in the 144 trusts with major units should be seen within four hours, a target that has not been met since the week ending 14 July in 2013. Previous years, in contrast, have seen hospitals meeting waiting time targets more easily in the summer months.

The past two years have seen the number

of A&E visits rise by 1.4 per cent to 14.2 million in 2013. Of the 14.2m visits last year, just under 3.8m ended up with an admission into the hospital. That is 5.7 per cent higher than two years previously.

Dr Cliff Mann of the College of Emergency Medicine said of the findings: “A lot of this is related to the ageing population and while the percentage rise may seem small we are still talking about a lot of people.

“We have a drastic shortage of doctors and that is hampering our ability to cope with rises in demand. We have to make the speciality more attractive.”

READ MORE: tinyurl.com/kejarzu

GP CONTRACTS

GPs favour local contracts over Quality and Outcomes FrameworkA survey carried out by Pulse has revealed that just under half of GPs would, if given the choice, opt out of the national Quality and Outcomes Framework (QOF) deal in favour of a contract negotiated locally with Clinical Commissioning Groups (CCGs). The QOF is an incentive programme that rewards practices for achievement in areas like treating chronic disease and patient experience. Somerset GPs have been granted permission to leave the QOF and are in the process of negotiating a deal with the LMC and CCG. 46 per cent of 413 GPs in the Pulse survey said they would ‘in principle’ be inclined to follow Somerset’s example as the QOF scheme was ‘no longer about patient care’ and clashed with the current emphasis on local budgets. 17 per cent said they would not consider leaving the scheme, and 37 per cent said they were undecided pending local proposals being made. The General Practitioners Committee (GPC) has criticised locally negotiated deals as undermining the national scheme. GPC chair Dr Chaan Nagpaul said: “We need to be very careful, the last thing we need is an unintended consequence, of GPs doing the same work, for less resources, and then having to work hard to earn that resource back. “Clearly there is value in elements of local schemes, resourced by CCGs or the area team, on top of a national contract.”

READ MORE: tinyurl.com/kzlhgnn

CLINICAL GUIDANCE

NICE lowers risk threshold for statin useThe National Institute for Health and Care Excellence (NICE) has recommended offering statins to anyone with a ten per cent risk of developing cardiovascular disease with ten years. The organisation says that this could save as many as 8,000 lives every three years.

This update to the 2006 guideline on lipid modification represents a halving of the previous risk threshold of 20 per cent risk of developing CVD over 10 years, and could see 4.5 million people classed as eligible for statins.

Professor Mark Baker, director of the Centre for Clinical Practice at NICE, said: “Doctors have been giving statins to ‘well people’ since NICE first produced guidance on this in 2006. We are now recommending the threshold is reduced further. The overwhelming body of evidence supports their use, even in people at low risk of CVD.”

READ MORE: tinyurl.com/mz44b2d

READ MORE: tinyurl.com/l8pgjwh

RECRUITMENT

£10,000 ‘golden hellos’ for Essex GPsPulse magazine has reported that GPs relocating to Essex for a minimum of two years are to be given up to £10,000 in order to tackle a recruitment crisis which, according to Essex LMC chief executive Dr Andrew Bradshaw, has left many practices “on the brink of collapse.” The region is short of the 143 full-time equivalent GPs recommended by NHS England. The scheme involves a basic sum of £5,000, with the possibility of another

£2,500 depending on the level of deprivation and an extra £2,500 depending on how under-doctored the area. Financing for the initiative has come from a £400,000 fund set up by Health Education England (HEE) to help local commissioners solve recruitment issues. A similar scheme in Doncaster has so far failed to attract new GPs despite offering a larger sum than Essex LMC.

READ MORE: tinyurl.com/m7yye8l



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PATIENT SAFETYNEWS IN BRIEFNICE safe staffing

guidance for nurse careNew guidelines have been published to help ensure safe nurse staffing levels are present during overnight shifts. The guidance from the National Institute for Health and Care Excellence (NICE) details how nurses in charge of shift allocation must be aware of ‘red flag’ events and allocate staffing levels and expertise accordingly. ‘Red flag’ events include pain relief not being provided and a failure to help patients go to the bathroom.

NICE says that while no one ratio of nurses to patients can guarantee that proper care is given, in cases where all nurses are caring for more than eight patients there should be close monitoring for red flag events and action should be taken if necessary. The organisation says that while implementing these recommendations may involve initial costs it would likely result in savings being made down the line.

Professor Gillian Leng, deputy chief executive and director of Health and Social Care at NICE said: “Safe staffing is more complex than setting a single ratio. The emphasis should not just be on the available number of staff, it should be on delivering safe patient care and making sure that hospital management and nursing staff are absolutely clear on best practice to do this.”

Miles Scott, chief executive officer, St George’s Healthcare NHS Trust and

Chair of the Guideline Development Group, said: “Acute wards see a variety of patients, from appendicitis to broken bones, from young to very old, and each individual has very different needs.

“This guidance has been trialled in over 100 hospital wards in 14 different hospitals and clearly sets out the factors that must be taken in to account to work out what is the adequate skill level and number of nursing staff required on that particular ward.

“Safe staffing needs to be about ensuring you have the right staff, in the right place, at the right time, to give patients the care they need and deserve.”

FINANCE

Migrants to pay over cost price for NHS treatmentThe NHS is to introduce charges of 150 per cent of the cost of treatment for non-EU nationals in an attempt to curb ‘health tourism’. The government hopes that the move, which will be implemented next year, will incentivise NHS Trusts to recoup the cost of treating migrants and other patients.

The UK sets out to reclaim the entire cost of providing treatment to EU and non-EU nationals every year. However, only a small part (£73 million) of the £460 million spent by the NHS on chargeable procedures is recovered at the moment as in many cases, the time and cost involved outweighs the sums recoverable. Standard costs for these procedures range from around £1,860 for cataract surgery to around £8,570 for hip replacement.

The new rules will not affect non-UK citizens who are lawfully entitled to reside in the country. However, temporary migrants resident in the UK for longer than six months will be faced with having to pay £150 for procedures costing £100, as well

as an annual health levy of £200. Trusts that fail to levy the charges will be fined.

While the new charges are aimed at reducing the financial burden on taxpayers, some in the medical profession have been critical, arguing that it will force doctors to act as border guards rather than treating those in need of care.

Dr Mark Porter, chair of the British Medical Council, said: “Without more detail, there are question marks over whether or not these proposals will be workable and if the NHS has the infrastructure and resources necessary to administrate a cost-effective charging system. Plans to fine hospitals who fail to recoup costs would see them punished twice over to the detriment of other services.

“Above all, it is vitally important that these proposals don’t have an impact on the care patients receive and that sick and vulnerable patients aren’t deterred from seeking necessary treatment, which can have a knock-on effect on public health.”

Third of CCGs do not plan to re-tender for community servicesOver a third of clinical commissioning groups do not plan to issue new tenders for community services such as community rehabilitation and home nursing, a report by the Health Service Journal has revealed. 72 commissioners from 195 CCGs said they had no plans to re-tender, leaving the future of at least £2.3 billion in annual contracts uncertain. Seven CCGs have already re-tendered for their community services, and a further 39 are currently planning to re-tender contracts worth £998 million by 2017.

READ MORE: tinyurl.com/nfocernREAD MORE:

tinyurl.com/muyq5mw

£800,000 spent on hospital adaptations for obese Scots Figures reveal NHS Scotland has spent at least £800,000 adapting its facilities for obese people in the past three years. However, the true cost is likely to be far higher as some health boards do not keep a track of obesity-related costs. Money has been spent on widening doors and adapting mortuaries, with reports that some hospitals have bought chilled body bags so they can keep the bodies of overweight people on specially designed beds able to cope with their size instead of putting them in the mortuary.

READ MORE: tinyurl.com/k4muyhc

Foundation trusts see agency costs rise by £300mAgency and contract staff costs for Foundation Trusts have soared up by £300m last year, according to a report by foundation trust regulator Monitor. The increase is a 27 per cent rise from £1.1billion in 2012-13 to £1.4 billion for 2013-14. In his introduction to the report, Monitor chief executive David Bennett said foundation trusts “continue to cite difficulties in recruiting to permanent posts.” Such difficulties had been “exacerbated” by the impact of increasing clinical staffing ratios following the Keogh and Francis reviews.

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The Department of Health launched its eProcurement Strategy back in May. The new strategy complements the recent Procurement Strategy, and is designed to support trusts in improving NHS procurement activity and delivering cost efficiencies through the increased use of technology. NHS Supply Chain welcomes the strategy and the efficiencies that eProcurement solutions can bring. Whilst all NHS providers use eProcurement solutions, none have fully implemented solutions that underpin all procurement activity. IMPROVED ACCESS“We’re delighted that the Department of Health has taken this step to improve access to eProcurement through the launch of this new strategy,” says David Rabjohns, eCommerce Enterprise Architect at NHS Supply Chain. “As a business, we greatly support the introduction of a new ‘common standards’ based approach to data processing for the NHS.” The eProcurement strategy will establish the global GS1 coding and PEPPOL messaging standards throughout the healthcare sector and its supporting supply chains. The adoption of GS1 standards will provide the master data required and is the foundation for improving all aspects of procurement. “There will be better financial visibility and understanding from having the core data. It’s difficult to get at the data for price comparison at the moment because it’s fragmented and people can call one product 10 different names, depending on who’s coding it,” says David. “This strategy will allow transparency throughout the NHS procurement process, simplifying the supply chain, driving cost efficiencies, increasing accuracy and allowing greater compliance,“ continues David. “It will also enable a more unified system of procurement across the NHS, enabling product comparison, aggregation and standardisation across trusts.”

DELIVERING BENEFITSNHS Supply Chain has already begun its journey on this standards-based approach to data through achieving GS1 accreditation, collecting and displaying GS1 Global Trade Item Numbers (GTINs) to improve accessibility to product information, and increasing the use of e-solutions, such as electronic invoicing, to simplify the procurement process. Their eDC inventory management system was referenced in the strategy as meeting the majority of needs of NHS acute providers. “We

welcome reference made in the eProcurement Strategy to eDC and eDC Gold – systems which are already delivering benefits to a large number of NHS trusts,” continues David.

WHAT IS EDC AND EDC GOLD? Electronic Demand Capture (eDC) is a system already used by the majority of NHS Trusts. It enables Trusts to manage their

levels of low value/high volume stock and non-stock products using a Personal Digital Assistant (PDA) to scan product bar codes. The system can be used to monitor and generate order information for all ward stocks, not just those products sourced via NHS Supply Chain. It also provides management information and informs future inventory levels based on historical demand profile.

E-PROCUREMENT FRAMEWORK

UNIFIED PROCUREMENT

Proc

urem

ent

The NHS Supply Chain’s Jennie Brice-Boutard examines how the Department for Health’s eProcurement Strategy highlights the use technology as a way to improve NHS procurement, deliver savings and increase transparency


HEALTH BUSINESS MAGAZINE | Volume 14.410

With an estimated £1 billion of the national NHS budget attributed to consigned and high value stock there will inevitably be complexities in managing it. NHS Supply Chain recognised that by implementing systems and processes that make managing this cost area more effective, it could

provide trusts with numerous benefits to the complex and widespread challenges that they have routinely been facing. eDC Gold introduces additional inventory management functionality enabling trusts to manage, track and report on high value/low volume product categories such as

Orthoapedics, which require an enhanced level of inventory management; whilst still enjoying all of the benefits of the existing eDC systems. eDC Gold not only tracks stock levels but stock movements as well, telling the trust where stock is, where it has been used (i.e. theatre location, consultant, patient), which products are owned, which are consignment. This enables consumption by location to be better understood which can be used to drive benefits and cost down initiatives with Trusts and inform their procurement strategies.

THE SOLUTIONMid Cheshire Hospitals NHS Foundation Trust recognised the need to place governance and control at the heart of its procurement processes. The key factor in achieving this was attaining the highest levels of data transparency across all non-pay spend. The trust agreed to work with NHS Supply Chain to develop the eDC Gold managed inventory system. The results were impressive. Tracking stock movements and not only stock levels led to a lower incidence of over ordering, easier management of stock, reduced availability and downtime issues, free time for clinicians and improved understanding of product consumption helping to inform strategic procurement decisions. “Before eDC Gold we did not know what consignment stock we actually had,” said Clive Mosby, Head of Procurement, Mid Cheshire Hospitals NHS Foundation Trust. TIME SAVING“Mid Cheshire Hospitals NHS Foundation Trust found that data transparency across orthopaedic procurement improved through the use of eDC Gold, reducing clinical time spent on stock management by 74 per cent and product recall processes by 92 per cent,” says David Rabjohns. “Time freed up for senior staff can be spent on training and support for junior members of the team and means that we have more time available to be in theatre,” says Claire Chesters, Clinical Lead at Mid Cheshire Hospitals NHS Foundation Trust. “There is little doubt that eProcurement is the way forward for the NHS in terms of delivering better value for money in procurement,” says David, but there is widespread agreement in the healthcare sector that implementing the strategy will take time and need a concerted effort across the NHS landscape, and the NHS supplier base, to achieve this ambition. As Dr Dan Poulter said in his forward to the strategy: “There have been many previous initiatives to realise procurement efficiencies but this time we mean business and are determined to deliver efficiencies to free up more money for frontline care.”

FURTHER INFORMATIONwww.supplychain.nhs.uk

Procurement

The eProcurement strategy will establish the global GS1 coding and PEPPOL messaging standards throughout the healthcare sector and its supporting supply chains. The adoption of GS1 standards is the foundation for improving all aspects of procurement



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Written by N

icholas Hutton, senior buyer, NHS Supply Chain

Each year it is estimated that 300,000 patients (one in 16) acquire a healthcare-associated infection (HCAI) while being cared for with the NHS in England. Each one of these infections means additional use of NHS resources, greater patient discomfort and a decrease in patient safety. It is widely recognised within the NHS that hand hygiene is one of the most important factors in the fight against HCAIs. The promotion of good hand hygiene practice has been the subject of various campaigns over the years, in particular the Department of Health’s Clean Your Hands Campaign, which had a significant impact on the healthcare environment. Since 2006 there has been an 18-fold reduction in MRSA (methicillin-resistant Staphylococcus aureus) bloodstream infections and a 5-fold reduction

in Clostridium difficile infections. Hand washing plays a vital role

in hand hygiene and alcohol rubs make it easier for

healthcare staff to clean their hand quickly when they aren’t able to wash them. A recent British Medical Journal report found that antibacterial hand gel use rocketed by 300 per cent during

the Department of Health campaign which

led to the introduction of alcohol gel dispensers by

patients beds, together with posters reminding staff about hand washing and hygiene compliance checks. Procurement data from 116 trusts were collected and the results found that increased use of soap significantly contributed to the reduction of Clostridium difficile infection throughout the study and alcohol hand gel had a positive impact on MRSA prevalence.

FRAMEWORK AGREEMENTThe availability of soaps, moisturisers, alcohol based hand rubs and alcohol free products is vital to support trusts, clinicians, end users and the infection prevention and control team professionals. In October last year NHS Supply Chain aligned all their hand hygiene products under one single framework agreement. The range of products and the number of suppliers was extended offering trusts greater choice and significant savings opportunities on a number of product lines. The specification and process for the tender were put together with input from the Infection Prevention Society and the Royal College of Nursing. Julie Storr, President of the infection Prevention Society (IPS) explains: “IPS supports the new Framework Agreement which constitutes an important component of a multimodal behaviour change improvement strategy.” “We fully support the development of this framework,” says Rose Gallagher E

HAND HYGIENE

HAND WASHING: THE FIRST LINE OF DEFENCEHand hygiene is widely recognised as a vital tool in combating healthcare associated infection, writes Nicholas Hutton of the NHS Supply Chain, who provides key information for hospitals

Infection Control

It is widely

recognised

within the NHS that

hand hygiene

is one important factor

to fight healthcare-

associated

infections



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Infection Control

HAND HYGIENE

Nurse Adviser for Infection and Prevention Control at the Royal College of Nursing. “It supports healthcare organisations by providing a range of resources needed for staff to perform hand hygiene. We know how important quality products and choice are in enabling hand hygiene and this framework is a positive step forward in assisting this.” A rigorous process of product evaluation into compliance with standards and toxicology was also carried out by the Health Infection Research Laboratory and the Health and Safety Executive Laboratory. Nicholas Hutton, Senior Buyer – Healthcare Acquired Infection Control at NHS Supply Chain says: “This contract will make it even easier for NHS trusts to order hand hygiene products, to make savings and will support them in their aim to meet hand hygiene compliance targets. With approximately 250 product lines and three new suppliers on contract, we offer an extensive range of first-line defence products in the fight against infection.”

PRODUCTSThe range of products on NHS Supply Chain’s framework are available through dispensers, free standing bottles and tottles and are all aligned to trust hand washing and hygiene guidance procedures. Most HCAIs are preventable through good hand hygiene, cleaning hands at the right times and in the right way, and there are a number of institutions working hard to get this message across. But is the hand hygiene message truly embedded in UK healthcare systems - or can we do better? The recent launch of a new National Institute for Health and Care Excellence (NICE) quality standard for Infection Prevention and Control stresses the importance of simple steps such

as hand washing to reduce infections. The quality standard which features six statements designed to drive improvements was welcomed by the Royal College of Nursing and the Infection Prevention Society. “It is really positive that NICE have published a quality standard on Infection Control,” said Rose Gallagher from the RCN. “These aspirations will support organisations to go that little bit further in terms of stopping infection and ways of improving infection control.” However Rose is concerned that the government had not made a commitment to evaluate this quality standard. “At the moment there is no formal mechanism to evaluate impact and inform future practice. It would be very helpful to both infection control specialists and staff working on wards to undertake this evaluation,” says Rose. “We still have a lot of work to do in terms of getting the evidence base much stronger and in terms of understanding why people don’t do things they should be doing,” she said. Julie Storr, President of the Infection Prevention Society, said: “The NICE standard reinforces the need for action on healthcare associated infection. It is only one part of an overall approach to quality improvement. Constant vigilance is

A recent British Medical Journal report found that antibacterial hand gel use rocketed by 300 per cent during the Department of Health campaign which led to the introduction of alcohol gel dispensers by patients beds

required if basic yet essential actions such as hand hygiene are to be integrated and embedded within care and treatment.” Procuring hand hygiene products alone will not end the fight against HCAIs. But it is vital that we work with key stakeholders to convey the importance of hand hygiene and the NICE quality standard.

FURTHER INFORMATIONwww.supplychain.nhs.uk

Hand Hygiene Alliance

Following the end of the Department of Health’s Clean your Hands Campaign, members of the former advisory panel got together to form the Hand Hygiene Alliance.

The group, which includes representatives from the Royal College of Nursing (RCN), the Infection Prevention Society (IPS), the Care Quality Commission and the Patient’s Association, felt it was vital not to lose the progress that had been made. “The danger is that without a high profile campaign or body we end up going back to low compliance with hand hygiene regressing,” says IPS President Julie Storr.

NICE infection prevention and control guidance: six quality standards

1: Antimicrobial stewardship

2: Organisational stewardship

3: Hand decontamination

4: Urinary catheters

5: Vascular access devices

6: Educating people about infection prevention and control


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Following a hugely successful conference in London, Infection Prevention 2014 is coming to Glasgow. The conference will be held at the SECC from 29 September to the 1 October 2014. Organised by the Infection Prevention Society, this is the major infection prevention conference and exhibition of the year. The conference has been awarded 14 CPD points by the Royal College of Pathologists. There will be in excess of 600 delegates in attendance and over 100 exhibitors. The scientific programme will deliver an array of renowned speakers covering all your infection prevention needs.

THE PROGRAMMEWith an exciting programme on offer, this event promises to offer delegates the latest in infection prevention research, education and expertise, with inspiring speakers and informative sessions. Confirmed speakers include: Dr Evonne Curran, Dr Stephanie Dancer, professor Jason Leitch, Dr Michael Borg, Andrew Jackson, professor David Weber, Peter Hoffman, professor Shaheen Mehtar, Dr Nick Phin, Dr John Coia, Julie Storr and many more. This year’s programme features specialist streams on invasive devices, carbapenem-

resistant enterobacteriaceae (CRE), community care, surgical and perioperative practice, dentistry and research. The purpose of the streams is to help delegates make the most of their time effectively at conference. There will also be sessions on antimicrobial resistance, leadership, zero tolerance, environmental hygiene, food hygiene and the opportunity to ‘meet the experts’.

INFORMATIVE SESSIONSThe inaugural session at Infection Prevention 2014 is from IPS Patron Professor Didier Pittet, Director of the Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Switzerland who will be presenting a session entitled ‘Generation We – inspiring the future of infection prevention’. Within this session Didier Pittet will conduct a think tank exercise, to outline how we can stimulate the current ‘Generation We’ that is or will be involved in healthcare delivery to be engaged in infection prevention and control. This session will also pose a series of questions that will ultimately outline how we need to influence leaders of the future to save millions of lives through their actions in healthcare. Professor Didier Pittet hopes to stimulate the audience to inspire action, to ensure the best evidence available to us is translated into patient safety at the bedside.

Dr Evonne Curran, recent IPS Research and Development Group lead will deliver the EM Cotrell Lecture. In her session ‘The times they are a-changing’, Evonne will explore how over the last 25 years, the infection prevention and control community has contributed enormously to patient safety by preventing, shortening and learning from outbreaks. The afternoon of the first day of conference features a wealth of speakers who will be covering four specialist streams. Deverick Anderson, associate professor of Medicine, Duke University Medical Centre, will look at ‘The Benefits of Universal Gloves and Gowns (BUGG)’. Within this session Deverick will explore why current discussion focuses on the relative value of universal vs. targeted interventions, how the BUGG study evaluated the impact of universal glove and gown use on the ICU, and discuss the outcomes and implications of the BUGG study. Concurrently IV nurse consultant Andrew Jackson will be delivering a session as part of the Invasive Devices Stream entitled ‘Past present & future state of central line bundles’. In this session, Andrew Jackson will discuss the influence of a central line bundle in bringing together scientifically grounded concepts that are both necessary and sufficient to improve the outcome. The Invasive Devices Stream will continue with a session on infection implications of chest drains. There will be E

EVENT PREVIEW

ROUNDING UP EXPERTISEInfection Prevention 2014, which takes place in Glasgow from 29 September to 1 October, will bring together an impressive range of experts in the field of infection prevention

Infection Control

Organised

by the

Infection

Prevention Society,

this is the major

infection prevention

conference and

exhibition of

the year



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a further session on urinary catheters from Jacqui Prieto, senior clinical research fellow and nurse specialist in infection prevention and Catherine Murphy, postgraduate research student, University of Southampton. They will look to examine the reasons for overuse of urinary catheters in acute medicine, explore the patient’s experience of voiding difficulty and urinary catheterisation when undergoing elective knew or hip replacement surgery.

SPECIALIST STREAMSTuesday features several specialist streams on ‘Carbapenem-Resistant Enterobacteriaceae (CRE)’, ‘Research Practicalities’ and ‘Community Care’. In addition separate events on ‘Surgical/Perioperative Practice’ and ‘Dental’ will be featured in the programme and can both be accessed as standalone events which can be booked directly on the conference website. The Surgical and Perioperative Practice Day features a range of sessions from experts within the field who will take a comprehensive look at various aspects of surgical care. The stream will open with professor David Leaper who will give an ‘Overview of surgical site infections (SSI)’. Within this session David will explore how an accurate definition of surgical site infection (SSI) is important for research and interdisciplinary benchmarking. This session will be followed by Jennie Wilson and Rose Gallagher who will discuss a collaborative project entitled One Together, which aims to reduce risk of surgical site infection by bringing together a variety of specialists. Professor Judith Tanner will take a look at the evidence base for the prevention of surgical Site Infections. In addition, Julian Jarman and Melissa Rochon will discuss how surveillance has driven changes in practice to reduce surgical site infection with a session entitled ‘Surveillance in action’. Peter Hoffman, consultant clinical scientist from Public Health England will discuss the requirements of ‘Theatre ventilation’ and finally Christina Bradley will discuss the current issues with safe decontamination.

The Dental Day features a session from Peter Hoffman, Consultant Clinical Scientist for Public Health England with a session entitled ‘Contamination risks and how to reduce them’. Peter will explore how dental settings and instruments are contaminated; identify the significance of contamination from various sources in a dental setting and the significance of decontamination of dental instruments and the environment. Other sessions include; ‘Local approach to delivering infection prevention in Scotland’ by Christine Young, ‘Translating new standards into practical design’ by Clive C Schmulian, ‘Legionella and water lines’ by Diane Lindsay and ‘Infection prevention in relation to the dental laboratory’ by Dr Rebecca Taylor. Other specialist streams include the Carbapenem-Resistant Enterobacteriaceae (CRE) Stream begins with a session from Dr Tara Palmore, director, Infectious Diseases Training Program with a session entitled ‘Controlling CRE at NIH’. In this session Tara will describe how CRE was controlled at the NIH Clinical Centre by describing the outbreak and key learning points for other healthcare facilities. This is followed by a session entitled ‘Controlling CRE – the Manchester experience’ by Dr Andrew Dodgson from Public Health England. In this session Andrew will highlight the emerging threat of CRE and discuss how to tackle the problem. Finally, this stream will close with a session entitled ‘Controlling CRE in a local hospital’.

THIRD DAY HIGHLIGHTSThe third day of conference will open with a presentation on “Food Hygiene” from

Hugh Pennington, emeritus professor of Bacteriology. Professor Pennington will explore problems relating to food hygiene and how this will influence future practice. The morning also features an interesting session entitled ‘The impact of HIV on IPC in Africa’ from professor Shaheen Mehtar, Chair Infection Control Africa Network (ICAN). The objectives of this session are to explore the burden of HIV disease, examine the impact on healthcare delivery and infection prevention and control including decontamination and sterilization. Dr Jimmy Walker from Public Health England Biosafety Unit is delivering a session entitled ‘Guidance on control of Pseudomonas’. Within this session Jimmy will look to understand the water system and the implications of P. aeruginosa in augmented care by discussing the application of control methods and explain the role of water safety group and how they can provide you with support. Author of ‘The Big Necessity’ Rose George will speak on ‘Examining the unmentionables’ which will be followed by the penultimate session from IPS Patron Tricia Hart with a session entitled ‘Realising the potential that resides in all of us’. The conference will be brought to a close by incoming IPS president Heather Loveday. These are just some of the highlights from Infection Prevention 2014 and there are numerous other sessions to keep delegates interested. For the full programme visit the IPS website.

FURTHER INFORMATIONwww.ips.uk.net

Infection Control

EVENT PREVIEW

Andersen Caledonia provides a wide range of infection control based services to support the manufacture and use of medical devices. In addition Andersen Caledonia provides testing to support environmental control programs within the healthcare industry and the wider community. Key services offered include ethylene oxide sterilisation, steam sterilisation, cleanroom packing and assembly of medical devices, laboratory testing, environmental monitoring and water testing. Andersen Caledonia supports a large customer base from across the UK and the rest of the world. Customers include hospitals, medical device manufacturers,

pharmaceutical manufacturers, local councils and research organisations. Whilst the company supplies many large multinationals, it also provides a high degree of service to small or start-up companies. The company is based around a flexible approach to production allowing Andersen Caledonia to handle small batches or orders quickly and efficiently.

The company has two large ethylene oxide sterilisation chambers and one steam sterilisation chamber. This allows it to process large volumes of product quickly and cost effectively.

The company runs both dedicated sterilisation cycles and mixed load cycles. For customers wishing to sterilize a load using ethylene oxide or steam sterilisation rapidly an express service is offered for an additional fee.

FURTHER INFORMATIONTel: 01698 844 [email protected]

Infection control services from Andersen Caledonia

There will be in excess of 600 delegates in attendance and over 100 exhibitors at Infection Prevention 2014 in Glasgow. The scientific programme will deliver renowned infection prevention speakers



Surfacide® Helios™— the only patented, automated, triple- emitter UV-C non-touch disinfection system. • Fewer shadows• Less Time

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Infection Prevention

Surfacide© Helios™ is the only patented, automated triple-emitter UV-C non-touch disinfection system on the market. With three emitters operating during the same disinfection cycle, no surface is left untouched. Single-emitter systems simply cannot reach all high-touch surfaces. Three emitters operating during the same disinfection cycle delivers more energy and disinfects the room faster than single-emitter systems, where as single-emitter systems must be repositioned up to five times, resulting in a 51–146.3 minute cycle. Surfacide does not require any additional repositioning after room set up. One cycle results

in a more thorough disinfection and faster room turn-around. Surfacide systems ‘see’ every surface, providing confidence that disinfecting energy has been delivered to the entire room. A tablet-based data tracking system automatically provides data in real time. Every system detects anyone entering the room and shuts off the three towers instantly, ensuring patient, visitor and employee safety. Surfacide provides greater value for money than a single-emitter system. A system can be implemented that contains three towers at a similar price of one single-emitter system on the market today.

FURTHER INFORMATIONwww.surfacide.com

Hard surface disinfection solutions from Surfacide

Techtex® Wipes and Healthcare is one of the UK’s largest independent manufacturer of dry and impregnated wipes for a wide range of markets. The Clinitex® Professional Care Products range is a leading brand of wet and dry patient wipes, detergent wipes, disinfectant wipes, gels, sprays, foams and disposable polythene products for healthcare and janitorial markets. Manufactured in the UK, Clinitex® products have been carefully assembled using the highest quality and most appropriate raw materials available. The Clinitex® range of healthcare and janitorial products is used extensively in the private nursing home sector and throughout the English, Scottish and Welsh National

Health Services. Technical Textile Services are continually adding to and improving the range to ensure that it remains one of the UK’s favourite healthcare brands. Techtex® Wipes and Healthcare has a number of registered brands which are well established and respected in the healthcare, construction, and engineering industries. They are synonymous with quality and innovation.

FURTHER INFORMATIONwww.techtex.co.uk/healthcareTel: +44 (0)161 643 3000

Techtex – one of the UK’s most trusted wipes manufacturers

Athenian Hygiene is one of the UK’s leading alcohol-free brands available on the NHS Supply Chain. The company was recently ranked the highest in its category on the new, revolutionary Hand Hygiene Framework – aimed at lowering the cost of infection prevention consumables to NHS Trusts. Currently used in wards in numerous NHS hospitals, care home chains, private healthcare networks such as the Circle Partnership and sold through a variety of hygiene retailers, Athenian Hygiene is growing in popularity due to its incredible compliance and that all products are more effective, more affordable and safer than leading brands. Athenian Hygiene is a range of high-grade hand hygiene products that deliver quality to those in health, care and clinical settings. The products actively destroy 99.99 per

cent of bacteria, fungi and viruses. Formulated for the highest standard of infection prevention, the product lasts eight hours killing microbes, whilst being gentle on skin and moisturising your hands. Athenian is a brand owned by the pharmaceutical company, WinchPharma, which works closely with the NHS and private healthcare sector in several countries across Europe, India and the Middle East. The company manufactures all components in the UK and flies the British flag of quality in several countries across the globe.

FURTHER INFORMATIONTel: 0845 055 9145www.winchpharma.com

High grade hand hygiene products for the NHS

Urocomfor™ has been successfully evaluated by nursing staff and patients in the hospital and community over a period of several months. This unique product produced outstanding results when compared to current pulp and plastic urinals. Urocomfor™ is a highly cost effective product addressing many infection and prevention control issues, especially waste management, which is vital for infection control. It has low waste volume when emptied, less than other disposables and is the first urine management system to have a closed system with a free flow anti-reflux valve that meets requirements to be used hygienically and effectively. For patients, Urocomfor™ can be used standing, sitting or lying down. Its closed system prevents the risk of spillage or escaping odours. It offers greater autonomy and dignity and is an easy to use device for ISC patients.

For staff, Urocomfor™ saves significant nursing time making it highly cost effective and requires far less storage space. It reduces the risk of odours or contact with bodily fluids and associated risks. It is volume marked and transparent, allowing accurate output measurement and visual check for diagnosing UTI’s. Urocomfor™ has an easy tear section for emptying and there is no requirement for jugs/receptacles for measuring urine output, scales to weigh urine volumes, macerator or washer/disinfector machine.

FURTHER INFORMATIONwww.m3at.co.uk

Revolutionary disposable urine management system



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The management of healthcare and clinical waste is an essential part of ensuring that healthcare activities do not pose a risk to the environment or human health and are securely managed. You will probably already be well aware of the series of brightly coloured bins and bags that are used to collect particular wastes, from syringes and needles (sharps) to drugs, vaccines, cultures and cytotoxic wastes. What you might not necessarily be aware of are the stringent regulations that apply to the handling and disposal of these wastes. Current regulation concerning clinical waste

disposal is strict, and there exists a sizeable range of legislation relating to healthcare waste. To effectively manage this waste stream, those responsible for the management of the waste should understand and must comply with the requirements of the various regulatory regimes, which include environment and waste; controlled drugs; infection control; health and safety; and transport. KEY REQUIREMENTSThe key regulatory requirements are found under the Controlled Waste (England and Wales) Regulations (2012), which were implemented on 6 April 2012. These regulations replaced earlier regulations and set out what is classed as clinical waste. Essentially, this is waste from a healthcare activity (including veterinary healthcare) that contains viable micro-organisms or their toxins which are known or reliably believed to cause disease in humans or other living organisms. It is classed as waste that contains or is contaminated with a medicine that contains a biologically active pharmaceutical agent. Clinical waste is also waste that is a sharp, or a body fluid or other biological material (including human and animal tissue) containing or contaminated with a dangerous substance within the meaning of Council Directive 67/548/EEC on the approximation of laws, regulations and administrative provisions relating to the classification, packaging and labelling of dangerous substances, and waste of a similar nature from a non-healthcare activity. The definition also includes any other waste arising from medical, nursing, dental, veterinary, pharmaceutical or similar practice, investigation, treatment, care teaching or research, or the collection of blood for transfusion, being waste which may cause infection to any person coming into contact with it.

In practice, the term ‘clinical waste’ is used to describe wastes produced directly from healthcare and which require specialist treatment and disposal, such as infectious wastes and pharmaceutical products. The Governments Guidance on the safe management of healthcare lists the relevant legislation and sets out best practice for clinical waste. This is often classified as ‘hazardous’, ‘offensive’ or ‘infectious’ and, using the Department of Health terms of definition, ‘offensive waste’ is waste that: may cause offence due to the presence of recognisable healthcare waste items or body fluids; does not meet the definition of an infectious waste; does not possess any hazardous properties; and is not identified by the producer, or holder, as needing disinfection, or any other treatment, to reduce the number of micro-organisms present.

HAZARDOUS WASTEMany clinical wastes are also classified as

‘hazardous waste’ and are therefore subject to further legislative controls.

Environment Agency guidance on Hazardous Waste identifies

the following clinical wastes to be ‘hazardous’: known or potentially infectious waste; cytotoxic and cytostatic medicinal

CLINICAL WASTE

DEALING WITH A HAZARDOUS WASTE STREAMNHS managers have a legal duty to ensure that the waste they produce is correctly managed. Sam Corp, head of regulation at the Environmental Services Association highlights the key areas and legal obligations that producers of clinical waste should know

How to ensure complianceClinical waste management is a complex area and producers of clinical waste should seek guidance from their waste management contractor and environmental regulator. A number of general rules should be followed:

Ensure staff are trained in how to correctly store and dispose of all waste.

Store all wastes in a designated area, as far away from drains and watercourses as possible.

Do not store waste on your site for any longer than necessary.

Label storage areas according to the different types of wastes that should be stored in each area.

Segregate waste to reduce waste management costs.

It is essential that producers of clinical waste are aware of their regulatory responsibilities and ensure that their waste is appropriately managed. ESA’s Members can offer a complete compliance service to customers for all types of waste.

Management

of clinical waste

is an essential part

of ensuring that

healthcare activities

do not pose

human health

risks



Current regulation concerning clinical waste disposal is strict, and there exists a sizeable range of legislation relating to healthcare waste

Waste M

anagement

wastes; and dental amalgam.‘Infectious’ and ‘potentially infectious’ wastes include all wastes which have been sent for specialist treatment and disposal because of their potentially infectious nature. Therefore, all wastes placed in clinical waste bags and sharps boxes and sent for treatment and disposal as clinical waste should be considered ‘hazardous‘. There is no definitive list of cytotoxic and cytostatic medicinal products, but producers should consult material safety data sheets and seek specialist advice to establish whether the products have any specific hazardous characteristics. Around 4.3 million tonnes of hazardous waste were transported from nearly 160,000 businesses and industry in England and Wales in 2011, so it is fundamental that professionals are aware of their responsibilities in dealing with this waste stream.

SEGREGATION AND LABELLINGThe Hazardous Waste Regulations place a duty on producers to segregate hazardous and non hazardous wastes. In addition a

national colour coded healthcare waste segregation system has been published by the Department of Health and is considered best practice – this is available from page 52 of Safe management of Healthcare Waste.

DUTY OF CARE All waste producers are legally obliged to ensure that information about the nature of the waste is accurately described on Duty of Care transfer notes and where necessary on Hazardous Waste Consignment notes, to ensure that the waste is treated and disposed of properly. If these notes are completed by a third party (a waste contractor), producers have a legal duty to ensure that the information provided is correct and accurately reflects the waste being transferred. A key element to the duty of care is the requirement for producers (other than householders) to ensure that a written description, adequately describing the type and quantity of waste, is provided for transfer of the waste as it is moved from point of production to point of final disposal. Waste can only be handed to such authorised persons as registered carriers, permit/licence holders or someone

who is exempt from either being a registered carrier or operating under a permit/licence.

HEALTH AND SAFETY Health and safety legislation is based on the assessment of risk. COSHH and the Management of Health and Safety at Work Regulations, in line with health and safety at work legislation, specifically require those dealing with potentially infectious substances (including waste) to assess the risk to the public and staff that may come into contact with it. Arrangements for managing healthcare waste should be part of an employer’s overall health and safety management system. In practice, this involves the development of risk assessment policies and procedures and putting in place arrangements to manage the risks effectively.

Transport and carriage legislation is based on the principles of hazard and risk assessment, and substances (including waste) are classified according to their primary hazard. The legislation requires consideration of: training of personnel involved in the chain of distribution; substance classification and identification; packaging; marking, labelling and documentation; safety advisor, equipment and emergency procedures; safe loading; vehicle specification and operation.

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PHS Group plc_HB14.4 - FP.indd 1 17/07/2014 15:25

Healthcare practitioners are busy people with little time to deal with the waste generated as they deliver vital clinical services to patients. But if the by-products of healthcare are to be safely and effectively managed, it is crucial that the process starts with the frontline of healthcare provision. Segregating waste at the point of generation is vital to ensure the waste is disposed of correctly. Much can be done to help make this process run smoothly. LEGAL REQUIREMENTSIt is essential to understand the legal context of clinical waste management, ensuring that your organisation complies with The Environmental Protection Act 1990 (EPA 1990) and the Hazardous Waste Directive 2011, as well as the Controlled Waste Regulations 2012. Fines for non-compliances are hefty. Under the EPA 1990, waste producers have a clear duty of care to ensure that the treatment and disposal of wastes are ‘appropriate’, and evidence must be retained to demonstrate the rules have been adhered to, for example, in the form of consignment or transfer notes. This duty of care extends to anyone who produces, stores, transports, treats, or disposes of waste; all reasonable steps must be taken to keep the waste safe and legal, without causing harm or pollution at any stage. The EPA 1990 also puts a responsibility on waste producers to segregate waste. The latest edition of the Safe Management of Healthcare Waste Memorandum (HTM 07:01) sets the standard for classifying different types of clinical waste and provides recommendations on how organisations can comply with waste legislation – and segregate waste effectively. WASTE SEGREGATIONFor clinical waste segregation to work effectively the Environment Agency for the healthcare sector, recommends that colour coded bins, sacks and waste receptacles are provided to enable easy identification and are placed as close to the point of waste creation as possible. According to the Controlled Waste Regulations 1992, clinical waste falls into two broad categories: infectious (hazardous) and non infectious (non-hazardous). The first covers any waste which can

be harmful to human health and can consist of human or animal tissue, blood or other body fluids, excretions, drugs or other pharmaceutical products. The second category covers any other waste arising from medical, nursing, dental, veterinary, or pharmaceutical practices, investigation, treatment, care, teaching, or the collection of blood for transfusion. COST SAVINGSThe correct and proper segregation of clinical waste is clearly vital for safety reasons – it can also offer significant cost savings. Some healthcare organisations put all their waste, particularly non infectious or offensive waste items such as nappies, into infectious clinical waste bags, which are more expensive to dispose of than non-infectious waste bags. It helps to know what eventually happens to the different clinical waste types to understand why the costs of disposal vary: infectious waste receptacles must be incinerated at special licensed facilities, while non infectious

or offensive wastes can go to landfill. If one item of infectious waste goes into a non-infectious bag – the whole bag must subsequently be treated as infectious waste and incur the additional disposal costs. PHS Wastemanagement’s healthcare waste collection, disposal and recycling service ensures that all the waste under the company’s duty of care is handled strictly in line with current legislation and according to best practice guidelines so that waste is controlled and disposed of in the safest and most environmentally effective way. Any organisation that produces clinical waste needs to ensure that those delivering frontline healthcare services clearly understand the difference between

infectious/hazardous and non-infectious/non-harzardous waste. This can be readily achieved by providing clearly marked bins that are easily accessed and providing information, for example, posters, illustrating – at a glance – the colour coded system. It’s also worth bearing in mind that the general waste management principles of reduce, recycle and reuse also apply to healthcare waste. From September 2011, European waste regulations introduced the Waste Hierarchy, which put the responsibility of waste management squarely on the shoulders of the producers. Producers must explore every avenue to ensure, wherever possible, that their waste has been reduced, reused, recycled or indeed recovered. POSITIVE IMPACTThese additional rules will have a positive impact on our environment and will help reduce the carbon footprint of every organisation around the UK as well as supporting their Corporate Responsibility

policy and ISO accreditations. With the right level of support and education from a licensed waste carrier, each member of an organisation can play their part in helping to manage clinical waste in a safe, responsible way that also reduces costs – making waste less of a headache for everyone.

FURTHER INFORMATIONFor more information on segregation please visit our website at www.phswastemanagement.co.uk

With the right level of support and education from a licensed waste carrier, each member of an organisation can play their part in helping to manage clinical waste in a safe, responsible way

WASTE MANAGEMENT

TAKING THE HEADACHE OUT OF HEALTHCARE WASTEBound by strict regulations, effective healthcare waste management can seem a tall challenge. But having a clear method of segregating clinical waste at the point of generation can make the process much simpler – and significantly reduce costs. Clare Noble, managing director at PHS Wastemanagement, explains how clinical waste need not cause a headache

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Having it all: efficient and effective referral managementMap Referrals allows GPs to access comprehensive, evidence-based local guidance at the point of care, and helps CCGs achieve their quality and productivity targets.

MONITOR AND STANDARDISELOCAL PERFORMANCEMap Referrals optimises Map of Medicine’s existing decisionsupport software by linking the clinical and administrative side of GP referrals to standardise activity.

Map of Medicine has worked with those on the front‑line of delivering and managing care to develop a tool that enablesefficient and effective referral management for both GPs andCommissioners. Map Referrals:

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FDB_HB 14.4 - FP.indd 1 22/07/2014 11:45

Written by Ed Fletcher, CEO, Fletchers Solicitors

There is evidence to suggest that some NHS institutions are not listening adequately to patients or using the ‘big data’ tools at their disposal to hunt out and stop negligent practice, and as a result are failing to prevent harm to patients. For example, the advances by the NHS Litigation Authority (NHSLA) in recording and sharing information about legal claims are not yet being used effectively by management teams within the NHS. In its last annual report the NHSLA reveals that it has provided all NHS institutions with direct access to their own claims information and improved the ways in which such information can be viewed. The NHSLA calls this an exercise in “learning from claims and making data work.” Despite this we have evidence that patterns in harm, as a result of negligent staff or procedures, are not being picked up early enough and therefore unnecessary injuries are being caused to patients. When we start investigating claims for medical negligence we gather information about the previous history of that institution or practitioner. Time and time again we are finding patterns that should have been picked up previously and stopped.

WARNING SYSTEMSWe applaud the NHSLA’s efforts to make evidence more easily accessible, but believe there now needs to be an agreed method for NHS institutions to establish early warning systems that pick up patterns and

nip negligence in the bud. The size of this problem can be seen in the increasing rate of clinical negligence claims against the NHS, which exceeded 10,000 for the first time in the last year, as evidence that more needs to be done to reduce negligent practice. In one example, where the surgeon cannot be named due to ongoing legal proceedings, a NHS Foundation Trust was asked to provide evidence as to the quality of a surgeon’s performance after he had left a number of patients with severe spinal injuries.The data being monitored by the NHS was provided to us. It suggested that the surgeon’s performance was above average based on rates of mortality, readmissions, infections and a number of other specific conditions that were only being recorded. However, the figures failed to show previous complaints or legal actions taken against the person concerned, of which there were numerous examples uncovered by our team.

TRACKING DATAThere might be a number of reasons why negligence might not show up on a list of narrow medical outcomes, but tracking other factors such as the ratios of complaints and ongoing legal actions would help raise a red

flag so that the right questions can be asked and future harm prevented. There needs to be a debate within the NHS to standardise how this data is being used as part of the ongoing monitoring framework being used to assess standards of performance and patient risk. Fortunately it seems that this debate is starting

to happen, alongside the recent announcement of the Sign

Up to Safety Campaign. This campaign

launched by the Secretary of State and supported by the NHSLA, amongst others, pledges to save 6,000 lives, halve

avoidable harm and halve the costs of

harm in the NHS over the next three years.

The way in which this ambition is to be achieved is

for all health organisations to develop safety improvement plans that explain the ways in which they will reduce harm, save lives and take a preventative approach. These plans will be reviewed by the NHSLA and if they are considered sufficiently robust, the organisation will help meet part of the cost of implementation. One area in particular where the NHSLA is keen to see improvement is in reducing the E

The NHS needs to make better use of negligence information to improve patient safety and halt the rise in patient claims, advises Ed Fletcher, CEO of Fletchers Solicitors

Litigation

NIPPING HEALTHCARE NEGLIGENCE IN THE BUD

PATIENT CLAIMS

The

advances by the

NHSLA in recording

and sharing claims

information is

not being used

effectively within

the NHS



number of brain damaged babies, through helping to improve the skills of staff operating and monitoring CTG machines when pregnant mothers go into hospital for their scans. In announcing its support for the scheme the NHSLA pointed to the fact that the NHS spends more than £1 billion on claims each year and that it would encourage “organisations to closely examine claims in areas where we see the most costly claims” to reduce their legal bills. All very well, but the hugely frustrating thing to anyone who deals with families who have been harmed by medical negligence, is that this change hasn’t happened sooner.

LISTENING TO PATIENTSIf all hospitals had to do to save 6,000 lives in three years was to review their procedures and consider better ways to prevent harm, it’s

bordering on the obscene that the motivation required to make them do so was a financial incentive from their legal expense insurer. I would suggest that the starting point for such change might be not only to review claims data, as the NHSLA suggest, but also to start listening more closely to patients. Many of the biggest flaws in the system come to light, not from management reviews, but by complaints being raised by patients and pursued with the help of their lawyers. The most glaring examples tend to be big news. The Stafford Hospital scandal, for example, saw a complete lack of attention paid to what were appalling cases of neglect, with completely substandard levels of care leading to unnecessary deaths. But what about the smaller cases – the ones which aren’t headline news, or at least aren’t yet? Is action being taken to

address failings and put these errors right?Our own study into whether patients felt they were being listened to when things went wrong asked 5,000 people to tell us their views. The study revealed that 57 per cent of patients had, or knew a family member who had, a reason to complain about their treatment, however less than a third (18 per cent) chose to do so. The most common reason for not registering a complaint was that the person didn’t believe anyone would listen to them, while a similar number said that they didn’t complain because they believed it would adversely affect their treatment. Patients were also highly critical of the procedures in place when complaints were made. When asked to rate their overall experience of the NHS out of ten, patients scored their experiences very highly, an average score of seven, with 51 per cent rating their experience of the NHS as eight or above. However, when those patients who had made a complaint were asked to rate the complaints process, they gave an average score of four, with a third rating the process as three or lower. Such perceptions of complaints procedures can be linked to a particularly startling admission made earlier this year.

THE OMBUDSMAN’S ROLEThe Health Service Ombudsman is the body with ultimate responsibility for complaints against the NHS and is the organisation that’s meant to deal with issues if the NHS itself has failed to do so properly. And yet it says it fully investigated less than 400 out of 16,000 patient complaints made last year – figures which have understandably not gone down well among those who have taken the plunge and decided to try and pursue a complaint. Many have been informed that an investigation wouldn’t achieve anything; others were told that there was no case to answer or that they should argue their case elsewhere. In one example, the Ombudsman did decide to investigate and found a hospital guilty of failing to adequately examine the reasons leading to the death of a baby in their care. The problem was, it took nearly five years – and a wider scandal involving the relevant hospital trust – before the investigation was even opened. For its part, the Ombudsman says it’s listened to feedback and changed the criteria for looking into complaints but the statistics from last year remain as evidence of a wider malaise in dealing with the problems which the NHS experiences. It’s a situation where NHS employees and patients are reluctant to complain in the first place and when they do it’s often to no avail. For the NHS to improve it needs to take on board what’s going wrong and do something about it. FURTHER INFORMATIONwww.fletcherssolicitors.co.uk

Litig

atio

n

PATIENT CLAIMS

Evidence shows that patterns in harm, as a result of negligent staff or procedures, are not being picked up early enough and therefore unnecessary injuries are being caused to patients

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, ATC

The UK is a country where hundreds of different languages are spoken, with over 300 spoken in schools alone, and English, while certainly the language spoken by most people, is not everyone’s mother tongue. However, regardless of language, people still get sick and need to be treated in the NHS. Ensuring high quality patient care and positive health outcomes is at the forefront of the health sector’s aims, but without translation and interpreting services, this is not possible with a significant minority of the population. CENTRAL TO CAREEffective communication is the heart of good medical practice. Whether patients are fluent in English, semi-fluent, or have never spoken the language at all, clear communication is essential. After all, clear communication can hold its challenges even when both parties speak fluent English, yet alone when there are issues of language barriers to consider. For those who do not speak the language, a medical interpreter is needed to ensure the patient is able to convey their symptoms, family history of medical problems, and any allergies to medication – all of which are vital in ensuring they receive the appropriate standard of care. Without translation and interpreting services in the health sector, linguistic barriers would have a hugely detrimental impact on

the quality of care that we are universally renowned to provide. On a daily basis, the NHS will see patients that are being treated for thousands of difficult and complex conditions. Those patients need accurate information, regardless of the language they speak, so that they have the appropriate information to make informed choices about treatments being offered, including fully understanding the risks involved. SERVING THE ENTIRE POPULATIONLanguage access is an issue in every component of our society – be it health services, business or education – and we must address this need if we are to provide a service of the highest possible quality. Inaccurate communication can have dire consequences in any sector, but in the health sector, it could potentially be putting a patient’s life at risk and could open the NHS up to legal claims against it. Having a basic understanding of the language may be sufficient in everyday life, but in a medical setting, simple differences in communication are critical. Patient care and patient outcomes suffer tremendously when communication between the patient and the doctor is hampered. From both the patients’ point of view and from those delivering the health services, it is in their best interests to be able to communicate accurately and effectively to provide the

best possible health outcomes – and to do so, professionally delivered interpreting and translation services are essential. Weekly headlines highlight the tight budgets in the NHS and a world where every penny counts sometimes results in reductions to translation and interpreting services. However, these services should not be deemed an addition or a luxury to the NHS – in fact, only those who speak English fluently would ever suggest such a viewpoint. Translation services in the NHS convey information and ensure the wellbeing of all patients and professionals. Healthcare professionals in the NHS are there to meet the needs of the patient, and this needs also to include their linguistic requirements. Language services bridge this gap and ensure patients understand the treatments that are being offered, so that they are confident on the issues and potential risks. When people have to make choices about their medication, or potential surgery, it isn’t possible for them to make those decisions unless they have accurate information – and this is of course impossible without the information spoken in a language they understand. PROFESSIONAL SKILLSThe service that the NHS provides also encompasses the support and care that is vital to anyone suffering from any kind of illness. According to the 2011 National Census published by the Office for National Statistics, 7.7 per cent of the population speak a first language that is not English – some 4.2 million – and while most of them have good command of English, the same statistics show that nearly 140,000 cannot speak the language at all. This means that it is essential for the NHS to have access to translation and interpreting services to deliver safe healthcare, whether this is in a primary or secondary healthcare setting. Apart from ensuring the availability of language services in the NHS, it is also essential that hospitals and GP surgeries are accessing language services that are of the highest quality to ensure that the translations are delivered professionally and with full regard to patient confidentiality. Unfortunately, it is not unheard of for some – where they don’t have access to translation services – to bring in someone outside of the profession in to help translate the doctor’s message. This person may be sweeping the floors outside a doctor’s office, for instance, but is the only candidate available who holds the necessary language

Tran

slatio

n

LANGUAGE SERVICES

MIND THE LANGUAGE GAPWhether patients are fluent in English, semi-fluent, or have never spoken the language at all, being understood is essential when communicating health information. Geoffrey Bowden of the Association of Translation Companies discusses the role that translation services play in delivering quality healthcare



skill and is therefore deemed suitable to translate sensitive and private matters regarding the patient’s health. This person is not a professional translator or interpreter and this custom is therefore not only unprofessional and bad practice, but also puts into question the confidentiality between the patient and the doctor. If interpreting services within the NHS were not easily available, as they are today, it would not be surprising to see more hospitals reaching for these types of solutions. Many members of the Association of Translation Companies provide language services either directly to local trusts or as part of national framework agreement in England. These services can be delivered either via face-to-face and over the telephone. They work to the highest professional standards and will provide information in a form convenient for the patient. For instance many will need their treatment options addressed in written form to allow them to discuss their options at a separate time with their families. It is crucial that the NHS works with those who are appropriately qualified, so that

patients and doctors can be confident that they understand the boundaries within which they are working. For instance, there are some ATC that specialise in telephone

interpreting services that are accessed during doctor and

patient consultations. In such situations the

interpreter acts as the relevant intermediary, to ensure all parties understand each other and no element of the consultation is open

to misinterpretation. Working without

such standards not only risks the reputation

of the NHS service, but also of the language service industry.

A HUMAN RIGHTS ISSUEIn 2013 a total of £22.7 billion – nearly a fifth of the NHS annual budget – had to be set aside to pay compensation to thousands of people harmed by poor care. If something goes wrong, for any reason, including issues that can be traced back to the provision poor language services, the patient could then argue that they weren’t properly informed which could lead to claim on the NHS.

There are some basic human rights issues involved in this whole question too. Every UK citizen is entitled to access NHS services, regardless of their language ability or preferences, and therefore they should be entitled to fully understand the diagnosis of their condition, what treatments are being offered to them, and what the implications are. Without this knowledge, people will be anxious of accessing the health service in the first place – and conditions further down the line can become more expensive and complex to treat. The basic issue of allowing patients to be fully informed is something that could change their lives, and this human right is something that is so fundamental to a modern society. You only have to think about how many Brits encounter health problems when travelling abroad. They would expect foreign health professionals to communicate in English with them, and yet this is simply a case of tourism and short visits, in comparison to those who live permanently in the country. Many immigrants in this country are elderly, and may not have a full grasp of the English language, but they are entitled to use NHS services – but without translation and interpreting services, we simply would not be able to provide an effective means of treatment for them.

FURTHER INFORMATIONwww.atc.org.uk

Translation

Many

immigrants in

this country are

elderly and may not

have a full grasp of

English, but they are

entitled to use

NHS services

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In October 2007 the Government Office of Science and the Department of Health released a foresight report suggesting that 50 per cent of the UK population could be obese by 2050 at an annual cost to the nation of nearly £50 billion pounds. However, a recent report conducted by the National Obesity Forum in January 2014 has warned that the UK is in danger of surpassing the 2007 predictions following analysis of official figures and academic studies on obesity, weight management and lifestyle choices. Increasing levels of obesity are having a direct impact on those associated with primary care and there is an acceptance of the issues faced by emergency services and carers due to the rapidly rising obesity levels. Necessary steps are being taken to find solutions to provide a professional service to users, while ensuring a safe working environment for their employees and the purchase of appropriate equipment. Hospital Aids is a UK based manufacturer and supplier of emergency evacuation equipment and moving and handling aids. The company has recently made additions to its product range to include equipment that caters for larger individuals and those

caring for them, from repositioning aids and body mass stabilisers to emergency evacuation equipment and training suits. The company’s most recent innovation, the Bariatric EvacMat is designed to assist emergency services personnel or designated moving and handling staff to evacuate bariatric people from locations such as a hospital ward or other public/private building

in the event of an emergency and has been safety tested to 350kg (55 stones). The EvacMat is an ideal choice for the evacuation of large individuals as it provides a solution to body mass stabilisation whilst enabling staff/crews to slide them to safety, including down staircases without any lifting involved. Due to its many ladder handles the personnel involved can adopt good working positions reducing the risk of injury to themselves, whilst anchor points give the option for the use of a winch, enabling extra control where needed. The Promove sling, also available from Hospital Aids is an ideal solution for extricating a larger person from very confined spaces such as a RTA as it is light weight and portable and will carry up to 45 stones in weight. As obesity continues to rise, the future care from emergency services and care staff will rely more on companies like Hospital Aids and its innovations in bariatric equipment development.

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Linda Hindle, Mem

ber of the British Dietetic Association (BDA) England Board

The growth in population obesity is greater than the effect of interventions to address it and as a result the prevalence of obesity is increasing. This increase has significant health, social and economic consequences. Many areas have developed obesity care pathways with effective interventions however the impact of these in isolation is inadequate to make a difference. The transfer of public health to Local Authorities in England has provided a unique opportunity to accelerate action to reduce obesity. Health and Wellbeing Boards are providing leadership; bringing NHS partners, local authorities and the voluntary sector together to tackle issues such as obesity that require a system wide approach. Financial pressures within the public sector increase the need for investment in strategies that are evidence based and will provide a return on investment. Specific evidence relating to successful strategies for the prevention of obesity is limited (although growing) which weakens the case for investment, however, the predictions of the future scale and cost of obesity are frightening and mean that to do nothing is not an option. There are several options for a strategic approach to tackling obesity based on international evidence and approaches.

GATHERING EVIDENCEThe Australian Assessing Cost Effectiveness (ACE) IN Obesity and ACE Prevention studies have assimilated a broad range of evidence for the prevention of obesity in Australia. These studies appraise both prevention and treatment interventions in children and adults. Interventions were assessed for comparative effectiveness and cost effectiveness. Of 20 interventions, eight were found to be both health improving and cost saving and a further three were cost effective. The conclusion from the ACE studies is that policy approaches

generally show greater cost effectiveness than health promotion or clinical interventions. No intervention, however effective will be sufficient to reverse the obesity epidemic in isolation. Solutions need to be multifaceted, with initiatives throughout governments and across several sectors. Interventions that might have quite small effects when assessed in isolation may still constitute important components of an overall strategy.

INTERVENTIONIt has been argued that obesity prevention interventions should be universal across entire

societies including people at every age and regardless

of risk factors given that we have too little data available on effective ways to identify and

manage

individuals’ obesity risks to justify a population strategy that would devote resources to sorting people by risk or readiness. However, there are specific times in the life course where there is greatest potential to impact on obesity including maternity, where there is opportunity to affect the future health risk of the child and the mother; early childhood where there is a high level of parental control and eating and activity patterns and preferences are being established; and school aged children where there are opportunities through schools to regulate eating and activity and to influence the family through the school. Evidence from a growing number of studies has indicated that treating obesity before puberty may have more long lasting effects on relative weight in the long term than providing similar treatment after puberty or in adulthood. INDIVIDUAL LEVEL APPROACHWhilst the collective systems approach being driven by Health and Wellbeing Boards is being prioritised to address obesity at a population level, healthcare organisations require an individual level approach to support the management of many health conditions. Obesity is an independent risk factor for premature death, but it is also strongly associated, probably

causally, with a number E

RESPONDING TO THE OBESITY CHALLENGEThe British Dietetic Association’s Linda Hindle examines the obesity crisis facing Britain and comments on strategic approaches to curb this worrying trend

Obesity M

anagement

NATIONAL HEALTH



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of other serious medical conditions (see table). Overall obese people are two to three times more likely to die prematurely than their lean counterparts and on average obesity reduces life expectancy by about nine years.

LOWER MORBIDITYThere is good evidence that losing even small amounts of weight can decrease the occurrence or severity of risk factors for disease e.g., insulin resistance, dyslipidaemia etc., but there is only limited evidence as yet from long-term prospective studies with hard outcomes on overall impact such as incidence of diabetes or reduced mortality. Nonetheless the decrease in obesity-related morbidity with weight loss of even five to 10 per cent among obese people (15 to 20 per cent in those with a BMI over 35), brings significant benefits to the individual including reductions in medication for other diseases, improvements in physical functioning and quality of life. Primary care staff have a key role in supporting patients to maintain a healthy weight by: monitoring weight; raising the issue of weight gain or obesity and providing brief interventions to encourage behaviour change; providing access to weight management services appropriate for the

individual; and by monitoring progress.Commercial slimming groups have been shown to be effective and cost effective for the majority of those who are ready to lose weight. These are often provided on an NHS referral scheme. Those with more complex obesity require specialist support with input from a dietitian often in collaboration with a specialist physician, psychologist and physiotherapist. This multidisciplinary approach allows the patient to be assessed for and supported with lifestyle, psychological and medical causes and consequences of obesity simultaneously. Specialist weight management services often called tier 3, also support assessment for bariatric surgery to ensure patients referred for surgery understand and are able to apply the lifestyle changes required to achieve a successful outcome.

CHILDHOOD OBESITYChildhood obesity is a particular concern with a third of children overweight or obesity in England. 85 per cent of obese children will become obese adults so failure to address childhood obesity is storing up problems for the future. The population preventative measures highlighted at the beginning of this article are the main intervention for preventing childhood obesity. For those children who are already obese, it is our

clinical duty to raise awareness of this and offer support. Childhood obesity is not puppy fat and children rarely grow out of it. Children’s BMI is measured on gender specific BMI charts rather than adult charts. In summary, obesity is a major health concern requiring action at many levels by many organisations. A systems approach involving all partners is recommended with actions focused on population level for prevention alongside individual level support.

FURTHER INFORMATIONwww.bda.uk.com

Obesity M

anagement

NATIONAL HEALTH

GREATLY INCREASED (RELATIVE RISK GREATER THAN 3)*

Type 2 diabetes

Gallbladder disease

Dyslipidaemia

Insulin resistance

Breathlessness

Sleep apnoea

MODERATELY INCREASED (RELATIVE RISK 2-3)*

Cardiovascular diseases

Hypertension

Osteoarthritis (knees)

Hyperuricaemia and gout

SLIGHTLY INCREASED (RELATIVE RISK 1-2)*

Certain cancers; including colon, kidney, prostate (men), post-menopausal breast and endometrial (women)

Reproductive hormone abnormalities

Polycystic ovary syndrome

Impaired fertility

Low back pain due to obesity

Increased anaesthetic risk

Foetal defects associated with maternal obesity



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Healthcare IT

In October 2012 the Prime Minister announced the establishment of a £100m Nursing Technology Fund to support nurses, midwives and health visitors to make better use of digital technology in all care settings, in order to deliver safer, more effective and more efficient care. The funding is for technologies such as digital pens, tablets and clinical software to support nurses and midwives to develop modern practices and to do their jobs more easily. Trusts applying for the funding had to demonstrate how their technology projects would deliver real improvements to patient care and safety. Beverley Bryant, Director of Strategic

Systems and Technology at NHS England, said: “This is about using modern technology to support and facilitate staff in providing compassionate and personalised nursing care. “It is about making life easier for staff – for example a digital pen can improve record keeping and reduce paperwork, a tablet or iPad can mean a community nurse can work on the go without needing to make as many trips back to the office, which means more time spent with patients. Also, mobile IT devices that can be used at the bedside puts valuable information at a nurses’ fingertips. This is ultimately about enabling nurses and midwives to improve the care they provide for patients.”

A POSITIVE RESPONSEThe response to the fund was huge, with over 220 applications from 140 health Trusts around the country bidding for part of the fund. Jane Cummings, Chief Nursing Officer for England, said: “We received an amazing response to application process and the decisions on choosing the successful projects have been difficult. It has always come back to one key question – how will this project deliver real, practical benefits for nurses, midwives and care staff and their patients.” In the first round, 74 Trusts were awarded funding totalling almost £30m for 85 projects.

THE PROJECTSBuckinghamshire Healthcare NHS Trust won the largest amount of funding, £1 million, for community mobile working. This will allow the trust to buy mobile devices and a supporting software solution to integrate directly to the EPR for community nurses and community midwives to enable more efficient ways of working. As an integrated Trust, community staff will be able to access records that support both acute and community care. East Cheshire NHS Trust received £725,030 for a bedside e-observation system, which works as an electronic vital signs data capture solution to improve the accuracy of data and timeliness of escalation. It will utilise hand-held technology to collect observations, E

TECHNOLOGY TO MODERNISE NURSING74 NHS Trusts have received funding to invest in technologies such as digital pens, tablets and clinical software to help nurses and midwives develop modern practices and work more efficiently

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and identify high risk and deteriorating patients, automatically sending an alert to the appropriate clinician. Specialist teams will then be enabled to proactively intervene.

DIGITAL PENSA digital pen is an device which converts handwritten analogue information created using into digital data, enabling the data to be utilised in various applications. Lincolnshire Partnership NHS Foundation Trust was awarded £107,000 for the use of digital pens in the community. The pens will be used by community nursing, consultant psychiatrist outpatient clinics and hospital in-reach services. The platform will allow in house design and management of forms for use with digital pens or tablets. The information captured can be integrated into back office patient systems and the original can be left with the ward, patient or carer. Guy’s and St Thomas’ NHS Foundation Trust was also awarded funding (£210,000) for the deployment of digital pens to community and district nurses and community midwives. The captured data will interface with the eNtoing community access and new midwifery systems. Northern Lincolnshire and Goole Hospitals NHS Foundation Trust received £36,550 for the extension of a digital pen solution within the maternity service to include antenatal maternity consultations and postnatal recording. This will improve electronic recording and enable the further integration of digital maternity records within the EPR system. What’s more, West Suffolk NHS Foundation Trust was awarded £246,097 to enable its midwifery service to go digital. The deployment of a digital pen and patient feedback solution will transform the way midwives are working, enabling patients to become involved in the collection of their own clinical information, while midwives provide live data to the hospital

systems to create a complete patient record of all treatment and care.

MOBILE DEVICESLancashire Care NHS Foundation Trust received £358,000 for agile working within the adult mental health service. The trust is striving to enable clinical staff in the community to become more flexible, more mobile, and reduce administration and travel burdens. As such, the funding will allow the rollout of 3G/4G enabled mobile devices and docking stations, which replace laptops and desktops PCs, to allow clinical work to be completed anytime, anywhere. Portsmouth Hospitals NHS Trust received £167,000 for a Hospital@Night System. Nurse Coordinators and practitioners provide nursing leadership and clinical skills to all wards and patients at night, helping to reduce junior doctors working hours. They currently rely on pager and landline communications in receiving and managing up to 200 calls a night. The project will provide a dedicated Hospital@Night task management system, supported by tablets and smartphones, freeing up time for the coordinators/practitioners to be clinically available to patients, educate ward teams and ensure requests are prioritised in a timely manner.

VOICE RECOGNITION TECHNOLOGYAlder Hey Children’s NHS Foundation Trust was awarded £164,500 for the implementation of voice recognition technology in the Paediatric Intensive Care Unit, integrated with the electronic patient record. This will free up time to care, and ensure that the broader narrative of the patient’s treatment is captured to supplement core structured data. Black Country Partnership NHS Foundation Trust received £89,300 for a VITAL Metrics Tool solution. This will involve the implementation of the hardware and software to understand the competency

levels of nurses across the organisation to identify gaps in practice, informed by results of service user feedback, concerns, complaints and the friends and Family Test. The software will develop e-forms to support the collection of information for audits such as Infection Prevention Control. All data will be captured through tablets and digital pens. Bradford Teaching Hospitals NHS Foundation Trust was awarded 346,000 for a paperless midwife project. The project will provide the technology to allow Community Midwives to access and add to the maternity electronic medical record whilst visiting women in the community. The project will also provide the technology to access and add to this medical record within the Bradford Maternity Unit and throughout BTHFT – for example A&E.

ELECTRONIC OBSERVATIONCalderdale and Huddersfield NHS Foundation Trust received £810,000 for the deployment of an electronic observation system that enables nurses and clinicians to record clinical data at the bedside on electronic devices in real time. Doctors and others are able to receive alerts and review the information on a personal device from anywhere with access to the hospital network and respond accordingly. Cambridge University Hospitals NHS Foundation Trust was awarded £630,000 for an eHospital nursing workflow system. Nurses in the ward environment will be enabled to be truly mobile using hand-held technology to record and review the crucial parts of the EPR at the bedside. The iOS app and iPod Touch devices incorporating barcode scanning will enable access to tools for clinical review, patient list management, medication administration, specimen collection, vital signs observation and fluid balance. Luton and Dunstable University Hospital NHS Trust received £260,113 for a range of fixed computers and screens to increase accessibility and visibility of the existing electronic observation system. Additionally, the Wardware open source e-Obs solution will be further developed in line with the business continuity plan to ensure continuous monitoring should an outage occur, and to improve usability. Homerton University Hospital NHS Foundation Trust received £677,000 for devices that can monitor vital signs. The deployment of vital signs and cardiac monitoring devices and software to record data from fixed and mobile monitors, supporting the capture of real time data directly into patients’ charts, removing the need for manual entry of all but respiratory rate and conscious level. Project aims will be delivered through empowered clinical decision making, increased efficiency, and the innovative use of technology.

BETTER COMMUNICATIONDevon Partnership NHS Trust received £103,215 for its learning disability nurses to be equipped with iPads and a range of LD apps. This will help them improve E

Healthcare IT

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accessibility and help with communication so that those with a learning disability are more fully involved in creating their own care plans, risk assessments, wellness recovery action plans and service evaluations. Pilot work has shown this leads to both clinical and operational benefits. Devon Partnership NHS Trust also received £295,000 for its mental health nurses. The money will buy tablet/laptop hybrids for mental health nurses working in both inpatient and community settings. This will allow nurses to move from person to person without needing to return to the office, thereby spending more time with people who use the service.

TRACK AND TRIGGER Southport and Ormskirk Hospital NHS Trust was awarded £986,361 for the implementation of an electronic track and trigger system throughout the organisation in all adult inpatient areas. Nursing and other clinical teams will be issued with mobile hand held technology to provide electronic capture of nursing observations and other critical metrics. This will facilitate the immediate escalation of deteriorating patients to clinical teams with auditable response times, and automated further escalation. Southend University Hospital NHS Foundation Trust was awarded £88,000 Electronic Pre-assessment System. The project aim is to implement a single pre-operative

assessment IT system that will ensure the appropriate risk assessment is completed digitally by pre-assessment nurses using tablets, and readily accessible to all clinical staff involved. Some self-assessment is also supported. Patients that are unsafe to be anaesthetised are identified so that appropriate steps can be taken. A full list of the 74 winning NHS Trusts can be found at www.england.nhs.uk.

TRANSFORMING NURSINGJane Cummings, Chief Nursing Officer for England, said: “Equipment like this simply wasn’t available as little as 20 years ago and using this kind of modern technology is part of the innovative and new ways of working we need to embrace in tackling modern health challenges.” Secretary of State for Health, Jeremy Hunt said: “Innovative new technologies such as digital pens, tablets and clinical software mean that staff can spend more time with patients, not paperwork, and offer safer care. “This fund will allow nurses and midwives to develop new, more modern ways of working that will benefit staff and patients.” A further prospectus for the second round of funding will be published shortly. £70 million will be available, to be spent in FY14/15.

FURTHER INFORMATIONwww.england.nhs.uk

Healthcare IT

TECHNOLOGY

The Tube Unloader optimises the workflow of handling blood samples in a hospital and clinical lab environment. Fully integrated in the TranspoNet Pneumatic Tube System (PTS) of the hospital, Tube Unloader reduces the manual handling of the carriers and their contents, thus increasing productivity and efficiency in the laboratory. Carriers are automatically unloaded, opened, emptied, closed and returned to their station of origin or wherever they are needed. Blood samples are collected safely in a special bin. For carriers marked as urgent or requiring manual handling, the Tube Unloader transports the carriers to urgent or manual-unload areas for faster processing. The Tube Unloader can safely handle and transport up to 300 incoming and 300 outgoing carriers per hour. By automating blood and other sample handling, the Tube Unloader increases staff productivity and delivery efficiency, especially during peak. Advantages include: reduced waiting time for lab results by 50 per cent, increased processed analyses up to 7.200 test tubes per hour, reduced physical strain, guaranteed

delivery and real-time management and the system is operational 24/7. TranspoNet pneumatic tube systems transport lab specimens, blood products, pharmaceuticals, documents, supplies, and other materials in carriers safely and reliably throughout hospitals. The Ultra stations are devices to send and receive carriers. The Ultra station features a stunning

design that offers healthcare facilities the simplicity of modern shapes combined with the latest technologies. The ergonomics, the acoustics, the illuminations, and the control panel of the station have been completely re-engineered to make use of the pneumatic tube system intuitive for personnel in hospitals, while raising safety and hygiene levels. Advantages include: Easy cleaning and disinfecting, 30 per cent less noise thanks to optimal acoustics, illumination design for calm setting, and messaging, perfectly adapted ergonomics at sending and receiving heights and an intuitive smartphone-style touch panel. The SafeSeal carrier sets a precedent with its extremely user-friendly

opening, its leak-resistance, and its possible use in automated loading and unloading devices. The completely re-engineered design was influenced by hospital personnel and their needs for easier and faster manual handling of the carrier.

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Case StudyThe midwifery team at Portsmouth Hospitals NHS Trust have been using digital pens since 2010 and the success of this has been recognised with many industry awards. Digital pens capture written information which can then be transferred to an IT system without needing to ‘type-up’ the information or carry paper notes. Midwives at Portsmouth have seen significant benefits in using digital pens including freeing up more time to care, efficient data capture and removing the risk of lost notes. This ultimately supports staff to deliver high quality patient care. At Portsmouth, the end vision is a maternity pathway where all information is captured using digital pens and processed and displayed via a fully integrated maternity information system. The transition between community and hospital settings will be seamless, with the same data collection techniques and information available in all care settings.



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You may or may not know this but there are around 800 GP practices in the UK that have the ability to automatically book GP and nursing appointments 24 hours a day, seven days a week and can offer this service over the phone. Dependent upon how the practice chooses to run the service, they can offer standard GP slots, nursing appointments, repeat prescriptions or even pre triage calls, so that the practice can quickly ring their patients from a pre-populated list as soon as they open in the morning. If we say that each practice has an average patient list size of 9,000 patients, 720,000 lucky people in the UK have better access to NHS services than the rest of us.

WHY ARE THEY LUCKY?As it should be with all technologies, both the user (the patients) and the implementer (the practices/CCG) benefit from the deployment

of the solution. The patients get access to services at the practice via a medium that they all have access to and are comfortable with. The ability to ring your practice no matter what the time, and be able to book an appointment or a call, is not only exceeding the expectations of the average NHS user but is very reassuring to the caller. The service can even be deployed in multiple languages. STAFF BENEFITSFor the practices, the advantages are many fold. How nice it must be for any practice to know as they open up in the morning that during the night and early morning, patients have been busy booking, checking, re-arranging and cancelling appointments or adding themselves with a reason for their call to a triage list. In the frantic first hour of opening the practice doesn’t have to face the usual bombardment of calls and can spend time with the patients that do call.

But the advantages don’t stop there. The headache of extending opening hours without incurring escalating staff costs is lessened as the surgery can deploy their staff across the day rather than have them all answering the phones in the morning. The ongoing battle with DNAs is also reinforced; if you empower your patients with the ability to control their appointments, and give them the ability to access this functionality simply through their phone, all the usual excuses of ‘I couldn’t get through to cancel’ or ‘you weren’t open so I couldn’t ring’ are taken away. Implement text reminder services at the same time and you have a powerful weapon at your disposal. Patients can respond to the texts straight away, freeing up slots that are then offered to other patients.

HOW DOES BETTER TELEPHONE ACCESS HELP THE WIDER NHS?A number of CCGs believe it can help with A&E attendance. A proportion of patients attend A&E simply due to growing levels of anxiety regarding an ongoing condition. They feel unwell during the evening or over the weekend and because they don’t know when they will next have access to a GP their concerns grow and they attend A&E. Patients that can book an appointment over the phone 24/7 know when they can next speak to their doctor. Knowing when you’re going to see a GP reduces anxiety, empowers the patient and makes the patient less likely to attend A&E.

ARE THEY REALLY LUCKY?The simple answer is ‘yes’ for the patients, they get all of these additional services simply from being in the right postcode. For the practices and CCGs the answer is ‘no’. It’s a ‘no’ because they made an informed choice to implement a product called Patient Partner. Patient Partner works with every appointment system in the primary care sector and is deployed to fit around how the surgery works. It doesn’t matter if your practice triages all their patients’ calls or if it is run on a more traditional appointment system, Patient Partner will benefit your practice. Practices still control which appointments, call-backs or services they wish to offer via the system and can even control when these services are offered. A good example would be flu season; the practice can send out texts and letters in a few minutes via “Medical Messenger”, inviting patients to book into their FLU services, rather than having to deal with all the calls on reception, the patients can call in during the evening and book themselves into the service at a time that is convenient to them. The patients are happy and the practice hasn’t had to deal with hundreds of calls. So, ‘get lucky’ and contact Voice Connect today regarding Patient Partner.

FURTHER INFORMATIONTel: 0116 232 [email protected] www.voiceconnect.co.uk

PATIENT SERVICES

THE FUTURE OF PATIENT SERVICESPatient Partner enables patients to book GP appointments 24/7

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Written by Jam

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As a nation, the UK is becoming increasingly aware of personal privacy, meaning that there is a greater scrutiny over any organisation’s performance in relation to information destruction. A recent example of this was when security was breached at NHS Surrey, after computers containing confidential files were sold on eBay without the hard drives being wiped or destroyed securely. It was one of the biggest security breaches ever witnessed by the now dissolved NHS Surrey, all due to the handing over of old computers to a new service provider who was not compliant with essential standards. Adam Chandler, chairman of the BSIA’s Information Destruction Section, comments: “Organisations tend to ‘turn a blind eye’ when it comes to selecting an information destruction service provider. The dangers associated with doing this were highlighted perfectly recently, when the Information Commissioner’s Office (ICO) issued a £200,000 fine to Surrey NHS for engaging with an unapproved supplier who was promising a cut price job for the value of the material they were supposed to be destroying.

In this case, it was computer equipment – some of which ended up on eBay.” WHO IS RESPONSIBLE?Information destruction itself ensures the secure disposal of information in all of its different forms. This varies from paper to media equipment such as CDs and memory sticks. Branded products such as uniforms also need to be discarded as if they are retrieved by the wrong person, they could pose a security threat to a healthcare establishment. These materials should be destroyed either on-site or off-site, to the extent that they may never be reconstructed. The client is then usually provided with an audit trail and a certification of destruction for their reference. There can sometimes be a question mark over who is responsible for ensuring the discarding of confidential documents. When asked about his experiences with information destruction in the health sector, Anthony Pearlgood, a member of the BSIA’s Information Destruction Section stated that: “Only a small fraction of organisational waste paper and data processing products such as hard drives, CDs, memory sticks and DVDs are

destroyed annually by professional firms. It is important that key decision makers do not make these choices lightly, and are sure to source a reputable supplier that meets the relevant standards,” he added.

WHAT ARE THE STANDARDS?There are particular standards that need to be adhered to by companies that are responsible for information destruction. Such standards guarantee that the service being provided is secure and professional, an essential requirement of the Data Protection Act. Failure to abide by these requirements can result in a hefty fine from the Information Commissioner’s Office. EN15713 is one of the key European standards for information destruction and this includes a range of requirements that an information destruction company must meet to guarantee a reputable service. These standards range from having an administration office on-site where records and documentation are kept, as well as having premises that are isolated from any other business or activities that operate at the same site. Intruder alarms and CCTV should also be present especially E

DOING AWAY WITH DATACareless disposal of confidential information, such as patient and staff records, or financial documents, can be detrimental to a healthcare establishment if the information finds its way into the wrong hands, says the British Security Industry Association’s chief executive James Kelly

Information Security

DATA DESTRUCTION



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in areas where unloading, storage and processing of information is conducted. BSIA Information Destruction companies all meet with this essential standard and are also required to comply with BS 8470, a British standard which includes the identification of product specific shredding sizes, guaranteeing that the information is destroyed beyond the point of irreparability. More information about these standards can be found on the BSIA’s website.

LOOKING AHEADAdam Chandler comments on the section’s outlook for the next year: “Over the next year we aim to continue the section’s key goal of educating customers on instances when they are most at risk of fraud and how the improper use of confidential information contributes to an increase in identity theft crimes. “The commitment of BSIA members to best practice enables us to help our customers at a time when their businesses are most at risk from fraud.“Almost any kind of personal information is valuable to criminals, whether it is residents’ records, financial reports, payroll information or personnel data. The unlawful use of such information contributes to an explosion of identity theft crimes and could put the institution, customers, or even suppliers, at risk.” As the section chairman, Adam has been tasked to review the section’s strategy for

the next year. “Like all sections, we are currently reviewing our strategy for the next two/three years and, as always, one of the key issues will be to deliver excellent value for our members and maintain the BSIA Information Destruction Section’s position as the leading association in our sector,” Adam explains. “As such, we are constantly looking for ways to improve standards and raise our profile. Whilst the aim is to deliver a quality service, there will always be challenges facing the information destruction sector. “Our members are operating within an extremely competitive market place, where a unique combination of conditions continues to be felt,” he says. “Firstly, the contraction of the market due to the recession resulted in huge declines of ‘paper in’ volumes, and that naturally feeds through to ‘paper out’, which directly affects the market available to our members. Secondly and more than likely related to this decline, the value of recovered fibre peaked a couple of years ago but remained unusually high for an extended period.” Consequently, the temptation of high paper values has attracted service providers into the market that do not necessarily hold all the correct accreditations, along with the systems and processes that impinge on that provider as a result. In very difficult trading conditions, some organisations might be tempted to ‘turn a blind eye’ when it comes to selecting a service provider in our sector.

As such, key decision makers in healthcare establishments should be aware of these new developments in the market and ensure that they are absolutely certain that their chosen supplier meets all the correct accreditations.Adam is keen to educate organisations on the value of making sure they choose a compliant provider to safely discard of confidential documents. The market is being driven down at the cost of security, meaning companies are happy to take a risky approach to the procurement of data destruction services, even knowing the consequences of a data breach. However, it is absolutely not worth taking a chance on a non-compliant provider for the sake of cost savings. The risk isn’t always worth the reward. Previously the Information Commissioner’s Office has been able to issue penalty fines of up to £500,000 for data breaches; Recent fines highlight lessons to be learned about information destruction When it comes to securing an information destruction supplier, it is absolutely essential that decision makers are choosing a company that meets with the essential standards highlighted in this article. Members of the BSIA’s Information Destruction Section all meet with these standards and meet with rigorous membership criteria.

FURTHER INFORMATIONwww.bsia.co.uk

Information Security

DATA DESTRUCTION

Cloud computing has brought a fundamental shift to the way service providers operate. The rapid growth of cloud computing has now expanded to the NHS’s own N3 network with an increasing number of trusts demanding fully hosted software packages from their system providers. By outsourcing the hosting of patient centred clinical applications via external third party providers, trusts gain several advantages. Those with limited suitable IT infrastructure will find an immediate advantage of remote N3 hosting – your software application can be safely located literally anywhere. In addition, benefit from reduced IT costs for system support, upgrades and maintenance, faster system performance, fully supported applications and hosting environment, secure off-site data storage and fast retrieval of critical data, instant system installation, upgrades and user management, guaranteed licensing management, service/data expansion capability as required, tailored hosting solutions, tailored solutions – one size fits all? Not at Asckey. Asckey has over 10 years of providing N3 hosting services to the NHS. The company’s dedicated account managers work with

you to develop an in-depth understanding of your requirements to provide a carefully structured hosting solution. Asckey’s N3 hosting network design team have extensive experience in providing bespoke hosting packages and detailed requirements analysis ensures a targeted, bespoke solution that provides clients with the most cost effective ROI. Asckey hosted applications are given immediate priority and the systems management team works with you directly to ensure essential service continuity and data security. Fully IG SoC accredited and Health and Social Care Information Centre (HSCIC) approved, Asckey are authorised to provide fully managed 3rd party and

direct N3 hosting services. The company’s Information Governance standards are there to ensure the principles of confidentiality, integrity and availability/accessibility are upheld for all NHS users. Asckey’s data recovery plans are reviewed regularly and include: secure, off-site data storage; data encryption; near-line back-up servers and separate SAN storage. Regular system maintenance and data cleansing ensures a secure, resilient hosting environment with a high level of network resilience and availability. Incorporating quality standard ISO 9001 into Asckey’s N3 hosting services further ensures a professional, high quality service that gives trusts the freedom to outsource application hosting. Both trusts and application providers can concentrate on providing the most effective patient care possible with the assurance that system availability is in `safe hands’.

FURTHER INFORMATIONContact Asckey Data Services Ltd today on 0845 270 7747 to find out how remote application hosting can improve your system performance.

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The alliance between two established names in the storage industry is represented on stand G22 at IP Expo 2014 where global IT services and solutions provider NCE are joined by Nexsan by Imation a leader in hybrid, data archiving and SAN storage. Working closely with Nexsan by Imation, NCE provides and supports solutions that incorporate best of breed storage density – with the E-Series capable of providing a colossal 360TB of storage capacity in a mere 4U of rack space. If that’s too much capacity for you then don’t panic, the E-Series family scales up (and down) to meet your business, performance and capacity needs. The Nexsan NST Unified Hybrid

system offers fibre channel, iSCSI, NFS, CIFS, SMB and FTP protocols – a solution to meet all of the demands in the constantly evolving storage market. Perhaps you are looking for a data archiving solution? Look no further, as the Nexsan Assureon meets regulatory and corporate compliance, and delivers the secure, long-term retention of files. Technical experts will be available to walk you through the technology and a live demo area will allow you to see the solutions in action.

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Independent doctors, hospitals and the NHS are all in a current battle to eradicate paper from traditional processes and embrace the digital generation. Whether it is patient information databases or clinical desktop solutions, healthcare professionals are looking to mobility in an effort to capture more accurate and precise data from their everyday practice; leading to higher efficiency and the ability to see more patients in their day.

Deloitte predicts that the number of smart health devices, including fitness bands, watches and smart glasses will reach 10 million units this year, with 170 million devices in use by 2017. This increase in mobile solutions is helping to fuel the phenomenal amount of data gracing our networks today. IP EXPO Europe is your one-stop shop to understand how this burgeoning issue will impact on your organisation. The modernisation of traditional processes

sparks an opportunity in the way the health sector uses data. The latest study from Transparency Market Research, shows that the Big Data market is expected to reach USD 48 billion by 2018. With the increasing demand for data handling, driven by clinicians switching to mobile devices, and therefore dramatically increasing data generated, doubt is building over the strength of existing IT infrastructures – which are not built to

cope with these modern data requirements. Learning how to manage the devices and analyse the large scale datasets is a key focus for this year’s IP EXPO Europe.

DIGITAL HEALTH MOVEMENTPerhaps more than any other sector, technology is impacting how health organisations operate, interact and communicate. From the increase in use of devices and rise of mHealth technologies, to

critical concerns regarding patient data and privacy, health professionals need to be one step ahead in understanding these issues. The speakers at this year’s event bring their considerable knowledge to ensure your organisation has the latest tools to exploit the expanding digital health movement. Whether you need to know how disruptive mHealth will be to your daily activities, or what health insights Big Data mining techniques can deliver, this year’s EXPO has the keynotes you need to hear. Government CTO Liam Maxwell, known for his reforms of government IT management will deliver key insights in an exclusive seminar, showing how big change is possible, even in a public sector setting – something of critical importance for most NHS and private professionals. Each year the show has seen a rise in the number of attendees from the health sector, with health IT specialists accounting for over 15 per cent of last year’s attendees. IP EXPO Europe is your opportunity to join health technology visionaries to identify key issues and trends emerging from the market.

A NEW GENERATION OF IT EXHIBITIONMore than 300 exhibitors will cover every facet of IT infrastructure including the cloud, data centres and the latest solutions to combat the growing incidents of cyber-crime at the show. With a massive 16,000 square metres of exhibition space – a 15 per cent increase on last year’s event, this year’s summit is a must visit for all IT specialists. This year’s opening keynote will be delivered by Sir Tim Berners-Lee, inventor of the World Wide Web, who TIME Magazine included in their ‘Top 100 Most Important People of the 20th Century.’ In his keynote presentation, Sir Tim will outline his vision for the 2050 Web and how organisations will use it for competitive advantage in future. He’ll also offer his insight into business strategies for innovation and for creating whole new markets through digital channels. Under one roof, this year’s integrated events mean every professional can gain the knowledge, advice and insight they are looking for, including IP EXPO Europe, Data Centre EXPO and Cyber Security EXPO. “The comprehensive, thought-provoking content programme includes over 300 top speakers covering the very latest thinking, perspectives and insights on IT for anyone involved in running a successful health organisation,” said Mark Steel, CEO of event organisers Imago Techmedia. Whether your organisation needs to learn how to combat the latest cyber attacks, develop its use of cloud infrastructures, understand what mHealth means or leverage the huge potential that Big Data offers, the IP EXPO is the event you need to visit this year.

FURTHER INFORMATIONwww.ipexpo.co.uk

Each year the show has seen a rise in the number of attendees from the health sector, with health IT specialists accounting for over 15 per cent of last year’s attendees

LEARNING TO LEVERAGE DATAData is now an essential component of the ever-growing health sector. IP EXPO Europe, on 8-9 October at London’s ExCel, informs healthcare professionals on how they can use it

IP Expo Europe

EVENT PREVIEW


GP access has long been a controversial issue, with concerns over whether primary care in its current state can meet patient demand in a country with a growing population. Many patients complain that appointments can be difficult to arrange at times they are able to attend, and practice staff have spoken of a loss of continuity of service, as well as an increase in the number of instances of abuse towards receptionists. Alarms were raised by recent reports of Gloucestershire’s A&E departments being flooded by patients

unable to secure a timely GP appointment. Commenting on recent research into this topic from Imperial College London, Dr Richard Vautrey, deputy chairman of the BMA’s GP committee, said: “General practice is under intense pressure from a combination of rising patient demand, especially from an ageing population, and funding cuts. “There are not enough GPs and other staff available to treat the sheer number of people coming through the surgery door. However, given the unsustainable strain

on GP services, it is understandable that patients are becoming frustrated at the number of appointments available, something that GPs are just as concerned about.”

GREATER INVESTMENTSome claim that the answer is to provide longer opening hours, extending to early mornings, evenings and weekends, though as this is expensive to carry out and could place more pressure on medical staff already stretched to their limits there is reluctance in some quarters. However, as general practice handles 90 per cent of the NHS’s patient contacts with 8.39 per cent of the overall budget, greater investment may be called for. Recent years have seen various solutions proposed, and a major initiative that has been running since April of this year is trialling a number of these ideas.

CHALLENGE FUNDIt is hoped that the recently launched Prime Minister’s Challenge Fund could help to bring about significant changes in how GP practices provide out of hours

THE DOCTOR WILL SEE YOU NOWThe Prime Minister’s Challenge Fund aims to raise standards of patient access to GPs throughout the UK. Health Business looks at the current state of GP provision and ideas on how to improve it

GP

Surg

erie

s

OUT OF HOURS SERVICES



services. The funding project, worth about £50 million in total, involves a number of trial projects testing ideas for improving patient access over 12 months, with individual schemes awarded sums ranging from £400,000 to £5 million. The ideas being trialled include having practices open from 8am to 8pm, making greater use of telecare and health apps, carrying out consultations through email and video calls, and greater flexibility with in-person access. Pilot projects were selected based on a set of criteria including: sustainability; scale and ambition; leadership and commitment; and links to local strategy. When the successful bids were announced in April, NHS England deputy medical director Mike Bewick said that the initiative aimed to help people manage their health needs more easily: “This fund is about helping those people who struggle to find a GP appointment to fit in with family and work life and making the most of new technologies. We need to create an environment that enables GPs to play a much stronger role, as part of a more integrated system of out-of-hospital care.”

PROJECTS BY REGIONOf the twenty successful bids, three bursaries were granted to projects in the London area. For example, Transforming Access to General Practice links 365 North West London surgeries to better serve residents in the area, with 39 networks offering appointments from 8am to 8pm and for six hours on weekends. Southwark’s scheme, Extending Access to Primary Care, supports 45 practices to improve urgent care and general access for 300,000 patients through ‘access clinics’ which are manned by existing practice staff. The North of England has seven schemes catering to diverse needs in the region. Morecambe’s Opening Doors - Aligning and Integrating Health and Care Services (awarded £1,137,132) features an out of hours X-ray service and apps to inform people about local services and to help people with long term illnesses manage their condition. Bury’s Easy GP Project focuses on working people and school pupils who find it difficult to make it to daytime appointments. It will see more flexible practice hours offered in addition to a mobile app which enables patients to order prescriptions and book consultations directly. Another scheme in Darlington will give additional support to frail and elderly patients, preventing unnecessary hospital visits. Schemes in the South include Steps to the Future in Slough, which allows patients to subscribe to free texts containing wellbeing tips, and pre-booked and drop-in appointments for out of hours GP visits. The Midlands and East England will see integrated health and social care services in Watford, in addition to a pilot scheme in Herefordshire which will help roll out an additional 90,000 appointments carried out in person, over the phone or over Skype. A cross regional pilot involves nine practices across England offering improved telephone services through a single contact point, whereby patients will be able to access key information on treatment and arrange prescriptions. NHS England’s Charles Alessi has said that these schemes could have wide ranging long-term impact: “The GP Challenge Fund will give colleagues the time and ability to work innovatively to ensure

better patient outcomes in an out-of-hospital environment.”Some figures in the medical community have urged cautious optimism around the scheme. The British Medical Association’s chair, Chaand Nagpaul, has said: “These pilots will give some GPs the opportunity and resources to test ways of improving access, use of technology, and extend their opening times in areas where it is felt there is demand from local patients. However, as pilots, it is important that these are independently evaluated to ensure they are a responsible use of stretched NHS funds.” Pointing out that there are no guarantees in place to continue the pilots beyond 12 months, and that around 7,000 practices are not benefiting from the Prime Minister’s Fund, Nagpaul continued: “It is vital that we have a long-term plan in place to help support all GP practices to deliver appropriate care to their patients. We must also make sure that finite NHS resources are directed to where they are truly needed.”

FOCUS ON CAREThe Prime Minister’s Challenge Fund is not the only project in place dealing with patient provision in primary care. The Care Quality Commission (CQC) is in the process of updating how it regulates and inspects out of hours GP services, with a statement due late this summer on how practices are managing. The CQC aims to apply more systematic measures of how successful out of hours services are, with particular focus on the main ‘five questions’: are practices safe, effective, caring, responsive and well-led? As reports come in from the Challenge Fund and the CQC’s inspections, we will hopefully have a more detailed view of whether the NHS is delivering the care patients need.

FURTHER INFORMATIONtinyurl.com/qelu2nw

Some claim that the answer is to provide longer opening hours, extending to early mornings, evenings and weekends, though as this is expensive to carry out and could place more pressure on medical staff already stretched to their limits there is reluctance in some quarters

GP Surgeries

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Do you need to review your GP appointment system? We can help you with a GP Access System Review. We have experience in redesigning appointment systems within the confines of your practice structure and that which will meet the needs of your patients.

Productive Primary Care Ltd, the market leader in patient demand management systems, have developed the innovative doctor-led phone consultation system, Doctor First.

Clinical data gathered from participating practices reveals: 50% increase in number of patients helped Patient satisfaction levels much higher Do Not Attends (DNAs) reduced to virtually zero Reductions in A&E attendances of around 20% which if replicated nationally

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Cofely can support all the non-core functions of your business. From energy efficiency to business efficiency, we’ll manage the activities that stop you focusing on what you do best – delivering to your clients.

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Cofely can support all the non-core functions of your business. From energy efficiency to business efficiency, we’ll manage the activities that stop you focusing on what you do best – delivering to your clients.

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Business Processes

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Integrated_Services_FMJ_AW_297x210.indd 1 19/02/2014 17:26

Written by Kevin Thoy, environm

ental services manager, United Loncolnshire Hospitals Trust

Pilgrim Hospital in Boston, Lincolnshire, has delivered one of the largest, most complex and successful biomass heating projects in the UK. It’s 3MW steam boiler is an ideal template for how the NHS can apply biomass heating to significantly reduce both carbon emissions and heating costs. With the Renewable Heat Incentive (RHI) massively incentivising biomass heating, a key question for the NHS is how can such a pioneering project be repeated and what lessons must be learnt?

THE BACKGROUNDPilgrim Hospital in Boston operates a 24-hour major Accident and Emergency Department as well as all main specialty services, serving South East and South Lincolnshire. In early 2008, the hospital was still depending on a heavy fuel oil boiler system, which was 40 years old and at the end of its life. The energy

strategy was neither sustainable nor efficient. The Trust was keen to adopt a solution that would ensure the provision of electricity, heating and hot water supplies, whilst simultaneously reducing carbon emissions and utilising sustainable fuels sources as far as possible. The Trust commissioned technical reports to identify a solution.A further challenge was that the quantity of gas available on the site was limited in comparison to the high demand for heating and the cost to bring further gas supplies to site was prohibitively expensive.

THE SOLUTIONIn April 2008, capital funds were made available from the Department of Health’s Energy and Sustainability Fund and Lincolnshire

County Council, under their Green Heat scheme. A solution was designed that made best use of the limited gas supply, whilst delivering significant further benefits. The technology selected was a 3MW biomass boiler integrated with a 526kWe gas fired reciprocating CHP engine (combined heat and power) and conventional steam oil boilers. The installation gives Pilgrim Hospital complete diversity of fuel supply with the base load being met by the biomass boiler and gas CHP engine, and peak demands met by standby fuel oil steam boilers. The control system enabled the complex arrangement to work effectively. The technology combination met all the challenges, providing the Trust with fuel flexibility, a reduction in carbon emissions and operating costs. The engineering was delivered by the companies Wood Energy and Binder, specialists within COFELY, which functioned as the energy services company on the project. Wood Energy specialise in the design, installation and commissioning of biomass heating in the UK and Binder are Austrian

manufacturers of biomass boilers. The delivery team were in

constant liaison with United Lincolnshire Hospitals

NHS Trust to ensure critical deliverables were met. This partnership and relationship E

GLOWING WITH GREEN WARMTHPilgrim Hospital in Boston is heated by one of the most ambitious biomass projects the UK has seen. United Lincolnshire Hospitals Trusts’ Kevin Thoy talks about how it is cutting carbon and costs

Energy

A Lincolnshire

hospital has

delivered one of the

largest and

most complex

biomass heating

projects in

the UK

RENEWABLE HEAT

Pilgrim Hospital, Boston, Lincolnshire



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has continued to ensure the ongoing success of the project. The 15-year agreement for delivery of the energy supply, operations and maintenance services consists of a site team of three full time technicians supported by an operations manager operating on a 24-7 basis and is fully supported with in-house specialist services incorporating energy and sustainability (E&S) and controls. This gives a standard operational maintenance regime; on-going performance monitoring; repair and replacement guarantee; delivery of heat and power; sale of steam, electricity and heat; and complete energy management service.

THE BOILERThe biomass boiler is able to deliver 3000kg/hour of steam including automatic start up, shut down and de-ashing. Wood chips are transported to the boiler automatically via a walking floor wood chip delivery system (13 metres by eight metres) then onto a fuel conveyor and ram feeder. The heat exchanger is fitted with an automatic cleaning system, ensuring high efficiency operation. Key attributes include a 3MW steam raising biomass boiler, which can work at up to 10 barg of pressure and uses an oil injection system to ignite the wood chip on start up. Within the boiler a step grate hearth allows excess moisture to be forced off the wood chip. Such a design is ideal for wet chip fuel with up to 50 per cent moisture content. Clever temperature and air flow controls including lambda exhaust gas monitoring and recirculation to continuously and instantaneously minimise nitrogen oxides (NOx) and maximise burn efficiency. Particulate emissions are minimised through the use of emission control technology with an exhaust gas cyclone, and there is also an automatic ash removal and ash collection mechanism using a chain conveyor to a large ash bin. Finally, remote control and monitoring using software graphics enables immediate and visual boiler diagnostics, as well as longer term data on boiler output and carbon savings. This highly automated and technologically advanced boiler is perfect for NHS applications as hospitals have high heating and hot water expenditure that also constitutes a large part of their total carbon footprint. This makes biomass heating an ideal solution for NHS carbon reduction and cost saving initiatives.

CARBON & FINANCIAL SAVINGS The overall project has significantly reduced boiler house carbon dioxide emissions by 35 per cent (excluding imported electricity). The biomass heating element accounts for a significant majority of the carbon savings delivered, and a reduction target of 50 per cent is currently being worked towards. Energy savings in the order of £400,000 per annum are predicted for Pilgrim Hospital. Biomass heat is also ‘zero rated’ under the Carbon Reduction Commitment (CRC), so the

hospital is saving 265kg of carbon dioxide for every MWhour of oil displaced. The benefits of this are currently £42,000 per annum and are expected to exceed £60,000 per annum. A new biomass boiler of a similar size to Pilgrim Hospital would be eligible for 2.0p/kWh payment from the RHI. This could equate to £200,000 per annum (depending on boiler run hours), which is additional to the significant financial savings already achievable through biomass heating.

SUSTAINABILITYThe Trust now has a higher rating in sustainability league tables. The wood fuel used in the biomass boiler comes from either local woodlands that are managed to increase biodiversity or from clean recycled wood sources. The sale of wood chip fuel provides a stable, long term income to the rural economy, helping to better manage and protect fragile natural resources and can reduce the volume of waste wood going to landfill. Biomass heating is a positive way to support your local community and economy rather than depending on fossil fuels from outside the UK. The Department of Energy and Climate Change (DECC) designed the RHI to revolutionise the

way buildings are heated. This will mean biomass heating is financially the preferred choice in all NHS buildings. These RHI eligible installations may be procured as part of an energy service contract (heat sold on a p/kWh basis as at Pilgrim Hospital), a lease or a direct purchase. The track record and expertise of the designer, installer and operator are critical to success. Once your RHI project is installed and running efficiently, output needs to be maintained for 20 years. Biomass boilers need regular operation and maintenance, available and responsive biomass engineering expertise and a continuous supply of fuel of the right quality, price and calorific value. Operatives based on site will also need to empty ash bins, order fuel, submit quarterly meter readings to Ofgem and receive regular fuel deliveries. This may all seem more complicated than paying a gas bill, but thankfully there are companies out there that have been planning for the RHI for many years and are now ready to deliver your installation, look after it and fuel it for the next 20 years.

FURTHER INFORMATIONwww.ulh.nhs.uk

Energy

RENEWABLE HEAT



Polyflor is delighted to announce the launch of Polysafe Verona PUR; the latest advancement in safety flooring design from its Polysafe range. Polysafe Verona PUR confidently lays a major foundation for the future of the decorative safety flooring market. Offering forward thinking design with safety as standard, Verona offers a clean and fresh look that is completely carborundum-free, containing no visible dark aggregate, unlike traditional safety flooring. Featuring a specially engineered emboss and unique matt finish, Polysafe Verona PUR uses complementary coloured quartz in the vinyl to harmonise with the base shade and generate slip resistance. The result is an aesthetic safety floor that looks like a smooth vinyl with virtually ‘invisible’ slip resistance once laid on the floor. TRIED AND TESTEDAs with all Polysafe ranges, Verona achieves the same tried and tested credentials of sustainable wet slip resistance, achieving 36+ on the Pendulum wet test with full conformance to HSE Guidelines and the EN 13845 50,000 cycles abrasion test. Tom Rollo, marketing manager at Polyflor comments “Polysafe Verona marks a significant development for Polyflor’s UK market leading safety flooring production line. Significant investment in advanced production processes has allowed the development of a product that combines forward thinking decorative appeal with the tried and trusted

performance of the Polysafe Brand.” Designed from the Natural Colour System’s (NCS) hierarchy of scientifically generated colours, this significant development presents an affordable collection of 18 new shades, aligned to today’s colour trends. Combining a variety of subtle pastel tones with bolder accent hues, Polysafe Verona features an attractive tonal and complementary chip decoration to give a distinctive look that is ideal for use in showcase environments within sectors such as healthcare, education, leisure, office and social housing. Designed for areas where underfoot safety is paramount due to risks of wet spillages or contamination, Polysafe Verona is suitable for both traditional safety flooring locations as well as the more design-led, high visibility areas within commercial and residential settings. LOW MAINTENANCEFor added reassurance of low maintenance in hygiene critical areas, Polysafe Verona features the renowned Polysafe polyurethane reinforcement (PUR) cleaning enhancement. Cross-linked and UV cured, Polysafe PUR is a super strength reinforcement designed to facilitate even easier cleaning, whilst providing optimum appearance and colour retention as well as improved soil release. Using a micro mop maintenance regime, chemical usage, energy intensive cleaning and water consumption are significantly reduced and life cycle maintenance costs of up to 60 per cent

are achievable over a 15 year period when compared to untreated safety flooring. ENVIRONMENTALLY FRIENDLYPolysafe Verona PUR contains recycled content through the use of natural recycled aggregates and is 100 per cent recyclable via the Recofloor scheme. Polysafe Verona PUR guarantees 36+ sustainable wet slip resistance for the life of the product and is readily available from Polyflor’s national network of flooring distributor partners. FURTHER INFORMATIONTel: 0161 767 1111Fax: 0161 767 [email protected]

Polyflor, a leading UK manufacturer of commercial and residential vinyl flooring, announces the launch of its Polysafe Verona PUR, the latest exciting advancement in safety flooring design from the world renowned Polysafe range

FORWARD THINKING DESIGNFLOORING

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Written by Jackie M

aginnis, the Modular and Portable Building Association (M

PBA)

Pop-up hospitals is a new term used to descibe the additional facilities fitted to hospitals to help them meet the demands on their services, for example, during winter when many hospitals are oversubscribed. For the well established modular building industry however, it is not such a new concept; it is something the industry has been providing for many years. Healthcare establishments are being forced to face demands of a growing and ageing population. This is an especially difficult time for public healthcare facilities owing to the increased pressure on services to meet both government targets and policy. Senior NHS officials have previously commented that trusts are struggling to handle the pressures on Accident and Emergency units. In an effort to prepare for the extra demands in winter the NHS will have to think of alternative solutions. Key factors such as cost, the urgent need for more hospital space, minimum disruption time and the sustainability performance of a building, have led many healthcare establishments to turn to the alternative building method of offsite construction.

DESIGN AND BUILDFrom individual wards to GP practices and complete operating theatres, modular build can offer both a single element solution and complete turnkey solutions to ensure the environment is clean, green and safe. Created in a factory, not only are modular units properly planned and designed to suit the end user requirements, this also results in sustainability by spending less time on site, minimising disturbance and significantly reducing waste. Modular construction means a project will

be completed fast and with fully functional modular facilities. The modular industry can also guarantee delivery dates, with buildings that are quality pre-checked, as many of the building elements are delivered to the site pre-fabricated. Build times can also be reduced by as much as 50 per cent compared to traditional methods, ultimately allowing the purchaser involved to deliver urgent clinical services faster.

REGULATIONSThe New Part L energy efficiency Building Regulations came in to effect at the beginning of April 2014. The measures that are taking place over the new few years will drastically lower carbon emissions and continue to significantly improve energy efficiency, providing a key role to help meet the government’s target of reducing the UK’s greenhouse gas emissions by 80 per cent by 2050. The modular industry was more than prepared for these changes. New buildings that are manufactured by members of the Modular and Portable Building Association (MPBA) will fully comply in the same way that traditional buildings have to. Members are also able to provide modular buildings for hire that are also required to prove energy efficiency. The MPBA has developed an Energy Performance Certificate (EPC) scheme, allowing companies that specialise in offsite construction to provide customers with the relevant energy performance certification. This again allows situations that are in need of urgent facilities to have buildings up and running far more quickly than traditional buildings. It also gives opportunities for extending buildings where space is at a premium.

If you are looking for a building make sure that you talk to industry direct, this will without doubt save money. Ask the company to provide a turnkey package as this should reduce the number of people that you have to deal with. Make sure you have an clear idea of your requirements. If in doubt, take advice from the industry before expensive plans are drawn as fancy buildings can be costly. Check out existing buildings that are being used for same purpose. And if you need advice, talk to the industry association.

BASILDON HOSPITAL EXPANSIONAs a result of an explosion in winter illnesses last year, Basildon Hospital experienced an unexpected surge in the number of sick patients requiring treatment. This necessitated in an urgent demand for temporary space in which to accommodate a number of additional patient beds. A number of possible solutions were considered but eventually it was decided to look at renting a pre-fabricated modular building. John Barnes, estates project manager of Basildon Hospital, commented: “When we purchased modular space to extend our pathology department we were impressed with the value for money and service that we received from the supplier and so decided to contact them about our urgent need for temporary patient accommodation.” Drawings were turned round in record time and while the building modules were being fabricated, groundwork contractors were already constructing the foundations and laying the drainage ready to site the new temporary ward. Neil Christie, manager of Portable Offices Luton, explains how they collaborated with the hospital team to bring the optimum design to fruition: “We ensured that the operational needs of the hospital were met by working closely with the nurses and the hospital team to produce a design that was not only practical but that would also exceed patients’ requirements and expectations. We also produced a series of feasibility studies to ensure the project direction was correct from the early stages onwards.” Designs were signed off by mid-November and by mid-December the building modules were delivered to site. In less than a month, notwithstanding Christmas in between, the new ward was handed over and the first patients were accepted into the ward on 12 January. Fully equipped with alarms, security doors, IT, medical gases, electrics, patient bathrooms and toilets, staff restroom, office reception, clinical areas, utility rooms and reception, the new ward accommodation has proved to be a godsend to Basildon Hospital. John Barnes highlights the most impressive aspects of the contract delivery: “The speed of fabrication and installation were exceptional with only seven weeks from design sign-off to handover. The quality and standard of E

MODULAR CONSTRUCTION

THE POP-UP HOSPITAL TRENDMany hospitals are adding modular buildings to their sites to see them through the peaks and troughs in demand for services, writes Jackie Maginnis from the Modular and Portable Building Association

Design & Build


INNOVATIVE TEMPORARY HEALTHCARE ACCOMMODATION

EMS Healthcare provides ready made clinical environments to help private and public healthcare professionals increase patient capacity.

Our medical trailers can respond quickly to urgent needs such as capacity challenges or during hospital refurbishments and building work.

Quickly transformed to create any clinical environment from a GP Surgery or Urgent Care Centre, to Renal Dialysis, Chemotherapy, Audiology, Optical or Dental suites.

Available for short or medium term hire, they are quick and easy to install with virtually no site preparation.

Contact usT 0151 350 1500

E [email protected] W ems-healthcare.com

EMS Healthcare_HB14.4 - FP.indd 1 17/07/2014 16:23

INNOVATIVE TEMPORARY HEALTHCARE ACCOMMODATION

EMS Healthcare provides ready made clinical environments to help private and public healthcare professionals increase patient capacity.

Our medical trailers can respond quickly to urgent needs such as capacity challenges or during hospital refurbishments and building work.

Quickly transformed to create any clinical environment from a GP Surgery or Urgent Care Centre, to Renal Dialysis, Chemotherapy, Audiology, Optical or Dental suites.

Available for short or medium term hire, they are quick and easy to install with virtually no site preparation.

Contact usT 0151 350 1500

E [email protected] W ems-healthcare.com

EMS Healthcare_HB14.4 - FP.indd 1 17/07/2014 16:23

the unit – warm, light, bright and modern – was significantly superior when compared to a number of competitors. The building was also exceptional value for money, far more cost-effective than other options. King College Hospital is a local acute care facility and major trauma centre for the south east of England, based in the London Borough of Lambeth. The part 5 storey modular wards and theatres at the country’s leading Hepatology (liver transplant) centre was constructed utilising new bespoke steel frame modular system.The scheme was funded through a SSAP21 compliant Operating Lease arranged through an NHS Leasing Framework specialist to ensure compliance with the strict accounting rules. The building was completed in less than 12 months ensuring that critical operational dates were met and that disruption to the hospital was kept to a minimum. The high performance volumetric steel structure was designed to ensure minimal deflection in all areas and incorporates concrete floors for the operating theatres.With a 60 year structural design life and a 25 year structural warranty, the new building complies with all relevant Health Technical Memorandum (HTM) & Health BuildingNotes (HBN) requirements. Sustainable and eco features incorporated into the design include increased levels of

insulation, low-energy lighting, energy efficient heating systems and water-saving technology.

SUNDERLAND HOSPITAL CARE UNITCity Hospitals Sunderland is an Acute Trust which provides a wide range of hospital services such as A&E, surgical and medical specialities, therapy services, maternity and paediatric care. Sunderland Royal is one of four hospitals from which the trust delivers these services. The addition of a 120 in patient bed unit, incorporates a new “state of the art” Integrated Critical Care unit which forms an integral part of their plans to improve patient care in the North East of England. The National flagship ICCU will care for over 1,200 patients each year, offering both intensive care and high dependency for those who need a high level of nursing care. Critically ill patients will be cared for in one of the most advanced units in the UK. The main benefits of the new hospital extension include advanced infection control and privacy for patients, with the new facilities featuring more space, better facilities for family and friends and cutting edge technologies. The new unit is part of a £33million project that will be one of the best intensive care facilities in the country and the new standards of design will help fight hospital infections and give better facilities for patients, staff and visitors.

The 9,000m² project was constructed using 106 steel frame modules, some of which are up to 19 metres in length and include the use of the latest technologies for robust floors. Units were typically 80 per cent finished before being moved to site, although in some cases may be 100 per cent complete. On-site, units are craned into position where all final connections are made. Quality assurance checks, undertaken by a dedicated team of quality assurance personnel, is a key procedure and is applied throughout the build process from tendering, through design and manufacturing, to erection on site. Less environmental impact with reduced waste and deliveries to site. The Royal Sunderland Hospital project has been designed to achieve BREEAM Excellent. The unit is also set to have an electronic pharmacy, using staff fingerprint recognition that can also send an alert for replacement drug stocks. Staff, who have helped design the new unit, will have the benefit of new facilities including changing areas and a training room.

Case studies provided by MPBA members. More detailed information can be obtained from Industry News Section on the MPBA website.

FURTHER INFORMATIONwww.mpba.biz

Design & Build

MODULAR CONSTRUCTION

With NHS England declaring waiting lists peaking at three million for the first time in six years, finding a cost effective and efficient solution is imperative for healthcare professionals and hospital management teams. The challenges facing hospitals is recognised in part by the recent creation of the NHS fund for ‘resilience’. Add to that the backlog from Winter Pressures on A&E, alongside prioritisation of elective surgery lists, the requirement to put smart solutions in place has never been more crucial. Implementing a new strategy to tackle soaring waiting times can be a stressful experience for healthcare and hospital management teams. They have to ensure that the patient experience is not disrupted, and that staff can deliver treatment as normal and also manage and monitor the results from their new innovative approach. Mobile medical units or pop up hospitals such as those deployed by Vanguard Healthcare can provide an effective way to manage the increased flow of patients, by boosting the capacity of existing facilities and preventing patients from being deployed to nearby hospitals.

Temporary to longer term solutions are now being widely used across NHS Trusts and private hospitals. With units deployed for as little as two weeks to units that can be in place for two years or more in some instances. At the University Hospital of North Staffordshire (UHNS) Vanguard installed a unit from March to June where 312 patients were treated for minor ear, nose and throat (ENT) surgeries. Installed to increase capacity and facilitate access to more patients, the unit has been a huge success as Mr Robert

Courteney-Harris, Medical Director at UHNS stated: “As an ENT surgeon, I was thoroughly impressed with the facilities and the service provided. Although temporary buildings have been used in the past by the NHS I don’t think I’ve ever seen one as sophisticated or versatile as this. In addition to treating additional patients, the unit has ensured that UHNS meets its commitment to treat its patients within 18 weeks.” This is a typical example of how a provider of mobile surgical units can support a hospital in meeting increasing demands and provide not just a continued patient pathway, but also matching the care standards of any fixed facility. A unit can be

installed and operational within days of confirmation of a contract, all achieved with minimal disruption. This means that even in periods of short notice or sudden peaks of high demand Vanguard Healthcare can deploy a unit ready and available anywhere in the UK or wider Europe.

FURTHER INFORMATION+44(0)845 630 6979www.vanguardhealthcare.co.uk

Mobile medical units and pop up hospitals could be the ideal solution to tackle long waiting lists



IFSEC International 2014 took residence at ExCeL London from 17–19 June. As the largest security event catering for a whole range of product areas across the security buying chain, the 2014 event was bigger and better than ever before. More than 650 exhibitors, 400 hours of education, 200 speakers and 50 seminar sessions were all available to visitors as they attended this market leading industry event. It was the ideal opportunity to network with the industry’s leading manufacturers, discuss the technical functionality of the latest products and gain a deeper understanding of what products are most suitable for a range of scenarios. IFSEC International continues to be used as a platform to launch the latest technology in the security industry to market and welcomed exhibitors including Samsung, ASSA ABLOY, Sony, Panasonic, Axis Communications, Canon plus many more to the show floor.

BRAND NEW FOR 2014IFSEC & FIREX TV was broadcast live to screens across the venue for the very first time, ensuring visitors didn’t miss out on anything on the show floor as it happened. Roaming camera crews covered the hottest events and interviewed key spokespeople within the

dedicated TV studios positioned on the show floor picking up on the buzz within the halls. IFSEC TV, sponsored by Xtralis, and FIREX TV, sponsored by C-TEC, were broadcast via 21 large screens and plasmas strategically located around the exhibition halls, including two giant screen in the boulevard of ExCeL.The broadcasts were screened simultaneously in IFSEC and FIREX and streamed over IFSEC’s websites, ensuring visitor didn’t miss out on any of the action. Security & Fire Installer Live was a one of a kind dedicated area for the installer community, a one stop destination where installers could get hands on with the latest products and test out the features. Installers also got the chance to seek practical

advice on how to grow their business and make current processes more efficient.Anglia Tools sponsored the Tool Shed where installers were able to get hands-on with the latest kit. The Networking Bar, sponsored by JVC was also a focal point for visitors to take some time to catch up and make new connections.

SAFE CITIES CONFERENCEThe Safe Cities Conference was launched as the first conference and exhibition dedicated to the security requirements of a city rather than its individual components. Dedicated content and case studies for London were presented to help shape the contribution and interaction from other global mega cities around the security challenges they face. IFSEC International is proud to confirm that the conference was supported by UK Government and endorsed by the London Mayor. High profile speakers who took to the stage included: Stephen Greenhalgh, deputy mayor for Policing and Crime who presented ‘A Roadmap to a Safe City’; James Cleverly, chairman of the London Fire and Emergency Planning Authority and chairman of the London Local Resilience Forum who discussed ‘Resilience & the Community’; Tom Wingate, public order engagement lead,

Metropolitan Police Service talked about ‘Public Order: Managing civil unrest and antisocial behaviours’; and Peter Wilson, Office for Security and Counter-Terrorism at the Home Office who went into detail about ‘Mechanisms to prevent cyber fragility to make the UK a safer place and enable businesses and individuals to self protect’.

BACK BY POPULAR DEMANDIFSEC & FIREX Global Meetings Programme in association with the IFSEC Global Directory was an exclusive, complimentary bespoke one-to-one matchmaking platform for exhibitors and visitors. Helping visitors to make the most of their valuable time at the show, the Global Meetings Programme

researched the most suitable providers for specific projects or businesses. Visitors were able to make use of this service and take the hassle out of researching suppliers and arranging the meetings themselves.

IFSEC ACADEMY IFSEC Academy at IFSEC International was the perfect opportunity to get up to speed on the latest regulations, industry developments and helped visitors become better educated on what solutions may best suit their business. With over 120 hours of free education available, key note speakers included representatives from the Bank of England, Metropolitan Police, Transport for London and the Mayor’s Office plus many more. Presenting the broadest range of education to date in the IFSEC Academy, visitors had access to seven theatres, each having a dedicated theme. Industry leaders discussed the holistic approaches that should be taken with security, fire, IT, data management and business solutions. HOT TOPICSTheatres and the topics within the Academy included: IFSEC Global.com Centre Stage, which showcased the biggest names and the hottest topics in the industry, looking at the key issues and trends defining the future of security; ipAssured Education Zone by Anixter, which offered specialist IP training and education; the Smart Buildings Theatre, which provided a holistic approach to security, fire,

EVENT REVIEW

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PUTTING SECURITY ON THE AGENDAIndustry professionals in every sector and at every stage of the buying chain made up the delegates at this year’s IFSEC event. We take a look at the key exhibitions and discussion points

Industry leaders discussed the holistic approaches that should be taken with security, fire, IT, data management and business solutions



IT, data management and business solutions; and the Convergence Solutions Theatre, which covered three core themes: Safe Cities, Protecting Transport & Critical Infrastructure and Future Control Room Technologies.

SECURITY PRODUCT AREASCovering the big issues in security, the show was split into seven dedicated product areas. Driven by rising concerns over public and private sector safety, the access control market is set to be worth a substantial $8.6 billion by 2018. At IFSEC International, leading manufacturers and distributors showcased their access control products including door entry systems, smartcard technology, time and attendance software and biometrics. To install or ensure an efficient and effective security system, visitors were able to source the individual elements in an integrated way. Whether it’s integrating with existing solutions set in place, or streamlining the integration process, IFSEC International provided a focus on determining system flows so each security service doesn’t work in isolation. The Smart Buildings area created a combined fire and security zone for both events, focusing on the common themes of systems integration and convergence. In a nutshell, Smart Buildings opened up opportunities for inter-operability and information sharing between fire, security, IT, data and building management systems.

IT & CYBER SECURITY Whether it’s assisting in the move from analogue to digital, or protecting online assets from cyber attacks, the IT and security functions must be interlinked. This area showcased the solutions designed to protect businesses or institution from IT & Cyber Security pitfalls, plus with Interop and Internet World housed under the same roof, every aspect of IT could be discussed and determined at the ExCeL London. The IFSEC International Physical Security & Perimeter Protection area allowed visitors to see a range of products in physical security, including perimeter protection, locking systems, safes and more. With a focus on four key areas – the city’s infrastructure, cyber security, counter terrorism and public order – the Safe Cities Academy and Exhibition at IFSEC International provided education and technology providers for global governments, public sector officials and global conglomerates. What’s more, the event covered all aspects of video surveillance and intruder alarms, with the very latest products and services in the industry, including video surveillance, central control rooms, and the innovations within high definition technology.

FURTHER INFORMATIONwww.ifsec.co.uk

IFSEC International

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X9 Services has been established for over 13 years as a private ambulance company providing emergency and non-emergency patient transport to both to the NHS and the private sector countrywide. During this time, the company’s reputation has grown and X9 Services has worked tirelessly to protect that reputation. The company is committed to working with its clients to provide high quality patient led services in an open and up front manner. Whilst X9 firmly believes that dedicated staff members for each client is the preferred way

forward to establish a good rapport with patients, hospital staff and the best possible service provision, the company also appreciates that in challenging times cost savings are necessary. X9 Services recognises that it must respond to that need and therefore is fully flexible in its approach. The company is fully registered with the Care Quality Commission and members of the Independent Ambulance Association.

FURTHER INFORMATIONwww.x9services.com

Providing patient transport services to the public and private sectors



More than 7,600 professionals congregated from all over the country to hear the latest political developments and educational and business updates in two packed days at the 2014 Health + Care and Commissioning event which took place on 25-26 June. Over 350 speakers in 14 theatres at the Excel London delivered informed legislation and policy lectures, live debates, case studies and keynote sessions on issues ranging from integrated care, CCG business and long term conditions to care commissioning, public health and care home and residential care business. LATEST INNOVATIONSSome 400 exhibitors were on hand to demonstrate the latest services, products, equipment and innovations on the market and to network with delegates.

The move towards a more integrated and collaborative health and care system was a key theme of the event. INTEGRATED CARE“This type of conference, the largest of its kind, represents the sort of change we need to see in our health and care system. We need to think beyond the bricks and mortar and separation between health and social care to collaboration at local level between all of the players,” Care and Support Minister Normal Lamb told delegates. “When I spoke at the conference here last year we were in the planning stages of what this more integrated service would look like. “At the time we were sifting through a remarkable 99 applications from all over the country to become integrated care pioneers. To me the level of interest in wanting to

become a pioneer when the Government was not offering not a single penny of support demonstrated the pent up energy in the system to do things differently, to take control and show what you could do without being dictated to from on high.” He said the 14 pilots chosen to pioneer integrated care pioneers were already having an impact by leading change and improving care. “What is really exciting is the innovation and experimentation that is going on all over the place,” said Mr Lamb.

COMMISSIONING PRIMARY CAREHealth Secretary Jeremy Hunt told a packed lecture theatre that the second key innovation in the last year had been the launch of the Better Care Fund, which gave CCGs and local authorities a leadership

EVENT REVIEW

THE EVENT FOR HEALTH AND SOCIAL CAREHealth Secretary Jeremy Hunt spoke of a “completely new vision for integrated healthcare” at June’s Health + Care 2014 event. Health Business reports from the show floor

Health + Care

Health Secretary Jeremy Hunt



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Mealtimes can be a source of injury for nurses and carers trying to push patients up to a table once seated. The most common injuries are to the back, hips and knees. A British inventor has created a kit that can be fitted to virtually any dining chair, solving this problem safely and at a low cost. Once installed, it makes moving a seated person to and from the table childs-play. The unoccupied chair provides excellent stability so that an unsteady person leaning on the chair will find it stable. Experience has shown that the device helps prevent damage to the chair and floor and many have remarked about improved dignity for the user. For larger chairs, an extension pedal is supplied to facilitate easy access for the users foot. The device (named millie-mova) has been taken up by a significant number of care

groups, councils and NHS trusts, plus many at home looking after a spouse or parent. It costs under £50 plus postage and is available from Jenry Ltd.

FURTHER INFORMATIONTel: 01202 240999www.jenry.co.uk

Millie-mova seating device for the disabled – so easy a child can use it At a time when staff resources

and budgets are under immense pressure in the healthcare sector, cost-effective and time-saving solutions are always welcome. Practices that currently print and mail appointment letters, vaccination reminders and other important information in-house know all too well how big an undertaking this can be. However, practices could be saving around £7,000 every year by switching to a hybrid mailing system. With an average saving of 70 pence per printed letter over the traditional method, the Docmail hybrid mailing service offers both time and cost saving benefits, as compared with labour-intensive task of a manual postal mailing, without compromising on service or quality. Docmail offers a tangible alternative for less than the price of a second class stamp. Instead of the time-consuming process involved with printing and stuffing envelopes, and the cost

of postage and stationery items, the Docmail solution allows practices to manage all their mailings with just a few clicks via an online portal, safe in the knowledge their correspondence will reach recipients on time, and looking just as professional as if they had sent it themselves. The efficiencies of the service have now been recognised by more than 2500 medical practices who have integrated the Docmail solution into their practice processes and enjoy the cost and time saving benefits.

FURTHER INFORMATIONTel: 01761 416311www.docmail.co.uk

Impressive savings for medical practices

Reval Continuing Care used the platform of the Health+Care conference to launch its Ruby mobile shower system. The event was a tremendous success, with visitors enjoying live demonstrations, which complimented the user video being shown on the stand. The Ruby is a mobile shower system, designed to bring the shower to the bedside. It enables high dependency patients to be showered safely, in comfort, in bed. This innovative and unique product has created a market segment of its own. It enables improved hygiene, reduces manual handling transfers and is more dignified and convenient for the resident or patient. Already popular in France, this product offers a new solution to an existing problem, and whilst originally targeted at residential care, the Ruby has proved beneficial from homecare to ITU; essentially anywhere where high dependency patients benefit from improved hygiene and dramatically reduced manual handling. The Ruby mobile showering system compliments the existing products in the Reval range. Reval Continuing Care is a leading European

supplier of an unrivalled range of assisted bathing, showering, transfer equipment and hydro rehab pools, with more than 35 years of experience in supplying acute, nursing and residential healthcare establishments. With a rapidly growing reputation for high quality and great value assisted bathing products, Reval’s proven record of on time delivery of reliable products is swelling the numbers of customers interested in switching to Reval as their preferred partner. The assisted showering range, now boosted by the Ruby, is also increasing in popularity and the Rehab hydro pools are attracting similar attention

based on the same perceptions of great value, high quality products. If you are involved in selecting equipment to be used in a health care project join the growing number of your colleagues evaluating and specifying Reval products. To find out more visit the website or contact the Reval customer service desk. The Ruby demonstration video can be viewed at http://www.burntorangecreative.co.uk/reval_micro_site/#video

FURTHER INFORMATIONTel: 01656 721 001www.revalcc.co.uk

Bringing the shower to the bedside – Ruby mobile shower system launched at Health+Care conference



role in jointly commissioning care. “We are seeing discussions happening as a result of the Better Care Fund which have never happened before.” Mr Hunt also spoke about the new opportunity for CCGs to co-commission primary care with NHS England. He told health and care commissioning leaders: “You are now in the driving seat to deliver a completely new vision for integrated care in your areas and you have the powers and freedoms and the clinical leadership in the way that people at local levels have never had before to break down barriers. Many of you are already starting to use those freedoms and I want to support you to do it.” A HEALTHCARE COMMUNITYStephen Dorrell, former chair of the Health Select Committee said: “Conferences like the Health + Care and the Commissioning Show are important because they enable the community of commissioners and providers of health and care services to meet and share each other’s experiences. Too often you find that good ideas are deployed in one area and even 20 or 30 miles away their neighbours may be entirely unaware of what is happening on their doorstep. It’s like a cross pollination process that allows people to see how good ideas might work for them.”Dr Charles Alessi, chair of the National

Association of Primary Care, NHS Confederation and lead for Preventable Dementia with Public Health England, said: “The Commissioning and Health + Care Show give people a real opportunity to connect, simply because of the size and scale of the event.”“One thing I particularly like about this

event are the interactive areas where you can play and learn at the same time,” said Dr Nav Chana, GP and vice chairman of the National Association for Primary Care. Jane Mulholland, commissioning director of Gateshead CCG, said the Commissioning Show was seen as the major conference for the commissioning community. “It’s the one that people want to get to because its well-attended,

there are excellent speakers and usually it has the Secretary of State for Health and the Shadow Secretary of State for Health – that means you can hear it from the horse’s mouth.” Rikha Shah, link officer for Domiciliary Care in Harrow Council, said the Health + Care Show was important for social care because it broadened the outlook of delegates and enabled

them to learn about what other boroughs were doing. ”This is the only conference we go to.” Speakers are already being booked for next year’s Commissioning and Health + Care Shows. Don’t miss it, save the date: 24 & 25 June 2015.

FURTHER INFORMATIONwww.healthpluscare.co.uk

Health + Care

EVENT REVIEW

“Conferences like the Health + Care and the Commissioning Show are important because they enable the community of commissioners and providers of health and care services to meet and share each other’s experiences” Stephen Dorrell

Medix Gloves is led by a strong dynamic team familiar with working within the strict guidelines of organisations such as the FDA (US Food and Drug Administration) and the MHRA (Medicines and Healthcare Regularity Authority). The company offers a wide range of disposable gloves, face masks, aprons and shoe covers under its brand name Medix Gloves to a huge range of industries including; domiciliary care, dentistry, automotive, nursing care, factory production, janitorial and cleaning services, electronics handling and food preparation and production. The majority of its products are produced in one of the largest glove manufacturing plants in the world to strict international standards, including ASTM and EN455. All products meet CE mark standards and

are all competitively priced. All Medix products are manufactured as per AQL 1.5 quality standards and the company carries large stocks ready for immediate next day delivery. Medix Gloves focus on customer service and commitment has helped attract many new large companies to its customer base. The company has just exhibited at the Health Care Show at the Excel Centre in London and is pleased to welcome new customers seeking quality disposable products.

FURTHER INFORMATIONTel: 0121 270 7271www.medixgloves.com

Quality products for the healthcare industry

Health Intelligence delivers solutions and services that will enable change in the management of long term conditions. The company’s vision for change is to work collectively with the NHS to reduce health inequalities and preventable health decline by enabling integration across the systems. Early identification of disease and proactive management of risk are key strategies to preventing health decline. Health Intelligence has worked with Asthma UK and national respiratory clinical leads to develop an innovative N3 based asthma and COPD solution. This will enable you to stratify your asthma and COPD population in a meaningful and manageable format, identifying patient cohorts at need of intervention based upon their risk position and gaps in care. This enables health economies to make informed clinical evaluations across the patient

pathway, shift resources based upon evidence from within health economy populations, complete key intervention planning at a practice/cluster level, map QoF delivery and identify gaps in care, make secondary care/pharmacy recommendations at a practice level, carry out virtual patient reviews – improving efficiencies in the system, make treatment interventions in line with disease status and track the impact of change management on patient outcomes. If you would like to find out more, visit Health Intelligence on stand M53.

FURTHER INFORMATIONTel: 01270 765124 [email protected] www.health-intelligence.com

Asthma and COPD intelligence solutions



Hosp

ital S

igna

ge

call 01737 774077www.stocksigns.co.uk [email protected]

Health and Safety signs

Wayfi nding and Directories

Dementia signs

Braille signs

Cut-out letters

Glass manifestations

LED signs

StocksignsThe chosen safety

sign partner

Supplying signs to the

Health Care Industry

For instructive signs

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Health business ad 178x125mm.indd 2 03/07/2014 10:37

The key to making signage work is to involve your manufacturer from a very early phase in the planning process. Stocksigns works with architects and principle contractors from the early design stages to try and avoid costly mistakes later on. As a member of the HSSA, Stocksigns regularly carries out signage projects in both large and complex health premises. Including signage at the beginning of a project enables you to create a signage scheme that works hard for the investment. It enables development of signage that fulfils a number of functions; brand building, information, continuity, safety and wayfinding all while displaying a sympathetic design to complement a premises’ overall ambience. In today’s multi lingual society, accurate, clear and engaging signage is even more important. Good clear signage should be instantly recognised, regardless of nationality, age or ability. Audiences should always be carefully considered and included in your brief with your signage contractor. Special thought should be given for DDA requirements; should braille or products

designed for dementia patients be included? Equally, if a building is littered with signs this can often be counter intuitive. Poorly conceived wayfinding actually hinders and confuses, while on an aesthetic level it’s important to complement the architecture. Stocksigns was awarded the contract for supply and installation of external signage for a major refurbishment and re-branding project for Anchor, one of the UK’s major care providers. Stocksigns had been working with Anchor for a number of years on maintenance

and replacement signs and were delighted to become more involved with the major re-brand project. Stocksigns’ preferred style of working is to create partnerships with their customers to ensure thorough understanding of their customer’s company culture, profile and needs. The project included the survey and installation of signs to 750 independent living locations and 98 care homes. The design changes were carried out to raise the profile of the Anchor brand and create uniformity across all their sites. Signage included wayfinding, branding and health and safety signs. Stocksigns’ installation crews are enhanced CRB checked and trained to

cause minimum disruption to the premises they work in. The teams have developed specialist care and procedures to work within sensitive environments, ensuring the privacy for the residents and patients is maintained with the least possible disruption through noise or mess.

FURTHER INFORMATION Tel: 01737 774077www.stocksigns.co.uk

One of the UK’s leading suppliers of high quality signage solutions for the healthcare sector



Jim Creak, chair, HSSA

The adoption of ISO7010 as a European norm has finally drawn the end game for fire safety signs that were introduced as a consequence of an EC Directive published in 1977. It is satisfying to know that NHS Estates realised the most important thing about the introduction of graphical symbols to convey safety messages is that the staff intuitively understand them. The research carried out 20 years ago by NHS Estates gave clear indication that there were risks involved with the introduction of abstract symbols to indicate escape routes. Research and the development of the Health Technical Memorandum 65 Part 2 – Fire Safety Signs, which has been superseded by NHS Wayfinding Document, has stood as a bed rock for the subsequent development by both British Standards and International Standards of comprehension testing and inclusion of all graphical symbols for safety application.

GRAPHICAL SYMBOLSThe development of ISO 9816-1: 2007 Graphical Symbols – Test Methods – Part 1: Methods for Testing Comprehensibility, is a testimony for the need to ensure not only the extent of comprehension but also gives indication of the need for supplementary text, training and instruction. The graphical symbol chosen by the NHS enhances the British and International Standard symbol with the use of flames as a determinant, presenting a clear and unequivocal message. Research and tests proved that the NHS symbol increased comprehension and understanding of signs by an amazing 300 per cent. The legislative framework derived from EC Directive 92/58 requires that responsible persons ensure that all building occupants, not only comprehend the meaning of the safety signs, but also understand the action to be taken in conjunction with the signs. This certainly was not the case with the previous signs. Looking at both, it is hard to believe that the first sign is more commonplace than the escape sign that conforms to NHS Estate requirements.

The changes in fire safety legislation moving from a very prescriptive regime to a risk based

engineered solution has highlighted the dangers when using escape

route signs that may cause confusion. It has taken 20

years for the rest of the industry to question the validity of using a graphical symbol that is not clearly understood.

EFFECTS OF UNCLEAR SIGNAGE

Using signage that is not clear may have an

impact on egress speed and efficient evacuation,

which could be fatal. The use of HTM 65 (NHS Wayfinding Document)

for escape route signs ensured that a known convention was implemented for safety way guidance. This simple convention was a foundation to BS5499 Part 4 2000 (revised 2013) and carried its provenance through to the development internationally of ISO I6069: 2004 – Graphical Symbols – Safety Signs – Safety Way Guidance Systems (SWGS). The understanding of the meaning and actions to be taken in conjunction with safety signs is a fundamental requirement of the Health and Safety (Safety Signs and Signals) Regulations. NHS Estates have to be congratulated for their insight 20 years ago. The NHS Estates will now wait for the rest of the world to catch up and stop playing ‘Pictionary’ with peoples lives.

FURTHER INFORMATION www.hssa.co.uk www.means-of-escape.com

The adoption of ISO7010 as a European norm has finally drawn the end game for fire safety signs that were introduced as a consequence of an EC Directive published in 1977

FIRE SAFETY SIGNS

GETTING THE FIRE SAFETY MESSAGE ACROSSJim Creak of the Health and Safety Sign Association (HSSA) shares his verdict on the introduction of ISO7010 as the standard for fire safety signage in hospitals throughout Europe

Hospital Signage

NHS Estates

realised the

most important

thing about graphical

symbols to convey

safety is that

staff intuitively

understand

them



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With its classic lines and dynamic design, the new BMW 2 Series Active Tourer is the Ultimate Driving Machine created for both business life and family pursuits, however adventurous they may be. Boasting a sporty design, this car still offers everyday practicality with adjustable sliding rear seats with a 40:20:40 split, a folding floor and a plentiful luggage compartment. Impressive fuel economy and benefit in kind from 17% (2014/15 BIK tax rates) make the new BMW 2 Series Active Tourer a compelling company car proposition, not only for the working week.

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Written by Laura W

oods, Brake

At least one in four (26 per cent) road casualties in Britain involve an at-work driver. As a road safety charity dedicated to supporting the bereaved and injured victims of road crashes and campaigning for safer roads for all, Brake knows all too well the suffering and trauma road crashes cause. But we also know, through our long-running work to engage employers through our Fleet Safety Forum, that at-work road crashes can be prevented, often through simple measures. By working with drivers, developing a road safety culture, and implementing tried and tested policies and practices, organisations can help tackle these devastating events and bring about other positive outcomes for their business. Employers who effectively manage their road risk tend to experience a range of benefits including improved staff morale and reputation, and significantly reduced costs. Managing road risk is also a legal requirement: employers have a duty to ensure the safety of all their staff on work time, including when they are driving (excluding commuting). However, it can be challenging for some employers, particularly small organisations with limited resources and without dedicated fleet or risk managers, to know where to begin and how to direct their efforts. Driving for work is often not considered as an integral part of health and safety. At the same time, even established fleet practitioners benefit from staying abreast with the latest best practice guidance, and learning from what others in this constantly-evolving field have achieved. That’s why Brake is very pleased to welcome the Health and Safety Executive’s (HSE) long-awaited update to Driving at

work: managing work-related road safety. This publication remains an essential guide for any organisation with employees who drive for work, and self-employed drivers, in helping them prevent needless crashes and casualties and drive down costs. It sets out a step-by-step guide to work-related road safety. It uses a ‘plan, do, check, act’ approach to risk management, covering driver risk, vehicle risk and journey risk.

DRIVER RISKSIt is estimated that up to 95 per cent of crashes are down to driver error. At-work drivers are more susceptible to a range of driving risks than other drivers, including driving tired, which costs at least 300 lives in the UK each year, and using mobile phones at the wheel, which increases crash risk by four times. Driving at work recommends employers ensure their drivers are capable of operating safely, by: checking driving licences on recruitment and on a regular basis; communicating road safety policies and expectations; regularly assessing training needs and providing training where appropriate; ensuring drivers are fit to drive; and educating drivers on basic vehicle maintenance and key risks.

VEHICLE RISKSInadequate vehicle maintenance can cost lives. In 2011, 2,125 crashes in Britain were caused by vehicle defects, 52 of them causing deaths. Vehicle defects can also

lead to costly repairs and insurance claims.Driving at work recommends employers evaluate vehicles for their safety features and suitability before purchase, and ensure privately-owned vehicles are well-maintained and serviced if they are used for work. Daily pre-drive checks should be carried out and

defects reported and repaired promptly, with appropriate standards

in place for maintenance and repairs, and unsafe

vehicles not driven. The guidance states vehicles should be correctly loaded and secured, not exceeding their maximum weight, and appropriate

restraints and crash protection

features fitted and working. Drivers should

be advised on safe and ergonomic posture and seat position.

Brake supports and agrees with these recommendations, as a minimum to ensure vehicles are safe. Brake additionally recommends servicing and repairs are carried out by qualified mechanics, preferably accredited by schemes such as irtec. Employers should ensure in-house mechanics hold appropriate qualifications and accreditation, and provide training as appropriate, and insist on minimum qualification standards and regular training for outsourced mechanics. Brake is aware vehicle safety and maintenance is a concern for many employers. We are therefore holding a low-cost seminar

EMPLOYEES ON THE ROADWith at least one in four road casualties in Britain involving an at-work driver, Laura Woods of road safety charity Brake sums up revised Health & Safety Executive advice on work-related road safety

Fleet Managem

ent

DRIVER SAFETY

At-work

drivers are more

susceptible to

driving risks including

driving tired, which

costs at least 300

lives in the UK

each year

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BMW CorporateSales

The Ultimate Driving Machine

FOR BUSINESS AND LEISURE.THE NEW BMW 2 SERIES ACTIVE TOURER.

Fuel economy figures for the new BMW 2 Series Active Tourer range: Urban 43.5 - 60.1 mpg (6.5-4.7km). Extra Urban 61.5 - 76.3 mpg (4.6-3.7km). Combined 53.3 - 68.9 mpg (5.3-4.1/km). CO2 emissions 124-109g/km. Figures may vary depending on driving style and conditions.

With its classic lines and dynamic design, the new BMW 2 Series Active Tourer is the Ultimate Driving Machine created for both business life and family pursuits, however adventurous they may be. Boasting a sporty design, this car still offers everyday practicality with adjustable sliding rear seats with a 40:20:40 split, a folding floor and a plentiful luggage compartment. Impressive fuel economy and benefit in kind from 17% (2014/15 BIK tax rates) make the new BMW 2 Series Active Tourer a compelling company car proposition, not only for the working week.

To find out more visit www.bmwcorporate.co.uk or call 08081 280039.

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Isla Components specialises in the manufacture of wiper arms & linkages.

Isla have a large range of wiper blades. It also offers conventional blades, upgrade blades, commercial blades, rear arms and blades for cars and the new type of flat blades for both car and LCV. This range incorporates a “Multi‑Fit Adapter” system, that covers 86% of the market place.

The commercial blades include a range of heavy duty hook blades (9x4 & 12x4 adapters), spray jet blades, with the jet fixed to the blade frame, also a range of saddle fitting blades, from 20” (500mm) to 48” (1200mm).

Isla manufacturer a variety of wiper arms for all types of PSV vehicles and CCTV cameras used in different industries & environments.Isla have an extensive range of replacement wiper motor & washer pumps for PSV vehicles.

Isla also supplies an extensive range of replacement wiper arms, blades,wiper motors & washer bottles for the Plant & Agricultural sectors.

Isla are able to offer “own branding solutions”.

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on vehicle maintenance and mechanics, helping employers apply the advice in Driving at work and go beyond this, on 25 June 2014.

JOURNEY RISKSIn 2012, 538 pedestrians and cyclists were killed on UK roads, 61 of them children. Brake believes that reducing traffic and vehicle speeds where people walk and cycle is one of the best ways to prevent needless casualties, and employers can play a key role in this. Poor journey planning can pressure drivers to take risks such as speeding or driving tired and mean your drivers are driving further and longer than needed. Tired driving kills at least 300 people every year in the UK. Driving at higher speeds increases your risk of being in a crash as you have less time to react to hazards, and poses a particular threat to people on foot and bike.

Driving at work advises employers to consider the safest routes for their vehicle types: for example sticking to motorways wherever possible and avoiding minor roads or those with low bridges for larger vehicles. It recommends planning schedules to take into account when drivers are most likely to feel sleepy, building in time for rest breaks, and considering where drivers can stop and what facilities they may need during breaks. Drivers should be allowed enough time to complete journeys safely, and monitored to ensure they are not putting themselves at risk or breaking drivers’ hours regulations (where applicable). The guidance also recommends taking weather conditions into account, by: adjusting journey times and routes where possible; ensuring vehicles are suitably equipped for bad weather; educating drivers on bad-weather driving; and ensuring

drivers know they can cancel a journey if bad weather makes it unsafe. Brake welcomes this focus on assessing and planning routes and journeys to minimise risks to drivers and other road users. Brake additionally advises organisations to reduce road travel as far as possible, for example through teleconferencing, remote working or encouraging use of public transport. Where this is not practical (for example, for delivery and logistics companies), journeys should be planned to use the safest, most efficient routes possible. ROAD SAFETY WEEKRoad Safety Week, the UK’s flagship road safety event coordinated by Brake, is a great opportunity for employers to ensure they and their drivers are doing everything possible to protect vulnerable road users and make local communities safer. This year it takes place 17-23 November, focusing on the theme “Look out for each other”. Brake will be calling on everyone to look out for one another on roads, but particularly drivers to watch out for more vulnerable road users. Employers are encouraged to get involved, which could include running awareness-raising activities to promote the importance of drivers slowing down to protect pedestrians and cyclists, or launching and promoting new risk management initiatives, or working with the local community to promote road safety.

NEXT STEPS FOR FLEETSThe HSE’s Driving at work guidance presents a practical outline of how employers can comply with their legal obligations and duty of care to their employees and the wider public. Brake believes it is essential reading for any organisation with employees who drive for work, and should form the basis of a comprehensive risk management policy and strategy. We are encouraging employers – especially those starting out in risk management, or wanting to check they have the basics in place – to use it alongside our own Essential guide to fleet safety, recently produced with the support of the Department for Transport. It’s specifically aimed at small businesses and employers with less experience in road risk management. All organisations with staff that drive for work, whatever their level of experience in road risk management, can benefit from the tools, guidance and case studies provided through Brake’s Fleet Safety Forum. This respected service helps employers keep up to speed with fleet safety best practice, and ensure they are equipped to not only apply the vital steps recommended in Driving at work, but go beyond, and make at-work road safety a priority across their business.

FURTHER INFORMATIONwww.brakepro.org

Fleet Managem

ent

DRIVER SAFETY

Inadequate vehicle maintenance can cost lives. In 2011, 2,125 crashes in Britain were caused by vehicle defects, 52 of them causing deaths. Vehicle defects can also lead to costly repairs and insurance claims



Intrim Medical & Rescue Services Ltd is based in Long Eaton area of Nottinghamshire with fantastic access to all major routes to the North, South, East and West, including major trunk roads such as the M1, the A50, A52 and the A38.

For the last 18 months Intrim Medical has been providing services to NHS, including Acute Hospital Trusts, Mental Health Trusts, and more recently the CCGs and CSUs since the takeover last April from the former PCTs.

Intrim Medical has been working towards becoming one of the major players in Ambulatory Care specialising in transporting Mental Health patients. Staff at Intrim Medical, have undertaken extended learning in Mental Health issues, and how to perform better assessments of Mental Health patients too, this in turn has allowed our crews to care for Mental Health patients much easier and also much more effective than we previously were able to.

Staff at Intrim Medical have also undertaken training in the use of Cuff and Restraints, including handcuffs, limb restraints and spit

hoods. As per NICE Guidelines and DoH Guidance staff only deploy these skills in extreme cases, however should the need arise,Intrim Medical crews are able to deal with these issues much more safely since January 2014.

Since the demand increased in transporting Mental Health patients, Intrim Medical opted for a change of uniform to become more approachable and less formal especially to Mental Health patients. Intrim Medical crews now wear Green trousers and Navy Blue Polo Shirts. This has proven to be more effective since the change made at the end of 2013 Summer time.

Intrim Medical are also able to offer other services too, such as; Non‑Emergency Patient Transport Services, High Dependency Care Transfers, Transplant and Organ Team/Tissue Transfers and much more including Response Cars, Emergency Ambulances and Personnel.

Should you feel your Trust, CCG, CSU, or Service would benefit in discussing Ambulance transport facilitation then please do not hesitate to contact us.

(T) 0844 310 0070 (W) www.intrim-medical.com (E) [email protected]

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Written by David Davis, director, Independent Am

bulance Association (IAA)

The speakers’ panel at the annual Independent Ambulance Conference earlier this year was loaded with some of the most influential leading figures from the National Health Service. That in itself was significant, but one moment in particular will prove to be especially relevant in the future. As delegates remarked afterwards it was clearly a deliberate comment from one of the speakers, a senior NHS commissioner in London, who had said: “Don’t wait for the ambulance trusts to come to you…go to them now and tell them what you can do for them….they need your help…partnerships are likely and relationships are key.” Those words were poignant for the ambulance industry. The companies which, just a few short years ago, were being branded ‘cowboys’ and described in Parliament as the ‘back door’ to privatisation of the NHS, were at long last being officially invited to come in from the cold. In reality they confirmed what most healthcare observers already knew but rarely

mentioned in public, that for the past few years, the NHS ambulance trusts were relying increasingly on private companies for help as they struggled daily to meet the ever growing demands on their emergency services.

GROWING IMPORTANCEIn the wake of financial pressures, some of the trusts have given up providing non-emergency patient transport services and it is now estimated that well over half of all NHS hospital transfers are carried out by private ambulance providers; even more significant is the fact that the companies’ resources are increasingly being called in for emergency duty. Healthcare industry observers are predicting that this is just the start of a complete transformation of the ambulance service in England over the next five years

when the independents will become fully engaged in carrying out both emergency and non-emergency work. These views were strongly echoed by other

speakers at the IAA conference. Professor Jonathan Benger,

National Clinical Director for Urgent Care, NHS

England, who is a key member of the Keogh Review, made the point that the new system of emergency and urgent care services

will see an increased provision of care over

the phone, at scene and in the community,

with transport to A&E the exception rather than the rule.

This will require an increase in community provision, free flow of information, joined up work with social care, enhanced clinical

EMERGENCY CARE

VITAL SUPPORT FOR THE EMERGENCY SERVICESDavid Davis examines how the independent ambulance sector has made great strides towards becoming accepted within the NHS as a crucial resource to support its emergency services

Ambulances

It is now

estimated that

well over half

of all NHS hospital

transfers are carried

out by private

ambulance

providers



sought the support of ambulance industry manufacturers and suppliers of equipment and specialist services who would be willing to offer members valuable business benefits and advice. Today the group of IAA Business Affiliates comprise some of the most important companies serving both the NHS and independent ambulance sector in information technology, vehicle manufacture, specialist ambulance building, automotive products, engineering, and insurance, business & financial services. Campaigning on behalf of members is a priority activity for the IAA and issues it has taken up include: local authority bans on private ambulances from using bus lanes; a new NHS commissioning model smaller and specialist contracts; ‘secondary employment’ of NHS personnel by private companies; and changes in EU public contract procurement directives.

CURRENT DUTIESThe IAA is presently working with the CQC on its new registration fee structure and compliance regime for ambulance services; it is engaged in discussions with the Department of Transport seeking members’ exemption from the speed limit regulations and is also part of the Keogh Review task force developing a new look for emergency and urgent care services. One expected lobbying success is likely to be a change in the law to close a loophole which allows ambulance companies, which are not registered by the CQC, to provide support services at sports events, concerts, and the like. The Department of Health, which is responsible for drafting legislation, has indicated that there will be changes – but not before the next general election in May 2015. For now, however, the IAA’s most important achievement has been gaining genuine recognition by the healthcare establishment, regulators and policymakers that the patient transport services provided by private ambulance companies are equal to those of the NHS ambulance trusts, in terms of safety and caring; they are also starting to realise that the private sector makes a vital contribution to the nation’s healthcare economy, that it has substantial resources in qualified people and a substantial ambulance park, and that it has a growing influence on healthcare services. Now in its third year, the IAA would be justified in looking to the future with a sense of optimism, provided it does not become complacent in the flush of its early achievements. The journey ahead will be a continuous set of challenges – social, economic and political. But its main concern will be the well-being of its customer – the NHS.

FURTHER INFORMATIONwww.iaa.uk.net

Ambu

lanc

es

EMERGENCY CARE

fine-tuned but it is already self-evident that all three ambulance providers will face tougher and more frequent unannounced visits by teams of CQC inspectors from next January. From the start of regulations, the IAA has been a strong advocate of continuously raising the performance bar and of more robust inspections in order to ensure that all registered providers perform to the highest level of safety and care for patient. This lobbying appears to have paid dividends as the CQC has indicated it will respond positively to proposals to make it more difficult for companies to be registered in the first place and then meet all the criteria for delivering high quality patient transport services.

INSPECTIONUnder the CQC plans the inspectors will carry out test inspections starting this autumn and providers will be assessed on 5 key questions: are they safe, effective, caring, responsive and well-led. To answer these questions the inspectors will increase the frequency of their unannounced visits to check ambulances inside and out, review personnel

employment and training files, analyse operational records, talk with employees, customers and patients, and question managements on their corporate culture. IAA members will support the new robust regime and will co-operate fully with the inspectors; equally they expect that the inspections will be carried out constructively and that the reporting of the findings will be fair and transparent. The inspection reports will be published on the CQC website and to help people compare the services of NHS ambulance trusts, independent companies and voluntary organisations, each will include a rating outstanding; good; requires improvement and inadequate. The CQC will have legal enforcement powers to require providers to improve, making sure those responsible for poor care are held accountable for it. In addition the IAA will itself take strong action, including suspension and expulsion, against any member which seriously breaches the CQC compliance rules.

WORKING WITH THE NHSThe introduction of regulations prompted the private ambulance providers to form the IAA to work with all the NHS and all the regulatory bodies, not oppose it – as had been practised by other ambulance organisations who were strong advocates of self-regulation. From the outset, the IAA actively

support and workforce development.Delegates were pleasantly surprised to hear his prediction that a range of new opportunities will exist for independent ambulance services in the new system, ranging from the support of new models of care to urgent transportation to transfer and retrieval for the most seriously ill and injured patients. Benger added: “There is an appetite for change within Government and all those engaged in the review. Ambulance services are central to the changes which will be radical and there will be a pivotal role for the independent ambulance sector.”

KEOGH TASK FORCESuch is the growing respect for independent ambulance providers that the IAA is represented on the Keogh Review Task Force, sitting alongside the three statutory emergency services – police, fire and ambulance – to chart the future development of emergency and urgent care services. It is the independent ambulance sector’s first opportunity to be directly involved in the future development of the nation’s healthcare services, a far cry from the days when

irrevocable decisions were taken without any reference to them or recognition of the impact of such decisions on their businesses. This change of fortune reflects the changes that are coming about across the whole NHS landscape. It has come about as a result of the Government decision in April 2011 to bring ambulance companies within the regulatory scope of the Care Quality Commission. Since then both the public and private ambulance services had for the first time a level playing field on which to operate – they have been legally required by the CQC to meet the same standards of patient transport services, face the same regime of unannounced compliance inspections and the same legal enforcement action for those companies which are continuously non-compliant.

COMPLIANCEAs with the Keogh Review, the IAA plays an important role in shaping the future compliance regime for ambulance services. The Association’s representatives sit with AACE, the national policy body for the 10 ambulance trusts, St John Ambulance, the British Red Cross, and various NHS organisations, as members of the CQC Ambulance Advisory Group which has been established to propose how the new regime should operate when it is introduced in 2015. Details of the new regime are still being

The IAA is presently working with the CQC on its new registration fee structure and compliance regime for ambulance services



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Your first call for missing or replacement keys

In a busy organisation like yours, the cost of energy can be high. With growing demand on our energy reserves we are already being warned that we face power shortages in the future. So what can you do to reduce your energy bills? Changing from compact fluorescent camps (CFLs), halogen lamps and fluorescent tubes to more efficient LED lamps could save your organisation money and reduce your costs. Many businesses believe that LED lamps cost more than halogen lamps and are put off by the price. WattLEDBulbs.com’s customers are amazed when they do the maths. For example,

a typical halogen lamp lasts for 1,000 hours and costs around £1.50. A typical LED lamp costs £6 and lasts for 40,000 hours. Just in replacement lamp terms, it will cost £60 in halogens lamps to last as long as a single LED lamp. So you have already saved £54 without even considered the energy savings. Looking at the energy costs, halogens use around 50w per hour compared to LEDs using around 5w. This is a saving of 90 per cent. What could your organisation save by moving to LED lamps?

FURTHER INFORMATIONwww.WattLEDBulbs.com

Cut energy costs by changing to LED lighting

ENERGYFACILITIES MANAGEMENT

The prevention and control of water borne bacterial illness has taken on a new dimension within the past year, with focus changing from simple ‘legionella control’ to an overarching ‘water safety plan’ that encompasses risks posed by pseudomonas, E. Coli and many other water borne pathogens. Scotmas understands that simple chemical dosing is not enough. Scotmas chlorine dioxide water treatment systems have been designed from the ground up to combine the unrivalled biocidal power of chlorine dioxide with the strenuous audit requirements of HTM04-01 and other NHS standards. The systems feature advanced ‘adaptive dosing’ to ensure that

you only dose the amount of biocide that you need, along with automatic datalogging and recording of chemical residuals and temperatures in accordance with CQC requirements. As specialists in the field of chlorine dioxide dosing, the company works alongside existing consultants and service providers to successfully integrate ClO2 into your water safety plan, and a team of chemists, microbiologists and highly skilled engineers are on hand to provide the highest standards of on going support.


Europe’s leading water treatment specialist

LEGIONELLA

With over 40 years’ experience in the water treatment industry, Water & Air Management understands exactly what healthcare providers need to keep vital systems running efficiently. Its team of highly qualified consultants advise on, manage and maintain a range of systems, whoever the supplier. Thanks to the company’s vast experience working within NHS and other healthcare facilities, consultants have a comprehensive knowledge of the water and air technology used in hospitals. Experts in legionella prevention, Water & Air Management regularly monitors equipment and assesses risk to keep your systems in top condition. Since hygiene is a critical factor in healthcare, consultants also carry out thorough cleaning and

decontamination of your facilities to ensure they are totally safe and fit for purpose. Specialised services include water sampling, chlorine dioxide applications and the supply, installation and maintenance of water softeners and reverse osmosis plants. Water and Air Management makes managing your healthcare facilities so much easier. Consultants work in partnership with you to guarantee your organisation meets strict industry standards and comply with government regulations, such as HTM01 04, AcOP L8 and HSG274 parts 1-3.


Water and air hygiene fit for your hospital

INFECTION CONTROL



Prod

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& S

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Aish Safety is a fire risk assessment company based in Stoke Newington, North London and is one of the leading names in fire risk assessment in London and the UK. Aish Safety uses the most current legislation for its fire safety assessments regarding business premises, a compulsory requirement for any business in the UK, big or small. With years of experience in the field of fire risk assessment, Aish Safety can deliver effective and affordable fire assessment services and training for your business. Meeting current laws and legislations can be a tricky business for any small business holder, which is why the company assists you every step of the way, bringing its expertise to your business, ensuring you meet all of the current legislations and legal requirements. Aish Safety take care of the entire process from beginning to

end, bringing all of its knowledge and experience to your business. From your initial assessments, right through to training and equipment, Aish Safety Ltd delivers a professional fire risk assessment service, giving you confidence and peace of mind.

FURTHER INFORMATIONTel: 0208 809 4331Mobile: 0798 069 [email protected]

Fire risk assessments from the industry experts

FIRE SAFETY

Do you know the whereabouts of your staff at all times and can you identify who they are with? As more healthcare workers work alone and for longer periods of time, how do you effectively control the risks that your staff may face? In 2011-2012 there were 59,744 assaults on Healthcare staff in the UK. With Guardian24, healthcare workers can be confident that every precaution is being taken to ensure staff safety. The company’s award-winning technology helps over 400 UK businesses address their health and safety obligations for lone working. Today, over 40,000 people rely on Guardian24 for protection, giving users the knowledge and peace of mind that help will be near if they need it. The solution has easy access to a discreet panic alarm, live audio channel to the company’s

24/7 monitoring centre, assistance from emergency services, GPS location tracking and man down alarms. Guardian 24 also allows users to log their daily tasks and can be used via BlackBerry smart phone, android, iPhone, windows PDA, tablet, mobile phone or specialist lone worker device such as the Pearl+.


Lone worker protection for healthcare workers

LONE WORKERS

Launching a new product into a new sector is always challenging but the number of sales received proves that the M-Power lectern, with its powered raise and lower facility, is massively ahead of anything on the market at this time. Enabling any presenter, no matter how tall or short, able bodied or seated to utilise the facilities that a lectern should provide was always the first consideration in the design and development of this unique product. Allowing students to see and be seen during presentations is so simple. The push of a button lowers or raises the lectern to the ideal height for any user. The range of materials and finishes allows us to offer any colour of powder coating on the metal lectern and any colour and grain finish on the wooden model. Adding connection facilities to the standard model allows

the use of computer screens for preview, touch screen use and a range of connectivity that includes VGA, HDMI, CAT5 and video in component or composite forms.

FURTHER INFORMATIONTel: 01202 474373Mobile: 07976 [email protected]

A professional lectern for just about every need

AUDIO VISUAL

Pharmabotics is a research and development company based in rural Winchester. The company designs, manufactures and sells innovative tactile training models for medical education. Pharmabotics’ products are distributed globally. Used extensively in universities and training hospitals around the world, they have become invaluable teaching aids for every level of medical education. The products are niche, innovative and ground breaking, yet enhance educational goals in practical core skills. Trainees are able to acquire skills in safe low pressure environments without the usual constraints of theatre time. Pharmabotics have recently worked alongside Mr Barry Whitlow MD MRCOG, award winning gynaecologist at Colchester Hospital University to produce a new Gynaecological Skills Trainer. The first of its kind,

it is a ground breaking leap forward in operable simulators. Medical education constantly evolves as new procedures and practices are developed. Pharmabotics has a crusade to facilitate these changes by working closely with skilled medical personnel who enhance the design of these simulators. The crusade encompasses a strong drive to promote simulators for training not draining public resources, to achieve a form of metaphoric alchemy, fusing a combination of art and science to create ground-breaking medical simulators at affordable prices.

FURTHER INFORMATIONwww.pharmabotics.com

Tactical training models for medical education

MEDICAL MODELS



Products & Services

Everyone knows good seating is critical. Long hours spent in a poorly adjusted chair causes unnecessary strain and can result in injury to the back, shoulders and legs. Back pain costs the NHS over a billion pounds each year. But what can you do about it? Adjust chairs so the level of the knees is slightly higher than the hips, ensure feet are firmly on the floor and choose chairs with lumbar supports and adjust them accordingly, use footrests to help maintain the correct seating position and try not to slouch or sit with crossed legs. Working in a laboratory? If staff use high-level lab chairs, health and safety guidelines advise against resting feet on the foot ring, as this restricts the flow of blood to the lower leg. Instead, consider adjustable laboratory footrests to maintain a good sitting position. The Work Area Ltd range includes seating for offices and

reception areas, as well as seating and footrests for laboratories, and clean rooms. Chairs come with a five year manufacturer’s warranty as standard and are weight-rated up to 25 stone.


Seating and storage solutions from Work Area

SEATING

G.D. Smy Ltd is a privately-owned and long established building, refurbishment and fit-out contractor based in Kent. The company has a long track record throughout South East England and is a member of the Federation of Master Builders, and the ConstructionLine, NICEIC, CHAS and Safe Contractor schemes. GD. Smy Ltd has extensive experience in the healthcare sector, and the company’s in-depth knowledge of the particular requirements of this challenging area makes GD. Smy Ltd the ideal partner for your forthcoming newbuild, refurbishment and fit-out projects. Recent clients include South London Healthcare NHS Trust, Croydon University Hospital, Maidstone & Tonbridge NHS Trust, Lewisham Healthcare NHS Trust and Oxleas NHS Trust.

The company ensures the success of your project by providing a detailed program of works to all parties, communicating with department heads on a daily basis, regularly communicating with all supply chain partners and applying a sensitive approach in order to minimise the impact on patients and staff. G D Smy Ltd’s range of skills include design, project management and all aspects of construction and interior fit out works from concept to completion.

FURTHER INFORMATIONTel: 01474 874006

G.D. Smy Ltd – the specialists in healthcare

REFURBISHMENT

Liquid Culture is passionate about all things refreshment; experts in coffee first and foremost, and specialists in providing the complete drink and snack service. Liquid Culture supplies a comprehensive range, from vending machines to professional coffee machines, and the best ingredients and products to serve with them. The company also shares its expertise and knowledge, offering business-to-business consultancy and a ‘Your Brew Buddy’ barista training service. Liquid Culture’s colleagues are knowledgeable and friendly and always willing to go the extra mile, whether they are chatting to you about new coffee blends, delivering your ingredients, or filling and maintaining your vending machine. Ideal for both retail and commercial venues, the Liquid Culture Espresso Tower offers exceptional quality at the touch of a button. It is exactly

the same concept as Costa Express and Starbucks to-go but supporting the independent coffee provider. Liquid Culture can also fully brand the towers to your requirements. So if your organisation serves refreshments to customers or staff, the company can design and deliver the optimum refreshment service. Liquid Culture strongly believes that every refreshment break deserves to be enjoyed – how totally refreshing.

FURTHER INFORMATIONwww.liquid-culture.co.uk

Liquid Culture – the experts in coffee

VENDING

The procurement of catering supplies can be a complex business. Balancing budgets whilst maintaining an optimal operating performance can be a tricky prospect at the best of times. The added challenge of accommodating green issues and the prospect of tighter waste management legislation will present healthcare buyers with future challenges. Fortunately Kitchequip is here to assist, with over 20 years of grassroots experience in providing catering solutions to the NHS and healthcare providers. The company works closely with major manufacturers to remain at the forefront of product development. Kitchequip is proud to be

an associate member of the Hospital Caterers Association and hosts an annual BBQ with several HCA branch meetings and top manufacturers. Kitchequip offers expertise in commercial kitchen design and planning services, and stocks an extensive range of kitchen and catering equipment in its warehouses. The company offers public sector healthcare clients an automatic credit facility in addition to special public sector prices and the experience of a team of specialists.

FURTHER INFORMATIONTel: 01704 535577www.kitchequip.co.uk

Providing catering solutions to the health sector for over 20 years

CATERING



Adve

rtise

rs In

dex

ADVERTISERS INDEXThe publishers accept no responsibility for errors or omissions in this free service

4imprint 76Aish Safety 80Altodigital 40Andersen Caledonia 23, 24Asckey Data 51Bio Technics 16Blue AV 80BMW 72By Box Field Support 46Capita Translation & Interpreting 35Certuss (UK) 48CFH Docmail 66Citroen UK 18, 19Cleric Software 76Cofely 56Colliers International 38Crown Moran 52DEB UK 16Decorative Panels 14E Share 42Easthampstead Park 8ECE Cleaning 36EMS Healthcare 62Fast Park System UK 50FDB 30Fitwise Management 21, 23GD SMY 81

Glasdon UK 27Greensafe IT 48Guardian 24 80Health Intelligence 69Hospital Aids 36ID Card Centre 65Intrim Medical & Rescue 76Isla Components 74Jenry 68Keys Please 79Kitchequip 81Liquid Culture 81M3at 24Medic Interpreters 35Medix Gloves 69Micronics 58Multitone Electronics IFCNCE Computer Group 52Page One Communications 44Pegler Yorkshire Group 16Pharmabiotics 80PHS Group 28, 29Polyflor 33Preventamed Technologies 24, 25Productive Primary Care 55Reval Continuing Care 68RSM ITIL Consultancy 82

S2S Data Destruction 82Sayvol Environmental & Building Services 24Scotmas 79Sketchers Stryker Germany 46Slip Tech 65Spacevac UK 58Stock Signs 70Sundeala 6Surf Telecoms 74Swisslog (UK) 45Technical Textile Services 22, 25Teknomek BCText Help 48Tin Global IBCUlysses Rostering Systems 66Unity 5 58Universal Pool Services 38Vanguard Health 4, 63Voice Connect 47VW 12, 13Water & Air Management 79WattLEDBulbs.com 79WinchPharma Group 20, 25Work Area 81X9 Services 66

Whether you have new or existing services, RSM ITIL Consultancy can work with you to develop, improve and add value to your services. RSM has the experience and the knowledge to take care of your needs in terms of IT Infrastructure Library (ITIL) best practice service delivery, helping to create service design packages as well as implementation roadmaps to ensure your business decisions do not stop you from reaching your goals. Services include educating staff about ITIL, helping reduce costs and improve efficiency, ensuring compliance with ITIL standards i.e. ISO20000 and assessing your

service processes and functions. RSM effectively manages business services across lifecycles, covering every aspect of your IT infrastructure management, including incorporating best practices from ITIL, expediting new service delivery, attaining transparency in IT expenditure, reducing IT operation and support costs, improving service quality, improving staff efficiency and controls for risk-free management.

FURTHER INFORMATIONTel: +44 1322 404 952Mob: +44 7931 879245enquiries@rsmitilconsultancy.co.ukwww.rsmitilconsultancy.co.uk

Practical solutions for IT service management

IT CONSULTANCY

Incorporating S2S Lifecycle Solutions, S2S Mobile Solutions and S2S Data Solutions, S2S Group operates from a high security facility, providing unrivalled asset recovery and data solutions for clients. From end to end IT asset management recycling to complete data or document destruction, S2S are able to offer a comprehensive ‘one stop in-house solution’. S2S Data Solutions is the CPNI approved data destruction division. It provides certified software data erasure/ degaussing, and the physical destruction of hardware off and on site to Government approved HMG IA Standard No.5. S2S Lifecycle Solutions is a fully ADISA certified asset recovery service including tracking, refurbishment and resale. In addition, S2S offer an in house Authorised and Approved Treatment Facility (AATF) for all commercial and industrial Waste Electrical and

Electronic Equipment (WEEE). S2S Mobile Solutions is the company’s specialist mobile phone and tablet refurbishment division. It provides a secure and safe solution for your redundant (working and non-working) corporate phones including full data erasure service. S2S Group are fully accredited to ISO 9001, ISO 14001 and ISO 27001, Safe Contractor approved and ADISA accredited.

FURTHER INFORMATIONTel: 01709 878878 Fax: 01709 763878 [email protected]

Unrivalled asset recovery and data solutions

DATA DESTRUCTION



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