Health Business Volume 10.3

FACILITIES MANAGEMENT – Improving the patient experience through innovative use of art

TRAINING FLEET MANAGEMENT

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VoLuME 10.3

EMERGENCY PLANNING

RECRuITMENTRecruiting and retaining the right staff

PLuS The importanceof a flexible workforce

Metropolitan TEGG scooped two awards at the TEGG Corporation of America’s recent award ceremony held in Pittsburgh USA. Anthony Ballard was the winner of the Veteran Sales contest, whist Gavin Lingham gained the title of Engineer of the Year.

This follows another successful year for the Metropolitan TEGG team who have recently carried out works in Paris, Budapest, Madrid, Frankfurt and Milan. Metropolitan Electrical Services Limited established in 1985, Metropolitan has steadily grown to become a respected Electrical Services contractor covering most aspects of the electrical services industry. Metropolitan Electrical Services has grown a reputation over the past 25 years as a contractor that has our client’s goals & objectives at the core of our work ethos.

Metropolitan Electrical Services created a Mechanical division in 2006 to supplement & complement the existing Electrical division

and have steadily grown the Mechanical business over the past 30months. In conjunction with the creation of the Mechanical division within the existing business Metropolitan Electrical Services created a specialist service division, Metropolitan TEGG working with existing clients and new clients with a selection of bespoke predictive & preventative maintenance solutions on energised & de-energised electrical distribution systems.

The metropolitan team is a cohesive self-motivated team of professionals, able to provide fast response times, the highest quality of service and workmanship plus a high level of technical competence. Fast response times achieved by directly employing a permanent team of highly motivated staff. Metropolitan have achieved accreditations to a number of national & internationally recognised associations, NICEIC, ECA, HVCA, ISO9001, Safe Contractor, ROSPA & CHAS.

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Dear Reader,So, we have a new government and a new health secretary – Andrew Lansley – who has the ambition for NHS outcomes to be as good as anywhere else in the world, saying that all service changes must be led by clinicians and patients, not be driven top down. He seems to be keen on empowering patients and one step in this direction is the weekly publication of rates of HCAIs, which can now be found online.

At North Tees and Hartlepool NHS Foundation Trust patient safety is top of the agenda. It also has a major change agenda to deal with in the shape of new ways of working, and is relentless in tackling C. diff and MRSA. The Trust’s director of nursing and patient safety Sue Smith discusses the hard work she and her colleagues do on page 15.

This issue of Health Business also covers the new CRC Energy Efficiency Scheme (p. 29), management styles (p. 55) and the importance of recruiting and retaining the right staff (p. 65) among other topics.

FACILITIES MANAGEMENT – Improving the patient experience through innovative use of art

TRAINING FLEET MANAGEMENT


VoLuME 10.3

EMERGENCY PLANNING

RECRuITMENTRecruiting and retaining the right staff

PLuS The importanceof a flexible workforce

HB

03THE BuSINESS MAGAzINE FoR HEALTH MANAGEMENT

www.healthbusinessuk.comHealth Business | Volume 10.3

ContentsHEALTH BuSINESS VoLuME 10.3

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NEWS

PATIENT SAFETYThe aim of last month’s Patient Safety Congress was to raise the profile of patient safety

We take a look at how North Tees and Hartlepool NHS keeps patient safety at the top of the agenda

FACILITIES MANAGEMENTThe Healthcare Facilities Consortium discusses the positive impact art can have on the patient environment

FLEET MANAGEMENTIt is vital that employers have a clear idea what “the fleet” is for, says ACFo

ENERGYThe CRC Energy Efficiency Scheme is now in place. The Environment Agency explains why both public and private healthcare providers must embrace it

The London Development Agency discusses how it’s working to reduce the Co2 emissions associated with the supply of energy to London’s buildings

ASBESToS MANAGEMENTThe Asbestos Removal Contractors Association writes on the importance of dealing with the removal of asbestos in the correct way

HoSPITAL FuRNITuREInfection control, ergonomics and comfort for both visitors and patients must all be considered when it comes to selection furniture

ERGoNoMICSAddressing the issues of obesity and manual handling is of great importance in healthcare settings

TRAININGThe Institute of Leadership and Management asks if best practice leadership can save the health service

Good leadership is something to be admired, according to the Chartered Management Institute

RECRuITMENTThe NHS needs a flexible workforce, says the Recruitment & Employment Confederation

In these lean times, recruiting and retaining the right staff is key, according to NHS Employers

EMERGENCY PLANNINGThe Emergency Planning Society talks about how they are reinforcing health sector resilience

ICTNick Hunn of the Mobile Data Association takes a closer look at the role of mobile and remote monitoring technology in healthcare

What is software Escrow, and do you need it?

CATERINGThe Food and Drink Confederation writes about healthy vending in the healthcare sector

CoNFERENCES & EVENTSCoastal resorts are chic and vibrant destinations with much diversity for event organisers

HEALTH & SAFETYSlips, trips and falls are the most common cause of injuries in the workplace. The Health and Safety Executive discusses how best to avoid this hazard

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OW

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E INTO

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inancial rewards for sustained weight loss could be the key to

solving the obesity epidemic, according to the results of a 745 person uK-wide trial run by Weight Wins, an innovator in structured financial incentive weight loss plans. The results include 402 people sponsored by NHS Eastern and Coastal Kent Primary Care Trust in a year-long trial. After 12 months, the average per person weight loss was over a stone (15.8 lbs), equivalent to 7.2 per cent of the group’s average body weight. This compares to only 5.5 lbs mean weight loss in a control group. Participants who were active in the programme after a year had achieved an average weight loss of nearly two stone (27.3 lbs), equal to 12.5 per cent of their

start weight. This is more than double the average 11.1 lbs long term weight loss of active members of traditional diet groups and four times the 6.5 lbs loss in the NHS’s own Counterweight counselling programme. Winton Rossiter, founder of Weight Wins, said: “We are absolutely thrilled with these results, which suggest that long-term financial incentives could be the best single weapon in the war on obesity. I urge the NHS and employers to adopt such schemes widely for the benefit of their patients and employees. I am so confident this works that, for our part, I am willing to guarantee results.” Weight Wins results are audited by the university of Hertfordshire Statistical Services and Consultancy unit.



Hospitals face penalties for readmissionsNew health secretary Andrew Lansley has announced plans intended to reduce emergency admissions within 30 days of discharge. Hospitals will face financial penalties if a patient has to be readmitted for emergency treatment. Mr Lansley said: “over the last 10 years, emergency readmissions have increased by 50 per cent. Not primarily because patients were more frail, but because hospitals have been incentivised to push people out early – process targets creating risks for patients. “So we are going to ensure that hospitals are responsible for patients not just during their treatment, but also for the 30 days after they’ve been discharged. If a patient is readmitted within that time, the hospital will not receive any payment for the additional treatment – they will be focused on successful initial treatments.”

online Scottish Knowledge Network announcedA new database set to provide NHS staff with online information on areas such as patient care, clinical practice and research has been unveiled. Cabinet Secretary for Health and Wellbeing Nicola Sturgeon launched the Knowledge Network during the opening address at the NHS Scotland Event in Edinburgh recently. Managed by NHS Education for Scotland the online resource will include a Google-style search engine giving instant access to 11 million learning and information resources from over 100 providers as well as personal space for employees to gather information. Ms Sturgeon said: “The announcement on the Knowledge Network is to be welcomed, not only will it save staff time, it will allow them to access a wealth of information which for the first time will be available online in the same place.”

NHS Supply Chain launches new leasing contractIn a tough financial environment where capital budgets are constrained, NHS Supply Chain’s new leasing contract offers NHS trusts access to fund new medical equipment. “Leasing can often be the most sensible choice within the NHS to finance medical equipment as technological advances often outpace the life of the equipment,” says Andy Brown, managing director of diagnostics at NHS Supply Chain. Through the new contract, 20 companies will be able to provide their leasing services to the NHS. Trusts will be able to compare and contrast deals to ensure that they find the most cost effective solution to meet their needs. The contract offers full cost transparency and complete administrative support from NHS Supply Chain’s specialist team, who complete all procurement mini-competitions and the necessary paperwork for trusts. The contract can be used to fund all types of equipment ranging from complex projects to basic equipment.

NEWSINBRIEF

ull and East Yorkshire Hospitals NHS Trust has increased the amount

of waste it recycles by almost 200 per cent in one year. To reduce the impact it has on waste landfill and to comply with a memorandum on healthcare waste the Trust launched a project to improve its segregation of waste. over 400 recycling boxes have been deployed across the Trust to segregate waste such as paper, cardboard, plastic and tin cans. Glass and scrap metal collections have also been arranged in conjunction with domestic waste contractor, Environmental Expressions. Marc Beaumont, sustainability manager for the Trust, said: “This is just one of many projects the Trust is working on to help

reduce our carbon footprint. As one of the largest organisations in the region we strongly believe we have a great responsibility to improve our rates of recycling and reduce the amount of Co2 we produce. “In addition to this we have embarked on a raft of low and no cost projects to reduce emissions including a promotion exercise to encourage people to switch of PCS and lights and a project to replace lighting around our hospitals with low energy alternatives. “For the second year running we are also arranging Sustainability Days which offer advice and information to our 8,000 staff on how they can help to reduce the impact the Trust has on the environment as well as how they can help at home.”

H

Hospitals committed to protecting the environment

t a special awards ceremony Gwenda Thomas, Deputy Minister for Social

Services, acknowledged the contribution of individuals and teams within health and social services who have shown exceptional commitment to using the Welsh language in their day to day work. Projects from all over Wales and across the border in England were recognised for their creativeness and resourcefulness in delivering bilingual services. The Welsh Language in Healthcare Awards are a platform for sharing and celebrating best practice in strengthening the Welsh Language to ensure that Welsh speakers receive health and social services effortlessly in their mother tongue. Closing the event Mrs Thomas said:

“This award ceremony has been an opportunity to celebrate initiatives that strengthen Welsh language services in health and social care. We have seen and heard some fantastic examples of Welsh at work and I hope they serve to inspire more bilingual projects across Wales. “I very much believe that providing Welsh language services for patients falls on the shoulders of all those that work in the service. Strong strategic leadership is also needed which is why I have asked each Health Board to nominate a Welsh Language Champion to support the Welsh Language officers so that we can fulfil our aim of providing comprehensive bilingual services for all who need and deserve it.”

A

Welsh language projects recognised

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Diet incentive scheme trial proves success

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ospital staff working on their own in Bradford now have a guardian

angel in the form of a high-tech protection device to protect them against harm. Bradford Teaching Hospitals NHS Foundation Trust has announced that since the start of the year they have distributed more than 200 personal security alarms to employees who work alone. The devices have been distributed to help staff who might find themselves in potentially aggressive or dangerous situations during the course of their work. The Trust’s security management specialist, Karon Snape, said: “The majority of our patients pose no threat and greatly welcome the community support we offer through many of our services but Bradford Teaching Hospitals has a responsibility to protect its workforce against the small number of incidents of violence, threatening behaviour and

verbal abuse which occur each year. “our staff can now use the alarms to monitor and record incidents where they feel their safety is threatened. Evidence obtained through these devices – including audio recordings – may be used in criminal and civil proceedings and to take local sanctions against alleged offenders.” Resembling a normal ID card holder, the alarm – called ‘Identicom’ – uses the latest mobile technology to protect staff in uncomfortable situations. NHS staff faced with a potentially violent situation can discreetly activate an alert, putting them through to a 24-hour call centre that can assist in the location of the member of staff and arrange for help to be sent by the police. The device also allows a phone line to be opened and sound from violent incidents recorded, which could then be used as part of any subsequent legal action.


H


New approach to treatment decisionsNHS Direct is piloting three online Decision Aids to help patients make informed healthcare choices in the first national web-based project of its kind in the uK. The online Patient Decision Aids (oPDA) have been designed for patients who are facing difficult decisions about medical tests or treatments, when there is no clinical evidence that one treatment is better than another and they don’t know which will be best for them. They will increase patients’ awareness of the expected risks, benefits and likely outcomes, empowering them to make informed choices about their care. In turn, this will also help ensure NHS resources are used appropriately. Phase one of the pilot has included the development of an oPDA for patients with osteoarthritis of the knee, and the transfer onto the internet of two already developed Decision Aids for patients with an enlarged prostate or localised prostate cancer. All three will be trialled in the NHS across eight pilot sites over eight weeks from the beginning of June 2010. Patients who are eligible to take part in the pilot will be given access to the oPDAs via their specialist clinician. Patients can review all the information, including the pros and cons of the treatment options available and can view filmed interviews with people who live with the conditions, before completing a short questionnaire to assess their treatment preferences. The questionnaire can then be used to support joint decision making between the patient and their clinician.

Funding approved for new hospital at WynyardThe treasury has approved the outline business case for the new hospital at Wynyard, which means that the final piece of the jigsaw to build a much improved healthcare system for local people can now be realised. Chief executive for North Tees and Hartlepool NHS Foundation Trust Alan Foster said: “We are absolutely delighted that the funding has been approved. For years this area has been subject to reviews and it has really held us back in terms of planning to improve services for people living in Hartlepool, Stockton and parts of Easington and Durham.”

NEWSINBRIEF

he Chesterfield Royal Hospital became the first in the world to take delivery

of state of the art bedside lockers that are specifically designed to help fight infections. The unit, featuring a patented design by Bristol Maid, has entirely smooth surfaces with no joints or crevices that make it difficult for bacteria to survive and features removable drawers allowing them to be cleaned thoroughly in less than a minute. Diane Simpson, senior matron for infection prevention and control, said: “This locker has been specifically designed to help us to keep the patient area clean. Because the unit has no back and we can take out the drawers completely, it can be wiped clean in minutes and be ready to receive the next patient. “A lot of the work we do in promoting good hand hygiene amongst our staff

is centred on the patient environment and this unit is a part of that. By making things easier to clean we are reducing the risk of seeing potentially harmful bacteria travelling from patient to patient.” The locker, developed as part of the ‘Bugs out Project’, has been created with patients and nurses in mind. The top section allows staff to dispense drugs or write up their notes; it also has key features such as raised sides so that any spillages can be contained on the unit and easily wiped clean. The unit was designed after extensive user research and consultation with patients, medical staff, infection control, pharmacists, cleaners and matrons to identify the key features that were required. These include electronic locks to remove the need for bulky bunches of keys and completely removable and reversible drawers to help with cleaning.

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FuNDAMENTALS oF PATIENT SAFETY

NoW IN ITS THIRD YEAR, PATIENT Safety Congress 2010 was better and more diverse than ever. over 1,000 attendees came together in Birmingham’s ICC representing acute and foundation trusts, primary care trusts, ambulance trusts, third sector organisations, SHAs, mental health trusts and international health bodies. Delegates ranging from chief executives to frontline practitioners had the opportunity to hear from over 100 speakers including Joe McCannon, Dr Phil Hammond and Jim Easton. The lively exhibition area showcased 42 companies including IT suppliers; pharmaceutical organisations; medical suppliers and health charities, as well as the Patient Safety Congress partners: Department of Health; NHS Institute for Innovation and Improvement; Health Foundation and National Patient Safety Agency. It proved to be an event filled not just with education but with emotion and optimism in the continuing quest to improve patient care.

CoNFERENCE AGENDAThe week’s activities began with the Fundamentals of Patient Safety conference – a jargon-free guide to the basic principles of patient safety. This practical training day covered core topics including infection prevention and medicines management, providing a solid foundation of knowledge and innovation to delegates who then went on to attend the Congress. Chaired by Dr Phil Hammond on day one and Maxine Power on day two, the Congress agenda combined a series of plenary sessions and streamed workshops examining patient safety in acute care, community care, primary care and mental health. Across 48 streamed sessions, speakers’ contributions were categorised as leadership, communication and culture change, improvement journeys and patient stories, intervention, improvement skills and measurement techniques. Speakers included winners of the inaugural Patient Safety Awards which took place on 5 February this year. Showcasing the very best of patient safety practice, the Awards celebrated the commitment and creativity shown by individuals and organisations, and disseminated best practice throughout the uK and beyond. Joe McCannon delivered a keynote session detailing how to build a patient safety movement. Pulling on experiences from the united States and his work in Africa and Europe, Joe identified 10 lessons for building social movements including listening to patients and service users and effectively using social networking such as Twitter and Facebook to hear the community. He also stressed the importance of having a shared story reminding us that while

We look at what took place at the Patient Safety Congress – the premier patient safety event in the UK – last month


PATIENT SAFETY


Delegates ranging from chief executives to frontline practitioners had the opportunity to hear from over 100 speakers including Joe McCannon, Dr Phil Hammond and Jim Easton

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people will forget facts and figures, they will never forget a moving story and a shared story has the power to propel change and power a movement. Human factors played a significant part in the Congress and some of the most thought provoking sessions were those which told real life stories. In the emotionally charged presentations, Julian Hendy and Clare Bowen’s heartbreaking tales of personal tragedy had the audience in tears and served as a hugely powerful reminder of why the event is so important. Providing a more clinical perspective, Dr Cheryl Crocker’s presentation – ‘Bob’s story’ – followed the journey of a patient, highlighting the importance of communication between services and agencies to ensure the patient’s safety is never overlooked. Delegates were also invited to attend lunchtime learning sessions hosted by the event partners and the Patient Safety Dinner, which provided informal networking along with some entertainment in the form of the Siren string quartet.

KEY THEMESWhilst the 2008 Congress raised the national profile of patient safety and 2009 turned policy into practice, the 2010 event took place in the context of an unprecedented political situation and financial strain. Against a backdrop of biting funding cuts and increased need for collaboration, the recurring key themes from the Congress were SBAR, patient engagement and communication – having the courage to speak up if something doesn’t feel right and to engage in the “difficult conversations”. While delegates benefited from hearing real life examples of how organisations have succeeded in reducing infection rates and tackling outbreaks of C.diff, the audience was also reminded that patient safety is not about solving crises, but having the right systems and the right people in place to ensure safe and effective care. Throughout the event, a cartoonist was capturing the major themes of the discussion in eye-catching, quirky sketches which were on display in the exhibition area – attracting delegates’ attention and stimulating discussion and debate when asked to vote on the one that best summed up the event’s key messages for them. The most popular sketch depicted patient safety as the beating heart of every NHS organisation. The Patient Safety Congress received a record breaking 250 poster submissions, 105 of which were accepted and displayed in the exhibition. Delegates voted for their favourite poster via text, and the winning poster came from Chelsea and Westminster NHS Trust titled ‘Improving documentation and handover communication for hospital inpatients using standardised weekend management planned stickers’. The Patient Safety Cinema was another focal point of the exhibition, showing films from partners, speakers and exhibitors communicating best practice in patient safety. The Congress also led a ‘Change one Thing’ campaign – encouraging delegates to pledge to do one thing differently in order to improve patient safety in their organisation. This engagement, dynamism and positive contribution was a theme that ran throughout the event, with speakers, delegates, exhibitors and sponsors all keen to celebrate the successes achieved so far and look closely to the future to keep improving. Hopefully the great enthusiasm of the three days translates into real improvements in patient safety, which will of course be the true measure of success. Next years’ Congress will take place 17-18 May 2011 at The ICC in Birmingham.



PATIENT SAFETY

Against a backdrop of biting funding cuts and increased need for collaboration, the recurring key themes from the Congress were SBAR, patient engagement and communication – having the courage to speak up if something doesn’t feel right and to engage in the “difficult conversations”

Eliminate errors and cut costs in the NHS

EDuCING AND eliminating errors in the matching of

patients with their care is central to improving patient safety in the NHS. The National Patient Safety Agency’s SPN 24 calls for standardised wristbands to be used throughout the NHS. The NHS Information Standards Board has also recently released an Advanced Notification of a new standard calling for the use of GS1 standards for any barcoded system deployment for patient identification from 1 July 2011. GS1 barcoding and RFID standards ensure that patients get the right treatment, the right dose, at the right time in the right way. In 2007, the Department of Health recommended the use of GS1 standards for coding systems throughout England’s healthcare system. using coding to manage supplies and purchasing electronically can also cut costs dramatically

and improve efficiency. GS1 uK has been working closely with NHS hospitals and agencies including SHA’s across the country to encourage the use of coding standards for surgical instrument tracking, pharmacy manufacturing and patient identification through workshops, guidance materials and consultations. So far almost 250 hospitals have registered to adopt GS1 coding standards.

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To register today call +44 (0)20 7092 3512 or visit www.gs1uk.org

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reinforce both hospital specific and national patient safety protocols. Following an extensive and successful trial at Central Manchester university Hospitals NHS Foundation Trust, Patientrack was selected to underpin the Trust’s commitment to patient safety and it will now be deployed in each of its hospitals.


If you would like more information about how Patientrack works and the clinical and efficiency benefits it helps to deliver please contact: [email protected]

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THE RELENTLESS quEST FoR PERFECTIoNNorth Tees and Hartlepool NHS Foundation Trust’s director of nursing and patient safety Sue Smith and her executive colleagues provide a leadership and cultural environment where patient safety is top of the agenda

NoRTH TEES AND HARTLEPooL NHS Foundation Trust is almost unique in England for being a trust of both community and acute services. It also has a major change agenda to deal with in the shape of a new ways of working, playing a major part in the creation of integrated care centres to move services out of hospital and closer to people’s homes complemented by a new hospital with single rooms. The aim is to make the new health care system the envy of the country if not the world. Its mantra is that quality, performance and financial stability go hand in hand. Director of nursing and patient safety Sue Smith, who joined the trust in August 2008, explained: “Like many trusts North Tees and Hartlepool had put finance, by necessity, at the top of the agenda. While we know we’re heading into choppy waters financially there is a shared understanding that quality (including patient safety, patient outcomes and patient experience) is as important as finance and operational performance. “Actually when you think about it, getting it right first time for the patient does mean better performance and the best use of financial resources so, apart from being the right thing to do for patients, it makes sense. That commitment to quality pervades the organisation; people know that quality is everyone’s job and it has

paved the way for some incredible ideas and work which is making a real difference to patients and the staff who look after them.”

WARD REVIEWSBy November 2008 Sue had set up a programme of quality review panels. Each month Sue and her senior nursing team get back into their uniforms, split into small teams and visit every ward in the hospital. They use a scoring tool that could best be described as firm but fair. Sue said: “The first thing we look for is almost a gut reaction; do we feel calm, secure and safe when we enter the ward or do we feel ‘get me out of here’. I’m happy to report it’s never the latter. “We score wards on a number of indicators including nursing documentation, nursing care and dress code and one missing observation means a failure in that whole section. We also ask around 10 per cent of the patients on every ward about their experience and ask them to tell us one thing that would have made their experience better. “I think at first there was some resistance and suspicion but now the race to be top has become competitive. We’ve had tears of sorrow when an indicator is missed and tears of joy with the sheer pride of being top.

“We’ve adapted the programme and extended it to the community visits and we’re picking up areas which we know we can improve on both for patients and staff. “one of the most important things the quality review panels have achieved is raising the profile of nursing. We’ve had guests with us on our panels including our own chairman; he’s an ex police chief constable and he was staggered at the military precision with which we plan the visits. We’ve also welcomed representatives of the Royal College of Nursing, other nursing directors and – I think very importantly – student nurses who see first hand why we place such importance on getting things right for patients. “What it does mean is I’m out and about a lot and I can see for myself that everyone is on the ball. In the early days I might have had to challenge a clinician who wasn’t following our no tie, bare below the elbows dress code but I must say that hardly ever happens now. I sense that people now get it; they know that everything they do makes a difference.”

LEADING IMPRoVEMENTS North Tees and Hartlepool NHS Foundation Trust was one of the first trusts to sign up for both the Patient Safety Campaign and the Leading Improvements in Patient Safety programme (LIPS) programme. It captured the


PATIENT SAFETY


Director of operations Kevin Oxley in the Leven Unit w

ith staff nurse Leanne Letherland

16 THE BuSINESS MAGAzINE FoR HEALTH MANAGEMENT

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Crown Trade targets hospitals with Steracryl anti bacterial coatings

RoWN TRADE HAS launched

two new anti bacterial decorative coatings to help prevent the spread of ‘superbugs’ in healthcare facilities and at the same time deliver cost savings by significantly extending redecoration schedules. Proven to provide effective anti bacterial protection, Crown Trade Steracryl Anti Bacterial Scrubbable Matt and Durable Acrylic Eggshell are also formulated for maximum durability in heavily trafficked areas and will retain their ‘just painted’ appearance even when subjected to the intensive cleaning regimes demanded in hospitals, clinics and surgeries. Steracryl Anti Bacterial Scrubbable Matt and Durable Acrylic Eggshell both incorporate SteriTouch® antimicrobial additives that employ the natural sterilising properties of silver. These same silver ion additives are used extensively in healthcare environments to provide anti bacterial protection in mattresses, textiles, wall

cladding panels, bandages, surgical equipment, etc. All SteriTouch® additives have comprehensive approvals, including FDA and EFSA

for food contact and provide excellent levels of protection while remaining safe for even the most sensitive applications. The coatings have been independently tested using the internationally recognised JIS z 2801:2000/ISo 22196:2007 method. They also boast a Class 1 Scrub rating (tested according to ISo 11998). In addition, Crown Trade has undertaken its own rigorous field trials at various NHS facilities to test their durability, scrubbability and appearance retention. Both products have been proven to extend redecoration cycles, enabling health trusts to stretch their maintenance budgets further.


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imagination of many clinicians because they could see the potential to learn quickly, put things right straightaway and, most importantly, prevent errors and harm to patients. Sue said: “We were lucky enough to be one of the early implementer trusts in the country to take this methodology on board. Clinicians and managers in service areas review sets of notes and look at areas where we could have caused harm using a tool called the global trigger tool. It’s excellent for spotting where things have the potential to start going wrong and we’re already saving lives as a result of using it. “You know you’re getting somewhere when you can win over orthopaedic surgeons. The LIPS programme has done that; it’s turned people who might have previously shown a bit of cynicism to this type of approach into patient safety champions.”

BEING oPEN“one of the reasons I wanted to come to this organisation was its reputation for good clinical governance, including its being open policy. I believe we are a leader in this area and our patients can rest assured we will be open with them, regardless of the circumstances. For example when we had an equipment error in pathology which caused a number of false positive Clostridium Difficile results we informed every patient this had happened,” Sue said. “Culturally this is not the easiest thing to achieve but we work hard to set a the tone of incident and near miss reporting as well as being open rather than a name, shame and blame culture which might have made people less forthcoming in the past when things went wrong.”

TACKLING THE SPREAD oF INFECTIoN“We are relentless in tackling C. diff and MRSA and we are very open with

our commissioners when we have something to report,” Sue explained. “We’ve toughened up our hand hygiene assessment with the introduction of the new, more complex Lewisham assessment tool. Actually this caused a temporary dip in our compliance rates but it was worth it to raise the bar. “It says something about our staff that while we’ve had outbreaks of Norovirus, we’ve contained it well and had no spread of C. diff. This tells me our nursing, medical, allied health professional and support staff put the safety of the patient first and it makes me extremely proud. We’ve appointed an antimicrobial pharmacist who targets high risk areas and audits our antibiotic prescribing policy. “We’re now reporting our performance on other infections such as MSSA to the board because we’re not content to look only at the infections we’re monitored on. I’m particularly proud of our critical care team who have been using the Matching Michigan tool to reduce infections from central line catheters for critically ill patients. With total engagement right across medical and nursing staff in critical care we’re seeing major improvements.”

MoRTALITY RATESDiscovering you’re an outlier in mortality rates (the numbers of patients who die in your hospitals measured against the numbers of patients who would be expected to die) is a sobering thought for directors of nursing and patient safety and medical directors alike. Sue said: “The temptation is to blame the coding and not to lift every stone to make sure there’s nothing lurking underneath. “Working closely with the medical director I’ve looked at this area in detail. Because if the range of patient safety measures we’ve got in place; quality review panels, a wide range of measures

to help us tackle the spread of infection, LIPs reviews of patients’ notes, effective clinical governance and an open reporting culture we’ve seen our mortality rates improve dramatically. “Quite rightly the bar is being constantly raised. As every organisation improves we have to keep raising our game but that absolutely the right thing to do for patients and we’re up for the challenge.”

TEAM EFFoRTIt’s all a team effort and never more so in keeping the clinical areas clean and safe. Director of operations Kevin oxley and his team work closely with Sue and her team on all aspects of the clinical environment. Kevin said: “our design team has patient safety at the top of its agenda when refurbishing areas. They understand the importance of safety and cleanliness and design these features in, working and consulting with clinical staff. “Keeping it clean is as important as designing it clean. We’ve been fortunate in bringing in some innovative practice to help us stay at the top of our game. We’ve bought five hydrogen peroxide vapour machines, used in wards where we’ve been able to decant patients. We can leave beds and cupboards in place because the machines create a fog which permeates everything it touches. It’s proving very effective. The machines are run by a specialist team of ward hygienists. Their role is also to reach the parts that others don’t reach by giving all of our equipment and furniture a thorough inspection and clean.” Sue concluded: “You never reach the end with patient safety but we’re striving for perfection because good enough isn’t good enough for us. We’re always looking at what we do and how we could do it better. That’s the joy of the whole thing.”



PATIENT SAFETY

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market. Patient safety continues to be a key focus for the company and our new, safer packaging was designed with this in mind. The new livery (which has been commended by the National Patient Safety Agency) includes the following safety enhancements: • Clearer font style and larger font sizes• Market leading innovation – Tall Man lettering • Judicious use of colour to differentiate between product ranges and strengths• Clear dual strength expression for liquid presentations (I.u./ml and total dose) • High dose caution clearly displayed (where required)• Route of administration clearly displayed and

moved to pack front in prominent position• Safety enhancements duplicated on vial and ampoule labels• Minimal “corporate” brandingOur new, safer packaging is part of an

overall drive to improve patient safety. E.g. Tall Man lettering is being used to help product identification and differentiation, as evidenced on our cephalosporin product ranges (cefoTAXime, ceftRIAXone and cefTAzIDime). Tall Man lettering has now been adopted by the MHRA as standard practice for these types of products. Further products will be launched in the new and improved livery throughout 2010.


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ART IN HEALTHCARE PREMISES

IN REVIEWING “REWARDING Innovation in the Workplace” in January of this year we closed the article by noting that the Facilities Team at Wolverhampton City PCT included two arts coordinators, who were working on a job share and doing some very innovative work with what could best be described as “tired” premises. I promised then to take a deeper look into their work and the impact this has within healthcare premises. Subsequently the topic came up at a local professional meeting and there was so much interest I decided this warranted bringing the topic forward in my plan of facilities editorials for the magazine. Art in hospitals has long been one of those topics that it appears only lip service is paid to. over the years we have seen, often politically driven, small schemes to place art work (normally pictures) in hospitals to improve the patient environment. The problem is that the funding has only ever been short term and so the pictures become fixed and/or damaged and the impact is severely diminished and often the end result after several months is that they are removed as an eyesore.

ART PRoJECTSI had the privilege in the 1980s of being involved in two schemes to improve the patient environment by the use of art in a rather unusual way. While overseeing the maintenance of two local hospitals (one now closed and the other in the care of Wolverhampton City PCT) I was charged with recovering stained glass windows from two churches that were closing and installing them in the hospitals to make chapels for patient and visitor use. The first scheme was as one church was being converted into the then new Sainsbury’s store in the town centre. Just inside the ring road the site is still in use by Sainsbury with all the original window openings filled in with matching stone. The windows we retrieved (with support from Sainsbury’s if I remember correctly) were overhauled and resized by Maybury Brothers and then installed into the curtain walling of a reception room at the then two-year old Penn Hospital on the outskirts of the town. The transformation was amazing and the room very well used by patients, visitors and staff alike. The roll of colour into the room was superb and because of the internal glazing also spilled into the main entrance and corridor brightening those two rather utilitarian areas.

The second scheme was rather more challenging and sadly the building, and indeed whole site, is now in a massive state of disrepair having been dropped from the local health estate by The Royal Wolverhampton Hospitals NHS Trust. While not wishing to get into the whys and wherefores of the decision making process (and there is much local discontent) I really would love to know if they recovered the stains for onward use elsewhere. The Wolverhampton and Midland Counties Eye Infirmary sits on the western side of the city centre in the fork between two main roads as they diverge to their differing locations into Staffordshire. The infirmary was a well loved and respected service provider under the old Wolverhampton Area Health Authority when I worked there from 1979. Just towards the town centre from the infirmary St Marks Church was closed and being converted to offices for a large independent financial advisor who is still there today. We had the opportunity to retrieve some of the stained glass windows and again Maybury Brothers did a superb job of cleaning and refurbishing them ready for our use. A new twin theatre suite was being built behind the main infirmary building and once commissioned I had the unenviable task of overseeing the conversion of the old theatres, including very rusty metal balconies and floor to ceiling metal framed windows, into a chapel. our in house carpentry team built an alter rail and other furniture custom to the space and also frames for the stains which were installed with stripped, cleaned and painted metal framing. Just off the main corridor, the new chapel was well used by people of all faiths and as the sun tracked across the beautifully clear glass the colours flooded into the room and to say the least the end result was very pleasing – but I would say that wouldn’t I? I only wish I could find the photos and get them scanned to include here but sadly I cannot.

PoSITIVE IMPACTSo my own personal involvement in these schemes has engrained in me the firm belief that appropriately used art of all kinds can and does have a very positive impact on the “patient environment” as we now call it. The provision of chapels and chaplains is an ongoing debate in healthcare but because of my involvement in local churches these two schemes were of great personal interest

and granted me the greatest job satisfaction. However, this only addresses one area of art and it has been thrilling to see and hear of how art is again being used in my home locality for the benefit of patients and their families. Before taking in some of the more recent schemes in the local area there is some guidance and encouragement in the use of art in healthcare premises and this is worth a look. The King’s Fund has been running a programme entitled “Enhancing the Healing Environment” and between 2003 and 2005 some 23 schemes were undertaken and they are reviewed in a very informative document jointly published in 2006 by King’s Fund and DH1. A series of roadshows were run around the country at the time to propagate the best practice derived from these schemes and some of the outcomes included guidance on colour choices for therapeutic benefit and art involvement for certain classes of patient. At about the same time a report was produced by DH and published in 20072. This report talks about how art in its various forms can positively contribute to key objectives relating to healthcare provision and health improvement. However, it also points out that although there was much being done, a great deal of innovation being shown and some high quality documents and information available through the web, this was not generally well know, publicised or made use of. With my own passion already declared I find it interesting to note that the report states:“When they (the materials and information) are (known about), they save time and effort and provide sound examples for others to use. Many have commented that they were most inspired and convinced of the need and possibilities by seeing live examples, either within their own organisation or elsewhere.”3

AWARDING EXCELLENCEWithin the Healthcare Facilities Consortium we have long been supporters and propagators of best practice within the facilities arena, effecting this through our workshops, day and conference events and our long established Benchmarking Club. This year as part of our drive to encourage innovation in the healthcare facilities arena we are sponsoring a new award in conjunction with Health Business – The Innovation in Facilities Management Award. No doubt more of this later but it is very interesting to note that the report makes the following recommendation:

Keith Sammonds, managing director of the Healthcare Facilities Consortium, explores some of the guidance and takes a look at what can be done to improve the patient experience through innovative use of art


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“The Department should establish a national award to promote the use of arts and health.” With all this in my mind I spotted the shortlists for the HefmA Awards being made later this week4 and noted that it included the very people that had started my ears twitching in late 2009 when I met with their managers to review the impact that winning awards had on the Facilities Team; the arts coordinators, Natalie Jones and Ruth Harvey-Regan at Wolverhampton City PCT. I already had an interview booked with one of them to go through some of their achievements and aspirations. one particular project that caught my eye was: ‘Snow Hill’ Sexual Health Clinic Refurbishment – Creating a brand identity for Wolverhampton Sexual Health Services. Knowing the building that was being used I knew that this was going to have been a real challenge and it is fascinating to see what has been achieved, but of course that is going to be very difficult to convey in an article like this. Particular points of interest are in the community involvement. Natalie Jones, one of the arts coordinators, told me: “A series of creative consultation sessions with a graphic design company and PCT Consultant in Public Health Medicine enabled young people to participate in developing the ‘Think’ brand. They wanted to create graphic icons to represent each key sexual health service to make it easier to identify what services are available and where. Young people from across the city played a key role in the refurbishment of the Snow Hill Sexual Health clinic alongside creating a brand identity for Wolverhampton Sexual Health Services.” A multi-agency partnership approach resulted in young people taking ownership of the project from the start and through extensive consultation with different stakeholder groups

a youthful new brand identity was created. The brand name ‘Think’ was selected by the Youth Council from shortlisted options. The brand identity aimed to increase awareness of sexual health issues and increase access to NHS services available across the city and bring clarity to what is available and where. For me, apart from the brand which now emblazons the front of the building, one of the most striking features is the transformation of what I know to have been a dire corridor which was known by staff as “the walk of death”. This has been transformed with the use of light boxes on the walls containing landscape photography created by students Jon Crump and Mairi Turner from the photography department of Wolverhampton university. This gives the impression of windows in the wall and has made the long, narrow corridor bright and airy and far less depressing for staff and those who have to use it on the way to life changing consultations. Away from this particular project the same principles have been applied to the refurbishment of various clinics and health centres showing a marked improvement in the premises. A partnership has been developed with Wolverhampton Arts and Heritage Service to enable the loan of museum objects from their local history collections to Penn Hospital for display in the main reception. The objects have been chosen by the Clinical Lead for occupational Therapy for over 65’s. The museum objects will provide a stimulus for conversations in relation to reminiscence work with dementia patients, an example being a display on our local football club, Wolverhampton Wanderers – still in the Premiership. The project included a session at Wolverhampton Art Gallery led by a specialist Art Interpreter, an experienced member of the education team who helped a group of elderly adult inpatients from Penn Hospital to further

explore the museums local history collection to encourage communication and sharing of memories – it also provided a day out in a safe environment for everyone involved.

IMPRoVING BuILDINGSIn late 2008 I wrote a Focus on Facilities Management5 and cited our local GP as an example of the future of healthcare premises. They were moving from a converted detached house into a purpose built medical centre and this has been very well received by their patients and the local community. Just after I took the photograph we used in volume 9.1 a piece of sculpture appeared on the walls of the new building and this to me is a shining example of how art can be used on the external of buildings to improve the impact the buildings have and also shows how the local community can be actively involved in such projects. The development project was managed by Primary Asset, part of the MedicX group. An interesting aspect of the project was that as part of the planning requirements MedicX was asked to provide a piece of community art. MedicX commissioned experienced community artists, Karl Lewis and Sam Hale of Bostin Arts to develop the artwork with the Community. The building is located on Windmill Lane and consequently Sam & Karl identified a broad theme of ‘...on a windy day’ as this provided a wide but interesting concept to develop ideas for the artwork. An initial art workshop was held with the pupils in Years 2 & 6 at Castlecroft Primary School, which is very close to the medical centre. Working with a variety of shapes, objects and books, and using a fan to simulate the wind, the children developed lots of exciting ideas. Drawing them on acetate these were projected onto an image of the building to discuss size and scale. Cutting out shapes and images in metallic plastic generated



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discussion about the different materials that could be used and how these would look on the completed building. Sam & Karl spent a long time considering the ideas generated by the school workshop and then from the images generated by the pupils developed seven designs for further consultation. The seven ideas were presented and displayed at the old surgery waiting room, shown to patients and favourites were picked. The dandelion image was very popular, a familiar refrain was ‘However old you are it’s magical to see a dandelion lose its seeds and then watch them blow...’ A further workshop was held at the Windmill Community Centre with the over 50’s group showcasing the seven designs and again the dandelion emerged as the most popular. Following the workshops, the Castlecroft Doctors, Primary MedicX and the Architects West Hart considered the designs and after much discussion selected the dandelion which was then manufactured and erected on the building by Rowley Engineering of Stafford. The artwork has generated lots of local interest with requests for information at the practice from proud grandparents of children who influenced the design. Craig

Lord, development manager at MedicX, commented: “MedicX are very proud to have been part of a project which has enabled the local community to be involved with creating such a tangible and exciting outcome. Not only has everyone come together to provide such a fantastic piece of work, but it will be able to be seen for many years to come and give enjoyment to the local residents.”6

Sadly for me the senior partner at the practice declined to offer any view on this exciting piece of art on his own place of work. In closing Natalie told me about a creative health education project that they have been running in conjunction with a number of local schools. The interesting thing about this project is that along with promoting exercise and healthy eating in line with the PCT strategic goals, it is also aligned to the “Eat 5 a day” national campaign for healthy eating and so is not just about the “look” of the facilities. Working within the schools the arts co-ordinators discovered that the children sometimes lacked enthusiasm for exercise, didn’t eat breakfast or had little understanding of what a portion of fruit really was. A grape for example was one answer. In helping the children’s understanding about

this a series of fruit people were developed, with the children’s involvement, which showed how a handful of a fruit made up a portion. The resulting health promotion artwork has been displayed in the local health centres alongside other improvement works resulting on a much brighter and more welcoming environment. one spin off is that the art work displays draw people into the health centres so that they are now more familiar with the premises and so are more willing to attend when they have medical needs. Art and Health in action: I love it!

Notes1. “improving the patient experience: celebrating achievement: enhancing the healing environment programme 2003–2005” executive summary available from the dh website under reference 4127234.2. report of the review of arts and health working group. available from the dh web site under reference 0735893. page 6 – section 8 of the above report4. hefma awards: thursday 27th may 20105. health business volume 9.16. thanks to the team at MedicX for their input to this article




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GETTING IT RIGHT

oNCE uPoN A TIME, THE CHoICE in business travel by car was simple, if a little stark: employees who needed to travel a lot had company cars; everyone else with a low travel demand used public transport or their own cars against a mileage payment. That all started to change in the mid-seventies, when the “perk” car market exploded, exactly because of taxation, economic policies and employment pressures. Sound familiar? In recent years what used to be called “the fleet market” has changed dramatically. There has never been so much choice, with so many schemes claiming market superiority as well as specific advantages in overall costs/driver tax burdens etc. The fact is that many of these schemes do represent an optimum solution to particular sets of circumstances – but it is clear that many are sold on the basis of the wrapping, with no clear understanding of how and why they should be producing a result. Sadly, it is true that some of these schemes are designed to exploit fleet operator lack of knowledge about the realities of the market place and the tax system.

uNDERSTAND YouR AIMS It is vital that employers have a clear idea what “the fleet” is for. Depending on circumstances for the business this can be anything from 100 per cent business use to 100 per cent private/perk use – or anything in between. So it is clearly necessary to understand what the actual need is, and build the policy and delivery to meet the need optimally. It is always worth remembering that the fleet must serve the business – not the other way round!

In looking at the need it is vital to collect accurate data about the current situation and assess that against what should be happening. When looking at any new scheme based, for example, on exploitation of the HMRC tax-free mileage reimbursement rates (AMAPs), there is an obvious need to have a clear picture of what business mileage levels are being

claimed – and why. It is pointless looking at a scheme that assumes a cost benefit for average mileage levels of 8,500 business miles pa if your fleet is only averaging 5,000 pa. Similarly the assessment of carbon reduction opportunities must be based on what employees might select under the allocation policy. It is important to recognise the value of low fuel consumption as a cost and tax reduction support, but there needs to be a mechanism to get people into these models – difficult if the

choice list makes it easy and attractive to drive a larger model with relatively poor consumption. A major issue is the fact that most employers do not have an experienced “fleet manager” any more. The job is often a part-time role with the “technical stuff” handled under an outsourced arrangement with a leasing/ contract hire company. But given the complexity

Stewart Whyte, director & membership secretary of ACFO, stresses the importance of strategy and tactics for business travel


FLEET MANAGEMENT


It is always worth remembering that the fleet must serve the business – not the other way round!

A New Era inSecurity and SafetyManagement

SECI 20T E N

International IP Solutions Exhibition & Conference

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Demonstrating security andsafety technology· Surveillance & CCTV· Access Control, Time & Attendance· Biometric & Video Analytics· Intruder Detection & Alarms· Fire Detection & Evacuation· Integrated Safety Solutions· Audio, Intercom & Messaging· Transmission & Comms Systems· Building Management Systems

Your security requirementstraditionally fall into 4 areas -Physical Security, CCTV, AccessControl, and Intruder Alarmsmost of which have eithermigrated from analogue todigital technology, or are in theprocess of doing so. Digitalsystems are increasingly beingrun over networks using IP(internet protocol). The benefitsare self-evident with furtherintegration of audio, intercomand messaging, fire andevacuation, asset managementand tracking and transmissionand comms technologies.

But the world is changing, andIT and Network professionals are becoming more involved, with growingresponsibility for both Physical and Logical security within an organisation,particularly with intelligent building management and facilities solutions alsobeginning to converge.

This shift will change the way we protect and manage all of ourorganisations, properties and people in future and will introduce bothopportunities and challenges for those responsible for security and safety.It's time to embrace and investigate this migration, and to identify how bestthey can be exploited.

In a recent survey of IT, ICT and Network managers, 80% of respondentsagreed that physical security was increasingly becoming part of their remitand that engaging with security and safety professionals was key.Convergence Key to EfficiencyWe are all acutely aware of the continued convergence between the physicalsecurity, life safety and IT worlds. We also understand that for NetworkedSecurity and Safety Applications to become more effective it is essential thatwe learn to engage with both the security specialists and the IT industry as awhole and the IP players in particular.

Preparing for the FutureHelping to increase the awareness and acceptance of new IP basedapplications across many market areas, the IIPSEC exhibition and conferencenow located at the IP EXPO will ensure that you gain from the synergiesbetween the various technologies on display and will provide a firm basisupon which Stake-Holders, Security and Safety Professionals and IT andNetwork Technologists can discover the opportunities that lie withinmutually accessible solutions.

Where to learn moreIIPSEC at the IP EXPO will demonstrate real life solutions and allow securityspecialists to engage with IT and network professionals for the first time. Thecombination of the product showcase, technical and practical seminars andworkshops and presentations tailored specifically to your needs will result inan informative and enlightening participation.

IIPSEC has always concentrated on the application of technology within theSecurity, Life Safety and BMS environments, whereas the IP EXPO isdedicated to the underlying technology itself, covering Cloud computing,Virtualisation, Infrastructure and Wireless and Storage solutions. This is aunique combination of events where Security, Safety, IT and NetworkProfessionals can mingle and understand the commercial and practicalpossibilities available when working together to increase security and safety.

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Security – who’s job is itanyway?

Halfpage-Vert-July 10/6/10 2:20 PM Page 1

and range of choice in the market, it is still important that someone in the organisation has an external point of reference.

ACFo’S RoLEACFo (formerly the Association of Car Fleet operators) has, since the 1970’s, provided a clear, unbiased forum for “fleet mangers” to come together to network and exchange ideas and techniques. Membership is open to any organisation with a “fleet” interest although nowadays many members deploy alternative schemes like ECoS (Employee Car ownership Scheme), cash allowance or mixed strategies. Regional meetings provide a friendly and non-threatening environment for delegates to mix and mingle, talk or just listen to the industry buzz. It sounds very mundane – but in reality the quantity and quality of information exchanged freely is very high. The natural flow of information is from the people representing the larger fleets down to those with small fleets – but it’s not all one-way! Many innovations and techniques have come from enthusiastic fleet managers with just a handful of cars and/or vans. Currently the three key topics across the fleet market remain:• Control of the fleet budget• Green fleet agenda• Duty of Care/road safetyone of the characteristics of fleet is the diversity, with every fleet operator looking at different priorities. Cost control is a long-term and on-going issue for all fleets: other factors tend to come and go depending on the national environment. So there are no specific quick fixes for these: the priority needs to be set depending on where on the scale the fleet is currently. And that of course needs an awareness of how the fleet performs in absolute terms and against similar fleets with similar patterns. A significant part of the debate includes ways to collect and use operational data to help gain better control of the whole “fleet” envelope. ACFo members know only too well the old adage “You can only manage what you measure”. Clarifying the really useful statistics has already helped many operators to cut costs and more recently, fuel use (therefore the carbon dioxide output) and accident rates. ACFo has a huge body of expertise across its membership of all these areas and indeed many member fleets have been used as Best Practice case studies in Green Fleet and Road Safety studies. All of this information is accessible by members both on meetings and online at our website (www.acfo.org).

ASPECTS oF FLEET MANAGEMENTSo much for the “advert” for ACFo membership. What readers should be considering is their ability to manage all the various aspects of “fleet management” to the right degree. This has to be much more than outsourcing the daily fleet management

to a leasing company: control of all the policy aspects needs to stay as an in-house responsibility, as does the whole business of “managing on-road risk”. Buying in some driver training might appear to put a tick in the box for “Duty of Care” – but is it enough? Increasingly, traffic police investigations of serious and/or fatal road traffic collisions asks about the purpose of the journey – and if it was a business journey then they are likely to follow through with an investigation into the employer’s policies and practices. In addition to any criminal investigation – which will of course include the top management itself – the effects of the no win no fee legal system means that employers face ever-increasing risks of claims from injured 3rd parties (or their survivors) on the basis that pursuing an employer is always likely to be more productive than chasing the driver. Retaining ownership of the policy also helps to clarify when it is time to

change the fleet organisation. Business patterns change. Tax rules and allowance thresholds change. New car models change and evolve. Employee expectations change – and budgets get severely challenged. In short, this is a fast-moving environment and what was the ideal policy four years ago may be wide off the mark in your fleet, today. ACFo tries to support members in several very practical ways. Internally we collect and publish Best Practice guides in specific areas of fleet management. our latest Guide was developed specifically to support public sector employers in how (and when) to carry out checks of drivers’ documentation. Health & Safety regulations make it pretty clear that “if an employer commissions a journey on the public roads, the employer carries the Duty of Care” – irrespective of the ownership of the vehicle being used. We have templates for Driver Handbooks and Driving at Work Policies, all based on very practical information from within the membership. Across the nine ACFo regions covering the uK, there are at least four meetings each year, with presentations and displays of the latest models, devices and regulations. These may cover tyre performance, new engine/ drive trains/fleet software or new tax rules. Nationally ACFo works with several government departments and agencies to ensure that the needs of “fleet operators” are properly represented when new rules and legislation is being framed. our input, covering the whole spread of public/ private

and charity sectors/large and small fleets and range of operating circumstances has been very valuable in protecting employers from excessive administration and red tape; and drivers from clumsy taxation layers.

FIT FoR PuRPoSEIt is pretty fundamental that the vehicles in use are actually capable of meeting the expectations of clients, employees and the fleet budget. “Free choice” for user-choosers may be a good system in some car fleets – but certainly not in all. In the van market, fitness for purpose is even more important, with payload weight and volume much more important than driver preferences. Again, the Duty of Care issue is an important consideration. Given the size of some member fleets, there are usually several members who have some experience of just about every make and model on the market – and can offer

an opinion tempered by direct knowledge. In the same way, new systems coming to the market have been tested by several prominent members, who can advise on the specific circumstances where any new scheme might – or might not – work well. one current consideration across all ACFo regions is the debate about “Salary Sacrifice” schemes which seek to optimise fleet costs and provide softer employee benefits. In some ways this tends to reverse the “get rid of company cars” philosophy which was prevalent just a couple of years ago. By examining the current market, the types of models on offer and employee travel patterns, such schemes evolve to optimise the overall fleet/business travel market. The next new thing might not be suggested by a current supplier – if they don’t yet offer such a deal! That is why it is absolutely essential for the business to retain some level of contact with and even expertise in the fleet market – to provide a counterbalance to even the best suppliers in terms of what’s best and when to change. Joining ACFo is easy. We are a single-tier organisation with a single membership subscription (currently just £170 + VAT pa. That’s probably less than one month’s rental of one of the smallest models on any fleet!) ACFo membership provides free access to the meetings, to a wealth of information and advice on www.acfo.org, and a weekly e-mail NewsFeed delivered direct to the named delegate’s mailbox.



Given the size of some member fleets, there are usually several members who have some experience of just about every make and model on the market – and can offer an opinion tempered by direct knowledge

FLEET MANAGEMENT

[ Neurofunction: Curiosity ]

ADAS and HealthSystems have joined forces to combine both environmental and health care expertise to deliver a unique set of practical solutions to the Health market in improved Carbon and Resource Management – Policy into Action. Still curious? Find out how you can lower both your costs and also your Carbon Footprint bycontacting ADAS.

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ADAS_HB_AD3.pdf 1 01/04/2010 15:35


CRC AND THE HEALTHCARE SECToR

THE uK HAS MADE A CoMMITMENT to reduce greenhouse gas emissions by at least 80 per cent from 1990 levels by 2050. This is a tough target will require significant changes in the way businesses and the public sector operate. The CRC Energy Efficiency Scheme is a new energy saving and carbon reduction scheme designed by the government to help reach this target. It could reduce carbon dioxide (Co2) emissions by up to 11.6 million tonnes per year by 2020 – the equivalent to taking roughly four million cars off the road. The scheme is also expected to save organisations money through reduced energy bills – benefiting the economy by more than £1billion a year by 2020, making it a valuable business opportunity. The CRC scheme will impact all large healthcare providers, both public and private. Most hospitals, including NHS trusts, will need to adhere to CRC, along with other organisations such as larger groups of nursing homes. From 1 April, large private and public sector organisations that had a half hourly meter during 2008 must register under the scheme. Around 20,000 organisations need to register for the scheme with the Environment Agency before 30 September 2010. of these, about 5,000 will qualify as full participants in the scheme (see below). Healthcare was one of the key sectors that were affected by the CRC Energy Efficiency Scheme when it started in April. The uK healthcare sector spends about £450 million annually on energy bills. While only large organisations will be caught by the CRC, both large and small healthcare organisations could save significant amounts of money through simple energy saving measures and put the savings into frontline services. For example, the average doctor’s surgery could save up to 20 per cent on its bills by taking simple steps such as turning down lighting and improving heating efficiency.

WHo quALIFIES FoR THE SCHEME?The threshold to qualify for the scheme is determined by 2008 electricity consumption: if your organisation had a half-hourly electricity meter and consumed at least 6,000 mega-watt-hours of electricity through all of its meters during 2008 (equivalent to an electricity bill of around £500,000), then you will need to

participate in the scheme by monitoring energy consumption and purchasing allowances. However, if your organisation has a half-hourly meter and you consumed less than this amount of electricity you will be an Information Declarer. This means that all you will need to do is identify your half-hourly meters and you will not have to purchase allowances. Whilst the Environment Agency’s aim is not to prosecute organisations, we do have the power to impose serious penalties for eligible organisations that do not register with CRC by the end of the registration period.

uNDERSTANDING CRCIt’s important to understand how CRC will affect your organisation. You will need to decide who will be responsible for the

ongoing data collection and CRC reporting. In most organisations, the day-to-day CRC management basis would be dealt with by an energy or facilities manager. You will also need to make sure all the preparation has been made so that the right data is collected. under CRC, you will need to report all of your emissions in the first year. After that, you will need to monitor your fuel and energy use as well as reporting your CRC emissions to the Environment Agency at the end of each compliance year. Participants successful in reducing energy consumption will not only save money on energy bills. They will also receive financial and reputational incentives. These savings should be well in excess of the costs of participating in the scheme.

REDuCING ENERGY uSEThere are many steps organisations can take to cut energy use. Simple actions such as turning off lights and unnecessary equipment are important, but there are

also more significant changes that can be made to cut energy use on a larger scale. It’s important to look at where most of your organisation’s energy is used. For example, heating and hot water can account for up to 60 per cent of your organisation’s total energy costs, while lighting can account for around 25 per cent of electricity use. However, steps can be made to make heating and lighting more energy efficient. It can be simple things such as ensuring that buildings are not overheated or heated when not in use, as well as bigger investments such as installing more efficient boilers. You can also explore energy efficiency technologies such as voltage optimisation, which moderates electricity use. other measures to improve energy efficiency

include adequate insulation, motion sensored lighting and de-stratification fans, which circulate the air in rooms with tall ceilings to prevent the warm air at ceiling level going to waste. While some improvements may require significant upfront costs, in the long term these costs will be outweighed by substantial reductions in energy bills.

LEADING BY EXAMPLEA number of healthcare providers are already leading the way in reducing carbon emissions and improving environmental performance. With many healthcare providers across the uK, especially NHS trusts, occupying large and old leaky buildings, improving energy efficiency is reaping significant financial rewards and improving patient comfort. Guy’s and St Thomas’ NHS Foundation Trust is one such example. Guy’s and St Thomas’ is one of the first trusts in London to produce its own electricity and heat to power the hospitals – saving the equivalent carbon dioxide of around 17,000 passengers flying to New York and

Tony Grayling, head of Climate Change & Sustainability at the Environment Agency, explains why the new CRC Energy Efficiency Scheme must be embraced by both the public and private healthcare providers


While only large organisations will be caught by the CRC, both large and small healthcare organisations could save significant amounts of money through simple energy saving measures and put the savings into frontline services

ENERGY

The Key Steps To CRC Success

To find out how we can help you:

Call Inenco on 01253 785000

or visit our website www.inenco.com

With the first full compliance year of the CRC well underway, we’re approaching the halfway point of the registration period.

You may still be working through the complexities of subsidiaries, SGUs and exemptions, but now is the time for action. You should also be looking at how you can get the best ranking on the early action metrics.

Inenco is already helping customers to ensure that they are compliant, to optimise their league table position and to get the long term benefits of becoming a low carbon organisation.

understanding energy

enough energy to power Newcastle for a week. The Trust uses two gas engines to drive alternators that produce enough electricity to meet a half its electricity requirements. The waste heat generated by this process, in the form of steam and hot water, is collected and used for the Trust’s heating, including space heating and hot water around the hospital. Because the units are located within the hospital grounds it is also very efficient as virtually no electricity is lost during transmission. overall the units will reduce Co2 emissions produced by the Trust by almost 11,300 tonnes per year. It will also save the Trust more than £1.5 million in energy costs annually – one of the largest savings from a combined heat and power for an NHS Trust.

HoW THE SCHEME WoRKSThe CRC Energy Efficiency Scheme will be phased in over three years. once fully operational, CRC Participants (not

Information Declarers) will be required to monitor their emissions and purchase allowances for each tonne of Co2 they emit at the beginning of each reporting year. The scheme is revenue neutral overall meaning all revenue raised from selling allowances is re-distributed back to Participants according to their position in the annual Performance

League Table. As a consequence, reducing carbon emissions means Participants will save money on their energy bill, will purchase fewer allowances and receive greater financial reward through revenue recycling. Participants that perform well will also be placed higher in the Performance League Table, which will be published annually by the Environment Agency. In an age of eco-conscious public, being higher up the league table will have the added benefit of enhancing the organisation’s reputation.

TAKE ACTIoN NoWIf you believe your organisation is likely to fall under the CRC Energy Efficiency Scheme, the first step you need to take is to identify your highest parent organisation, as that’s the body responsible for registering for CRC on behalf of the entire organisation. Before registering, determine if your organisation qualifies for CRC as a Participant

or Information Declarer. This will require taking account of all half hourly meters in your organisation and their total electricity consumption for the calendar year 2008. once you know if you are a Participant or Information Declarer, you will need the following information to register for the scheme: your registration address, the names

of senior officers and contact details along with the half-hourly meters your organisation has and those meters’ electricity consumption. Making sure this information is easily available and getting all the data in order beforehand will make registration simpler and quicker.

PuBLIC AND PRIVATE SECToRSWhen it comes to reducing our emissions, we are all in this together. Many public bodies are setting the right example for the corporate sector in cutting emissions. However, it is possible that poor public sector performers will take out less than they put in, while good corporate performers will get a financial bonus. But it also works the other way round. If a public sector organisation performs well, it could get an extra financial boost. our own research shows that the public sector has the potential to cut its energy use by a fifth at no overall cost, so there is no reason why this sector should not do well out of the CRC. organisations like hospitals and local authorities that get smarter with their energy can divert money wasted on energy bills into front line services. organisations housed in old buildings stand to benefit as much, if not more, from the CRC Energy Efficiency Scheme than those in newer buildings. This is because there are many small and cost effective steps that these organisations can take to improve the energy efficiency of older buildings and reduce carbon emissions. These simple steps will save money on energy bills. These savings are expected to be well in excess of the costs of participating in the scheme, freeing up capital to be used elsewhere in the organisation. We all – including the public sector – have a part to play in cutting dangerous greenhouse gas emissions. The government



HE ENERGY INSTITuTE (EI) is the leading chartered professional membership

body for the international energy industry, with over 14,000 individual members and 350 companies in over 100 countries. The EI provides a home to all those working with energy, and a scientific and technical reservoir of knowledge for industry. We serve our members by acting as a source of knowledge, training and networking, as well as offering a variety of professional recognition opportunities. Affiliate membership is the “fast track” route to membership benefits including:• Free magazine subscription to Energy World or Petroleum Review, keeping you up to date with industry news and developments

• Professional recognition and career development opportunities, offering higher levels of membership, the new and exclusive Chartered Energy Manager title, Chartered Engineer, Chartered Environmentalist and Chartered Scientist registration, and more• Discounts on journals, publications, events, training courses, seminars, conferences and workshops

• Free access to the EI Library and Information Service, offering a huge resource of knowledge, information and research• Exclusive information from the “members only” section of our website• Unrivalled peer networking opportunities

through a series of free of charge events, including member workshops, evening lectures and branch events.


Contact: Simon PriceTel: +44 (0)20 7467 7146E-mail: [email protected]: www.energyinst.org

T

Energy Institute – energy professionals

Participants successful in reducing energy consumption will not only save money on energy bills. They will also receive financial and reputational incentives. These savings should be well in excess of the costs of participating in the scheme

ENERGY

can’t have one rule for businesses and another for its own operations.

TIME To TAKE CHARGE The CRC Energy Efficiency Scheme gives financial and reputation incentives to businesses and public sector organisations to reduce their Co2 emission. However, the real opportunity lies in the financial savings to be made by improving energy efficiency. organisations have the choice between viewing CRC as a benefit or a cost. CRC can be a cost on poor energy management or a financial incentive for low carbon leadership. The Environment Agency hopes other organisations will follow our lead and embrace their role in helping to fight climate change.

PRoCESS HEATING AND DRYING About 40 per cent of the energy used in uK industry goes on process heating and drying. Cutting the energy costs of process heating is often a great way for a company to save money. up to 10 per cent of this energy could be saved using straightforward techniques. • Heat recovery: Re-using heat from a process makes financial sense • Insulation: Insulate all steam pipework (including valves and flanges), as well as all hot-water and hot-oil systems. Effective insulation can cut energy costs by up to 5 per cent.

• Boilers: A well-maintained boiler is far cheaper to run. So, closely monitor your boiler’s combustion efficiency and schedule regular maintenance work.

HEATING AND HoT WATERHeating and hot water can account for 60 per cent of your total energy costs. And because it’s possible to reduce your heating costs by up to a third, the potential savings are substantial.• Install boiler sequencing controls: If you have a number of boilers on your site, a boiler sequence control that fires the minimum number of boilers at the same time will save energy• Replace inefficient boilers: Higher efficiency boilers gain better energy savings• Install de-stratification fans: In commercial or industrial buildings with warm air heaters and high ceilings, de-stratification fans can reduce energy use by 20 per cent by blowing warm air down to ground level where it’s needed.

LIGHTINGon average, 25 per cent of an organisation’s electricity costs come from lighting. Yet you can cut these costs by up to a third while reducing your carbon footprint and improving the working environment for your staff. Switch lights off in empty rooms. You could cut your lighting costs by as much as 15 per cent just by making sure you turn off lights in areas that aren’t being used.

• Use energy efficient lamps: If you have fluorescent tube lighting, changing from T12 tubes to T8s will bring energy savings of 10 per cent. upgrading lamps and fittings to T5 will bring even greater savings and will retain a high light output. This short video explains how to replace T12 tubes• Install occupancy sensors: Why light empty spaces? occupancy sensors, which switch off lights when a space isn’t being used, can reduce lighting costs by 30 per cent• Install daylight sensors: Lighting a space artificially when daylight is already doing the job is a waste of energy. Light sensors (photocells) can switch off or dim artificial lighting when there is sufficient daylight.


For more information about the CRC Energy Efficiency Scheme and to download the CRC Registration Guidance visit www.environment-agency.gov.uk/crc.

For assistance or queries about the scheme contact the CRC dedicated helpdesk at [email protected]. You can make an action plan for reducing your organisation’s energy use on the Carbon Trust website: www.carbontrust.co.uk



ENERGY

Power Efficient Systems: saving energy for others

oWER EFFICIENT Systems Ltd (PES), is one

of the leading manufacturers and suppliers of energy saving systems for industrial and commercial clients within the uK. our approach to energy reduction at a plant’s main supply using a number of proven technologies combined is quite unique within the uK and is proving to be a solid and cost effective route to reduce energy costs and carbon emissions in an ever increasing energy conscious environment. With the main emphasis on Power Factor Correction and the EnergyAce Power Reduction System, we are continuing to deliver impressive results on energy reduction for many of our new and existing clients within all industrial and commercial sectors in the uK and overseas. our products and services in association with the Carbon

Trust, Envirolink, Regional Energy Forums and many other energy saving organisations are designed to reduce energy costs, improve utilisation of switchgear and reduce carbon emissions in line with the latest CRC legislations (Carbon Reduction Commitment).


To benefit from our energy saving products and services, visit www.pesgroupltd.co.uk, contact us on 01695 559785 or e-mail [email protected]

P

Saving you money on your energy bills

EDuCE YouR energy bills

now with our energy surveys and tailor-made energy saving jackets and mats. By using our energy saving products you can protect your building from heat loss as they are highly resistant to thermal transmissions withstanding temperatures up to 1,200 degrees C. The energy saving jackets are oil resistant and waterproof and have a hook and loop velcro fastening for easy application and removal for inspection and maintenance. For external uses the insulation jackets protect your valves and flanges against adverse weather conditions and spillages, and ultimately provide a prolonged life cycle on adjacent motors and other temperature sensitive equipment making them efficient, and also reducing your energy

consumption. We have a team of qualified and experienced engineers who can visit your premises to carry out an on-site energy survey and calculate your potential energy and

carbon emission savings. Following the initial survey we can provide the services of our qualified engineers to install our made to measure energy saving jackets and energy saving mats which are designed and manufactured by our skilled team of workers at our Nottingham based factory. our clients based throughout the uK and in Europe include hospitals, MoD, local authorities, power stations and bakeries.


Tel: 0800 0937810 Fax: 0115 9700862 E–mail: [email protected] Web: www.cordtape.co.uk

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With our cost-effective Energy Surveys and thermal insulating Energy Saving Jackets

Designed for valves, flanges, boilers, generators and other temperature sensitive equipment our energy saving jackets:

• Are highly resistant to thermal transactions• Provide minimal heat loss from your building’s pipe work • Can withstand temperatures of up to 1200°C• Protect external valves and flanges against frost protection• Are quick to unfasten with a velcro and cord fastener

We have an experienced team of engineers who can visit your site to carry out an energy survey and calculate your potential carbon emission savings.

With projects completed for many plant rooms throughout the UK our clients include hospitals, universities, local authorities, the Ministry of Defence and many other blue chip organisations.

Call us on 0115 978 0554, or email [email protected] to find out how much we can help you save on your next energy bill.

Cordtape Energy Management Systems Ltdwww.cordtape.co.uk

Reduce your energy bills



ENERGY


CuTTING LoNDoN’S ENERGY EMISSIoNS

LoNDoN PRoDuCES oVER 40 MILLIoN tonnes of carbon dioxide every year – adding to the threat posed by climate change, bringing with it the promise of more extreme weather events such as flooding, drought and overheating. The London Development Agency is leading programmes that will cut carbon dioxide emissions from London’s buildings, which are responsible for almost four out of every five tons of its Co2 emissions1. our RE:NEW scheme to retrofit homes to cut their carbon emissions and save on their energy bills has been developed with London’s boroughs and could reach up to 1.2 million homes by 2015. This scheme uses a delivery model that enables local authorities to install energy efficiency measures in homes and to lever in additional funding. our RE:FIT scheme introduces energy efficiency measures into London’s large stock of public sector buildings – creating a cost neutral means of reducing energy bills and the carbon footprint of buildings. Both these schemes have been designed

in partnership with London’s boroughs and other partners and are being rolled out ‘at scale’ across the capital.

RE:NEWWhile there is already a lot of work going on in London to improve the energy efficiency of homes, it is frequently confusing for customers, not cost effective and not scalable enough to reach the ambitious reduction targets. In partnership with the Greater London Authority (GLA), London Councils, the Energy Saving Trust, Waterwise and the 33 London Boroughs, the LDA has developed and is rolling out a programme to retrofit energy and water efficiency measures in London’s homes. RE:NEW takes an area-based, whole house approach that covers all types of housing tenures and has something to offer every household. It includes offering a range of free-of-charge, easy-to-do measures, from changing to low energy light bulbs to installing stand-by switches and giving energy saving advice. Water-saving measures

such as aerated showerheads and advice on climate change adaptation are also offered, which ensures it is a holistic service. It also provides more substantial steps such as loft and cavity wall insulation – free for those on qualifying benefits and subsidised for those able to pay. In the future, with the development of new financing mechanisms such as Pay As You Save, solid wall insulation and micro-renewables will be offered to the householders at no upfront cost. RE:NEW works by levering in additional funding to pay for the measures such as Carbon Emission Reduction Target (CERT) funding from energy companies and Warm Front funding from central government. A typical London borough delivering RE:NEW to 6,000 homes over two years could attract a further £1 million, save 4,200 tonnes of Co2 and reduce fuel poverty. The results so far from our trials and demonstration projects are encouraging. over 800 homes received improvements through our technical trials, saving around 600 tonnes

The London Development Agency wants to reduce London’s dependence on fossil fuels, cut the waste generated in London and help reach the Mayor of London’s target to reduce carbon dioxide emissions in London by 60 per cent – or 18 million tonnes – by 2025

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Get us on board and we will help you to• Minimise waste• Use less and spend less• Target and Track exceptions• Set up action plans to stop nasty surprises• Provide all your utility services for smaller sitesWe specialise in providing energy wastage tracking. We can advise your organisation in making better use of building services. Better use will result in getting more for less waste. Our skills and knowledge will help you to focus on the systems that are wasting your resources and creating an environmental impact that is too high. Remote metering/ bureau services can be provided with no capital cost or installation of further automated metering. We will help you to highlight when and where waste is occurring together we will set up action plans to minimise cost and waste.

Carry out surveys and produce budget proposals for automated metering projects. If you want us to manage and run the improvement projects we will be there. Advice and support can be provided for getting DEC and EPC certification. In addition management processes for the CRC audits and permits can be developed and operated if you require this service. Documents for projects and tendering can be structured to your project needs. Validating tender offers with the emphasis on meeting best practice in services installation and the whole life costs of a project. Provide cost effective utility supplies without locking you into contracts and poor invoicing.

You can talk with me on 0808 1088057e-mail [email protected]



each and every year in energy bill savings. unlike traditional public building improvement programmes, a whole group of buildings are offered up for retrofitting in one go, allowing energy services companies to achieve economies of scale. This also allows for more long-term infrastructure investment to be off-set by savings from cheaper, quicker measures. Central to RE:FIT has been the appointment of a framework panel of approved energy services companies with pre-agreed contracts and defined deliverables. This helps public sector organisations to avoid lengthy and complex procurement processes. It has also been designed so that RE:FIT can be rolled-out across the public sector nationally and could then modified to work within the private sector. It is a clear win-win scheme, with the framework panel in London to be opened for use by local authorities across the country.

Notes1 Buildings are responsible for 78 per cent of London’s CO2 emissions.2 The Clinton Climate Initiative (CCI) brings together the world’s most significant cities (C40) to tackle climate change.


Web: www.lda.gov.uk

(GLA), Transport for London, Metropolitan Police Authority and London Fire Brigade, and the Clinton Climate Initiative2, has developed RE:FIT – a cost neutral way for organisations to reduce their energy bills and the carbon footprint of their buildings. This works by appointing an energy service company (ESCo) to install energy efficiency measures in a building and to guarantee a set level of energy savings. This offers a financial saving over a period of years and transfers the risk of not reaching the potential energy savings onto the ESCo, rather than the owner or occupier of the building. In the initial pilot phase, 42 buildings were improved and achieved Co2 reductions between 19-42 per cent – with an average saving of 28 per cent. This equates to just over 6,000 tonnes from 42 buildings and £1 million

of carbon dioxide. our demonstration projects in nine boroughs across London will have treated nearly 10,000 homes by the end of April 2010. The next stage will see RE:NEW active in every London Borough from summer 2010 and reach around 200,000 homes by 2012. RE:NEW places London’s local authorities at the centre of delivery as they are already implementing aspects of the Household Energy Management Strategy. For example RE:NEW builds on the strategic relationships between energy companies and local authorities and is a local, area-based programme.

RE:FITPublic sector buildings across London have the potential to make high Co2 savings. The London Development Agency, in partnership with the Greater London Authority

RE:NEW takes an area-based, whole house approach that covers all types of housing tenures and has something to offer every household. It includes offering a range of free-of-charge, easy-to-do measures, from changing to low energy light bulbs to installing stand-by switches and giving energy saving advice

ENERGY

Reduce heating costs with biomass boilers

uR RANGE oF BIoMASS heating and cooling

products can reduce your fuel bills. Savings of 50 per cent are possible by using wood based fuel instead of fossil fuels. The equipment can seamlessly be incorporated into your existing heating system and can come fully set up in our containerised solutions, you don’t even have to take out your existing plant. We can offer fixed price fuel contracts for our wood pellet systems, avoid the daily energy price fluctuations and budget more accurately. our installations costs can be 100 per cent offset as an enhanced capital allowance, other grants and loans are available. The equipment we supply is top of the range Austrian boiler

technology, and has proven track record for reliability and efficiency. They are fully automatic with little maintenance requirement. Reduce your carbon footprint, save money and add valuable kudos to your business by heating with renewable energy. Jones Nash offer a full turnkey solution, from the initial phone call to the handing over to the client and training of relevant staff. Book your consultation now, give one of our consultant a call and we will talk you through the benefits of biomass heating and cooling.


Tel: 0845 345 2049 E-mail: [email protected]: www.jones-nash.com

O

T Jolly – high quality engineering services

JoLLY SERVICES Limited are a building services

engineering company who specialise in the healthcare sector. By way of example, we recently carried out a major theatre refurbishment programme for Lancashire Teaching Hospitals NHS Foundation Trust, completing the work on programme and with minimal disruption to patient services. Services provided were:• Project management• Risk Management• On-site waste managementBenefits to customer were:• Modern theatre facilities• Retained theatre use through phased programmeJolly competitively tendered for this project and were the successful preferred main contractor. The

project involved the refurbishment of 12 theatres and the replacement of the chilled water system to a major part of the hospital. The theatres were refurbished in six phases to minimise disruption to the surgical

programme. The projects included building works,

mechanical, electrical and air conditioning installation, domestic services and medical gases. It delivered state of the

art operating theatres in this

Lancashire hospital facility allowing improved

and expanded surgical procedures to be carried out for the future benefit of the community.


For more information why not give us a call?Dominic Evans 01772 707500 [email protected]

T

www.elcomponent.co.uk e [email protected] t 01279 503 173 f 01279 654 441Unit 5, Southmill Trading Centre, Bishop’s Stortford, Hertfordshire CM23 3DY

aM&T Sub-Metering SystemsFlexible cost-effective metering for all utilities and every type of business. We have the hardware, software, networking and installation skills to supply the package you need, on time and on budget.

• Automatic data collection and alarm signalling

• Flexible networking options

• Web enabled hardware

• Tenant Billing

Energy Data LoggersEasy to use portable data loggers for electricity and general utility monitoring. Safe, non-invasive.

• All kits supplied ‘ready-to-go’

• Tough waterproof cases (3 phase analysers)

• Simple Windows software

• Available to hire

Power Quality AnalysersHigh performance instruments for the most demanding energy and power quality analysis applications designed and built to the highest quality standards. Supplied complete with the latest windows software.

• All electrical parameters

• THD, Harmonics, Flicker etc

• On-board power for flex CT’s

• Plug-in Memory

• Available to hire

Sustainable energyLeading metering & monitoring specialists

Halfpage_Ad.indd 3 13/8/08 12:30:26

Changing habits, saving you moneyInterested in how we can save your business money by reducing your carbon footprint?

Our Energy Monitoring System is Guaranteed to reduce your running costs by between 10% and 20%.

Please contact us for further details on 02920 880115 Or visit www.energymonitoringservices.com


TAILoRED HEATING

THE SPECIFIC REquIREMENTS oF healthcare facilities, ranging from hospitals to GP practices, make it essential to work with suppliers that understand these requirements. Such understanding can only come from years of experience, backed by an extensive product range and a high level of technical expertise. For example, when arriving at appropriate heating solutions it is now very important to address sustainability issues as well as the need to meet space heating and hot water requirements. Thus, the majority of current projects now feature a blend of renewable heat sources such as biomass boilers, solar, thermal and heat pumps – backed by high efficiency conventional boilers. Getting the right mix is crucial to achieving maximum efficiency with minimum emissions. This is clearly exemplified when considering the range of heating requirements across the health estate. Not only does the size of the buildings range from large hospitals to small converted houses but the age of the buildings – and therefore their insulation levels – also varies greatly. Consequently, as featured in a forthcoming TV documentary on energy efficiency in the NHS, our product range has changed considerably since we first began manufacturing boilers for the healthcare sector in 1887. Not only have the boilers become considerably more efficient, using a wider range of fuels, but the range now also incorporates renewable and other low carbon heat sources as well. With such a wide range of options it is

possible to meet the needs of any healthcare facility, whether it’s a large energy centre for a hospital right through to a heat pump and small boiler at a health centre. In all such instances it’s important to tailor the heating solution to the specific circumstances and this is where a combination of understanding and engineering expertise comes in. For example, if heat pumps or solar heating are used to help address sustainability issues, these will need to be backed up by additional heat sources. These may be biomass boilers, to increase the sustainability credentials of the project even further, or they may be gas-fired condensing boilers. understanding the heat loads and patterns of heat usage in the building(s) will help to determine the most suitable combination. Then, all of these heat sources need to be integrated in such a way as to ensure each performs at maximum efficiency. Specially designed and configured control systems will ensure that this happens. Biomass is proving particularly popular in the healthcare sector as a renewable source of energy, and we offer boilers to suit all sizes of projects. In using biomass, though, it’s important to be aware of the implications in terms of fuel deliveries and storage. Again, Hoval’s expertise in this area can prove invaluable in determining the best choice of wood fuel and well as addressing the day-to-day practicalities. Wood chips, for instance, show greater variation in combustion efficiency and physical

size, and have a lower calorific value than pellets, so for a given heating capacity they will require either higher storage volumes or more frequent deliveries. Ideally, the storage volume will allow a full lorry-load to be ordered each time as this reduces cost and carbon footprint. There will also be variation in the way that different types of wood fuel are delivered to the boilers – wood chips requiring more robust handling equipment than pellets. And all of this needs to be balanced against the variation in fuel prices as chips cost less than pellets but require more investment in additional equipment and produce more ash, which has a bearing on maintenance costs.

TAKING THE AIRAnother factor to be aware of is that all solid fuel boilers, including biomass, produce some particulate emissions and it is particularly important to minimise these in the vicinity of healthcare facilities. There are also new air quality regulations coming in that will require control of particles down to 2.5 microns diameter (PM2.5). The operation of cyclones and multi-cyclones that have been traditionally used to remove particulate emissions is dependent on particle size, and they are only able to remove about 50 per cent of the particles down to a diameter of 10 microns (PM10). To address this, Hoval has developed its CF ceramic filter, capable of removing up to 96 per cent of PM2.5 and PM10 particles. Furthermore, the CF can be retrofitted to existing wood pellet or wood chip boilers, as well as to new installations, helping healthcare facilities to address their duty of care to patients, visitors and staff. When considering heating solutions, therefore, it makes a lot of sense to team up with a specialist company such as Hoval that has the expertise and experience to provide sound advice, anticipate issues and resolve them before the project begins.


Tel: 01636 672711Fax: 01636 673532E-mail: [email protected]: www.hoval.co.uk

Meeting the heating requirements of healthcare facilities requires an in-depth understanding of their specific requirements. With over 100 years experience of providing heating solutions to the healthcare sector, Hoval has the answers


ENERGY

E: [email protected]: www.allandyson-asbestos.co.uk

Allan Dyson Asbestos Services is one of the leading providers of Asbestos Services. Since our incepti on in 1996 we have earned a

reputati on for quality, professionalism and excellent customer service.

0800 9885010Offi ces in

Stevenage | Lincoln | Manchester

Asbestos Removals & Encapsulati on• Asbestos Consultancy• Reinstatement Work• Asbestos Surveys• Duct Cleaning• Soft Strip•

arca

allan dyson A4 advert.indd 1 11/06/2010 09:56:42


HANDLE WITH CARE

THE HEALTH AND SAFETY EXECuTIVE estimates that over 1.5 million commercial buildings still contain asbestos materials, and that 60 per cent of all asbestos imported into the uK has been used to produce building materials. Asbestos is likely to be present in a building if it was constructed between 1940 and 1980, and can sometimes be found in buildings constructed in the 1990s. The main uses of asbestos are, or have been: as a reinforcing agent in asbestos cement sheeting used on walls and roofs; in asbestos cement building products, such as tiles, cold water tanks, pipes and gutters; in insulating board used as wall partitions, fire doors, ceiling tiles, etc.; in yarns and textiles, in lagging and in sprayed coatings for insulation and decorative purposes.

RISK ASSESSMENTEmployers of building maintenance and repair workers are required to carry out a risk assessment before undertaking any work which exposes, or is liable to expose, employees to asbestos. They must take the appropriate steps required by the Asbestos Regulations to prevent or reduce these risks. However, in many cases the employers and their workers have little or no information about the premises where they are going to undertake work, and are not aware if asbestos containing materials are present. Consequently, it is difficult for them to consider the risks, or if precautions may be needed. A duty to manage the risk from asbestos in non-domestic premises was therefore added to the Control of Asbestos at work Regulations in 2002

to address this. These requirements have since been brought forward unchanged in the Control of Asbestos Regulations 2006 as Regulation 4. Those who own, occupy, manage or have responsibilities for premises that may contain asbestos, will either have a legal duty to manage the risk from asbestos material, or a legal duty to cooperate with whoever manages that risk. They will be required to manage the risk from asbestos by:• Finding out if there is asbestos in the premises, its extent and what condition it is in• Presuming the materials contain asbestos, unless you have strong evidence that they do not• Making and keeping up to date a record of the location and condition of the ACM’s or presumed ACM’s in their premises• Assessing the risk from the material• Preparing a plan that sets out in detail how they are going to manage the risk from this material• Taking the steps needed to put their plan into action• Reviewing and monitoring their plan and the arrangements made to put it in place• Providing information on the location and condition of the material to anyone who is liable to work or disturb it.

LICENSED CoNTRACToRAt some point somebody has got to work with asbestos containing materials, but who is allowed to do this? In the uK work on asbestos has by law to be carried out by a contractor who holds a licence under the Control of

Asbestos Regulations 2006, although there are exceptions. Normally, non-licensed work includes work on asbestos-containing textured coatings, asbestos cement and certain work of short duration on asbestos insulating board. Short duration means any one person doing this type of work for less than one hour, or more people doing the work for as total of less than two hours, in any seven consecutive days. The total time spent by all workers must not exceed two hours. This includes time setting up, cleaning and clearing up. It must be borne in mind that even non-licensed asbestos work is still subject to the strict requirements of the Control of Asbestos Regulations 2006. The duties imposed by Regulation 4 of the Control of Asbestos Regulations 2006 supplement the provisions of some of the duties imposed by other sets of regulations, in particular the Construction (Design and Management) Regulations 2007 which require the client to provide designers and contractors who may be bidding for the work or who they intend to engage), with the projects specific health and safety information needed to identify hazards and risks associated with the design and construction work. The Control of Asbestos Regulations 2006 place legal duties on employers and employees with regards to asbestos in the workplace, Regulation 10 states: “Every employer shall ensure that adequate information, instruction and training is given to those of his employees who are or are liable to be exposed to asbestos or who supervise such employees...” Therefore those who employ construction

Asbestos must still be considered as an important issue for all those charged with responsibilities for facilities management or maintenance


ASBESToS MANAGEMENT

Written by the Asbestos Removal Contractors Association

LLAN DYSoN ASBESToS Services is one of the uK’s leading providers of asbestos

services. Since our inception in 1996 we have earned a reputation for quality, professionalism and excellent customer service. With a wealth of specialist experience within asbestos management and two offices strategically located in Stevenage, Lincoln and Manchester. We are ideally placed to deliver a professional asbestos removal service throughout the uK. We pride ourselves on our rapid response to client requirements and safe work practices across all aspects of our asbestos services. We have provided quality and reliable asbestos services for local authorities, and are no stranger to delivering effective asbestos

services within the retail, pharmaceutical and National Health Trust sectors. From site surveys and management planning to safe and efficient asbestos removal and disposal, as a Full Contracting ARCA member we ensure that quality control and best practice procedures are upheld at all times, in line with Health and Safety

Executive guidelines as appropriate. With credentials including ISo 9001:2000, ISo 14001 and oHSAS 18001 quality assurance, CHAS accreditation for Health and Safety, plus Constructionline and Safecontractor registration, we are your ideal asbestos services partner. We are committed to delivering safe, effective and cost-effective asbestos removal and surveying

services and are extremely proud of our flawless Health & Safety record.


Tel: 01522 681394Fax: 01522 684320E-mail: [email protected]: www.allandyson-asbestos.co.uk

A

A leading provider of asbestos services

A significant change in the Control of Asbestos Regulations 2006 was the inclusion of mandatory training for those liable to come into contact with asbestos

Regulation 10 states that ‘Every employer shall ensure that adequate information, instruction and training is given to those of his employees who are or who are liable to be exposed to asbestos, or who supervise such employees…’.

Asbestos awareness training is required, amongst others, for:

• General maintenance staff • Electricians • Plumbers • Gas fitters • Demolition/Construction workers• Roofers • Heating & ventilation engineers• Building surveyors & other such professionals

We are pleased to offer a 3 hour training course covering the four key areas:

• Properties, uses and risk to health• Use of asbestos in the construction industry• Risk of exposure and control methods• Legislation

Portsmouth based Gully Howard Technical Ltd is run by qualified scientists, Occupational Hygienists and surveyors who have extensive experience in providing training in all aspects of asbestos work.Training can be delivered in our dedicated training facilities or we can organise course training at your own premises.

Tel: 023 9272 8040 Fax: 023 9273 12115 St George’s Business Centre, St George’s Square, Portsmouth PO1 3EY

Unit C, Astra Park,Parkside Lane,Leeds LS11 5SZTel: 0800 834 [email protected]

We have over 25 years’ experience of asbestos removal and management.Call us now 0800 093 7810 for advice on: • Asbestos Surveys and Sampling• Management of your Asbestos containing material• Asbestos Removal• Asbestos Waste Management

We are fully licensed by the Health and Safety Executive and are registered by the Environment Agency.

With clients based nationwide we have successfully completed projects for the NHS, local authorities, demolition contractors, major construction companies, property developers and consultants

Free phone 0800 093 7810 or email [email protected] for a confidential and free estimate.

Cordtape Environmental Services Ltd www.cordtape.co.uk

Are you meeting the latest Health and Safety regulations for Asbestos?

workers to carry out demolition or refurbishment work have a legal duty to ensure that they have adequate information, instruction and training regarding asbestos, as those tradesmen are always liable to be exposed to asbestos as a result of the type of work they carry out. In fact, the Approved Code of Practice which accompanies the Control of Asbestos Regulations 2006 states: “Asbestos awareness training is required to be given to employees whose work could forseeably expose them to asbestos. In particular it should be given to all demolition workers and those workers

in the refurbishment, maintenance and allied trades where it is foreseeable that their work will disturb the fabric of the building because asbestos containing materials (ACMs) may become exposed during their work. Exemption from this requirement would apply only where the employer can demonstrate that work will only be carried out on buildings free of ACMs. This information should be available in the client’s asbestos management plan.” An Approved Code of Practice has special legal status; it is the accepted way of complying with the law. If you do not comply with the Approved Code of Practice you must demonstrate that

you have complied with the law in some other way, to an equal or better standard.

AWARENESS TRAININGFrom the above it can be seen that asbestos awareness training is a legal requirement for most employees and supervisors working in the construction industry. In addition to initial training, the Approved Code of Practice which accompanies the Control of Asbestos Regulations 2006 also states that refresher training should be given at least every year. Therefore, there is an ongoing annual legal requirement for refresher training to be carried out for the identified employees. ARCA is the leading supplier of asbestos awareness training aimed at building and maintenance workers. ARCA trainers have considerable experience within the asbestos removal industry and understand the issues that are faced every day. The range of courses which ARCA have available is comprehensive. Each has been designed to ensure that your staff acquire a real depth of knowledge and capability.


Tel: 01283 531126E-mail: [email protected]: www.arca.org.uk



ABouT ARCA

The Asbestos Removal Contractors Association (ARCA) is the leading trade association in the Field of Asbestos Management Services. ARCA was formed 1 July 1980 and since that time has seen many changes in working procedures and legislation. However, one thing has remained constant, ARCA members are recognised for their professionalism, the quality of work they carry out, and they continue to be seen as the specialists in this

difficult and hazardous industry. Membership has grown considerably from the original four founder members. The association has gained credibility with government, local authorities, and all those concerned with safety in the occupational handling and removal of asbestos and any other airborne hazardous materials. Clients now know when they choose ARCA members for tender lists they are selecting from the very best in the industry.

ASBESToS MANAGEMENT

Antec – the specialists in asbestos removal

NTEC CoNTRACTING Services (Anglia) Ltd was

established in 1991. We offer a fully licensed and insured, safety conscious service in asbestos removal and surveying. With a wealth of knowledge gained from extensive experience and training. Antec is able to advise and assist in all phases of the control and elimination of asbestos from the identification of problem areas to the completion of remedial measures. Antec holds a full licence (4910903507) to remove asbestos issued and regulated by the HSE (Health and Safety Executive) under the Asbestos (Licensing) Regulations 1983. Alongside the remedial services

provided by Antec, our surveying team offer extensive knowledge and experience in locating and identifying asbestos containing materials (ACMs). All our surveyors have been trained to BHoS P402 standard depending on the need of the client. Clients range from RAF sites, councils, building/demolition contractors and numerous commercial premises both large and small.


Unit 2 Ashwellthorpe Industrial Est, Ashwellthorpe,Norfolk, NR16 1ERTel: 01508 481630Fax: 01508 481631E-mail: [email protected]

A

Nichol Associates – asbestos management consultants

E HAVE MANY years of experience in health

and safety, and environmental matters, specialising in commercial environments (offices, hotels, retail, hospitals, educational establishments and domestic properties). We hold quality accreditation that conforms to two international standards, both of which are assessed by uKAS (The united Kingdom Accreditation Service). our testing accreditation is assessed to ISo/IEC 17025 and rigorous assessment and quality control procedures ensure that all in house testing methods conform to current international standards and HSG 248, the uK’s approved method for asbestos materials testing. our inspection accreditation is

assessed to ISo/IEC 17020, and is again supported by in house procedures that conform to HSG 264, the uK’s only approved method for asbestos surveying. In most cases our clients are interested in the management, surveying and testing of their asbestos, not only because of the potential threat to human health, but also the potential liability they may incur should they not fulfil their legal obligations. That is why they choose to use a service that is uKAS accredited in its entirety. Risk is inherent – we act to minimise it.


Tel: 0191 4385432Fax: 0191 4699562E-mail: [email protected]

W

W Shuttleworth suppliers of the full range Hospital Products to the NHS and Healthcare Industry throughout the UK for over 15 years.Our in-house design and manufacturing capabilities enable us to supply products from our standard product range or to manufacture products specific to your requirements whether that be a one-off or in hundreds.W Shuttleworth prides itself on being easy to do business with allowing our customers to focus on what they do best – caring for patients.

Whatever your Hospital Products requirement contact us at [email protected] or 01706 845966

Suppliers to the NHS under National Contract: 2009/S77-110710

Give us a try and find out how easy it is

Ergonomic seating including ranges of extra large and posture support chairs. Specially selected, sensibly priced and UK made. Easily ordered and delivered direct to your site.

Individual chairs for individual people

For more information call: 0118 941 1144 or visit www.businessfurnitureonline.co.uk

IN ASSOCIATION WITH

MAIN OFFICE:40 WINSTANLEY ROAD

SAFFRON WALDENESSEX, CB11 3EQ UK

LONDON OFFICE:RUSSELL HOUSE SUITE 7

37 GREAT RUSSELL ST.LONDON, WC1B 3PP UK

UK FREEPHONE: 0800 096 0414OVERSEAS: 00 +44 1799 501 301

FAX: 00 +44 1799 501 364EMAIL: [email protected]

WEBSITE: WWW.HIGHANDMIGHTYSEATING.COM

Sole distributor of BODYBILTOFFICE SEATING direct fromERGOGENESIS in the USA.

Panther Interiors

T. 0845 634 1458 E. [email protected] W.www.pantherinteriors.co.uk

Stunning furniture for offices and reception Call 0845 634 1458

www.pantherinteriors.co.uk


KEY ISSuES FoR SELECTIoN oF HoSPITAL FuRNITuREHealthcare professionals play an increasingly important role in the selection of hospital furniture argues Nigel Davis of Teal Furniture Ltd, members of the British Contract Furniture Association

WALK IN To ANY HoSPITAL today and you are likely to find a mixture of ward furniture, sourced over many years and from a growing number of NHS contract approved suppliers. But hospitals like the spectacular new Queen Elizabeth Hospital Birmingham, equipped with individual rooms, or four-bed rooms with en-suite facilities are well placed to equip with new furniture, including patient seating throughout. So which factors are influential in the furniture selection process for both refurbishment or new build projects?

EFFECTIVE CLEANING SERVICESAccording to NHS Evidence tackling cleanliness and infection control is the responsibility of everyone who comes into contact with the NHS – from visitors to managers to nurses to surgeons. Healthcare Associated Infections (HCAI) continue to receive high priority and more action has been announced to tackle HCAI, with reporting processes to trust boards by matrons and clinical directors on infection control and cleanliness. Further action will involve specialist inspectors and tough new powers to inspect, investigate and intervene where hospitals are failing to meet hygiene and infection control standards. Given this background, infection control practitioners play an increasingly important role in influencing those involved in the procurement of furniture for hospital environments. It has been argued that routes to infection are diverse.

WooD FINISHES & VINYLSTo aid infection control, surfaces and furniture need to be both durable and easily cleaned. Wood finishes should be sealed using a high quality clear lacquer, which is not only durable but incorporates antimicrobial agents that suppress the growth of micro organisms. In the fight against HCAIs fabric choice also plays an integral part. High performance vinyls are ideal in extreme hospital environments, with their anti-microbial and anti-fungal protection (tested to NHS specified requirement AATCC147) that prohibits growth of bacteria and associated odours, infection and cross-contamination. The fabric does not absorb spills and is easily wiped clean, making it ideal for use in high risk infection control areas.

Regular cleaning with warm soapy water and clean water rinse is sufficient to retain the fabric’s appearance and durability.The upholstery maintains its appearance over long periods of time, provided it is cleaned in line with the vinyl manufacturer’s instructions.

BARIATRIC PRoDuCTSThe Health and Safety Executive reports that 40-70 per cent of Trusts do not have a bariatric policy in place, an important process which helps amongst other things to manage manual handling risks when dealing with bariatric patients. Specialist bariatric seating, designed and tested to handle patients up to 300+ kilos (50 stones) is available with fixed and drop arms and in a choice of seat heights dependent on client and carer requirements. Integral housekeeping wheels, allow what are essentially large, bulky items of furniture to be repositioned, without the need for manual handling. BB pressure cushions aid pressure relief and comfort.

PRESSuRE RELIEF & CoMFoRTTo meet the needs of a variety of client groups, patient seating can be supplied in a number of seat grades, depending on the risk of tissue breakdown, following a clinical assessment. High grade polyurethane foams are often supplied as standard, with the option to upgrade to a low/medium risk comfort cushion, or for high risk environments to pressure relieving foams, such as Reflexion foam, which helps prevent the development of pressure ulcers, but also reduce sliding and improve posture. This is achieved by helping to distribute body weight across a greater surface area, avoiding localised interface pressure by responding to body heat and forming to the body’s shape. Reflexion foam features two layers (the upper layer is Vasco, a Visco elastic which is both temperature sensitive and energy absorbing, while the lower layer is Reflex, providing support and flexibility for the upper layer).

SEAT HEIGHT & DEPTH ADJuSTMENTHow do you ensure that the patient seating provided for clients in specialist units or at ward level have the correct seat height to suit a variety of clients? Clients with varying posture, leg lengths

and physical abilities mean that a standard seat height may not be appropriate in all situations. Simple accessories such as height adjusters can provide the answer, offering a variable seat height, with adjustment in increments up to 100mm (4”) maximum, allowing bespoke seat heights to be created, along a preset range.Housekeeping wheels can also be added to seat height adjusters, which offer height adjustment, but with the added benefit of improved mobility, allowing the chair to be easily positioned and without the need for manual handling. Many NHS Trusts in specialist areas such as admissions, mental health, oncology or in more general ward applications choose to order chairs both with and without seat height adjusters, to suit a variety of clients. A simple pin adjustment allows for seat height adjustment in-situ, helping to avoid situations where the seat is too high and the clients’ feet are not in contact with the floor, or where the seat is too low, making it difficult to get out of the chair for those with impaired strength or mobility. Clients encouraged out of bed during a period of recuperation may also spend extended lengths of time in a patient chair. For this reason correct height adjustment and ergonomically designed furniture to ensure correct support and posture are also important factors. A removable seat option can also provide seat depth adjustment and with a wipe down rigid base it allows for easy cleaning and hygiene control. Similarly, a removable seat platform allows seat cushions to be interchanged for specific pressure reducing needs and can be used in conjunction with suitably inflated air cushions.

CLEANING & DECoNTAMINATIoNRemovable seat bases allow seats soiled with bodily fluids including urine, mild acids and alkalis, drinks and beverages to be changed and cleaned in line with current guidelines to prevent and manage the spread of infection. Effective cleaning services always need to be available and a piece of equipment used for more than one patient should be decontaminated according to current guidelines following each use. Clinical teams must ensure that equipment is clean, maintained and fit for purpose.


HoSPITAL FuRNITuRE




Data centre design and consultancy services

HINK oF YouR DATA centre as an ecosystem.

There’s a landscape (the building and its infrastructure), an ever-growing population (the IT equipment), and, thanks to the exponential power demands of the microchip, an increasingly warm climate with the population at its mercy. Sound familiar? Just like our global ecosystem, left unchecked this “local warming” can spell data centre disaster. Yet it needn’t be that way. Get the climate right, and the population not only survives, it thrives – long into the future. At Future Facilities we have a simple mission: to ensure every data centre is a near-perfect ecosystem in which risk is mitigated, energy efficiency maximised, and capital/operational costs are reduced to a minimum. In other words, your data centre becomes a

model data centre. This is no fantasy, it’s a reality. Yet it relies on a different kind of model – a holistic three-dimensional CFD simulation so powerful and sophisticated that it recreates your unique data centre in every detail – enabling you to accurately predict every “what if” scenario you can imagine. We call it the Virtual Facility©. You’ll call it peace of mind. Future Facilities is a leading provider of design, optimisation and management software for data centres. The company’s solutions ensure capacity, efficiency and reliability criteria are met throughout all phases of the facility’s lifecycle.


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ADDRESSING THE PRoBLEM

To ADDRESS THE ISSuES oF oBESITY and manual handling, we set up a bariatric working party with representatives from Acute care, Fire, Police, Ambulance (this included the private sector) and community care services in an attempt to work in partnership with outside agencies. The ultimate aim of the group was to work in partnership, sharing experience, skills, knowledge and equipment through effective communication.

PRACTICAL MoCK uP EXERCISESThe group wanted to work proactively so over the past few years a number of practical exercises have been organised to establish how each discipline worked, what equipment they used and how they could improve the service to benefit everyone and give the patient the dignity they deserve. Manufacturers of equipment were invited to bring some of their products along to enable members of the group to have the opportunity to see what is available to them. Scenarios were developed to enable participants to practice taking a bariatric patient from a mock situation and eventually deposit them into a waiting bespoke vehicle. The scenarios have included working in confined spaces, retrieving a patient from a first floor flat with the assistance of the fire service, who removed a window to allow the patient to be evacuated on a cherry picker with the assistance of the ambulance service.

MoVING oBESITY FoRWARDThe group have been working together successfully in partnership for four years with the support of their organisations. It was now time for them to invite senior people from those organisations to take things to the next level. An awareness day was organised and invitations sent to chief executives and board members of each disciplines organisation. The aim was to encourage the attendees to sign up to sharing information, equipment and expertise to improve the management of the bariatric person in crisis. At present there is resistance to the idea of sharing equipment. These range from legal issues such as who is responsible for the equipment to who has the confidence and expertise to use it. on the day a number of presentations were given in an effort to give the audience a better understanding of the difficulties the

disciplines experienced when the patient is bariatric. The first presentation was ‘scene setting’ from the ambulance service and examples were given to demonstrate the sort of problems the group had identified when attending an emergency call. This was followed by a video clip of a patient’s perspective of being handled in this sort of situation. The patient told the audience how they had felt about being handled by an ambulance crew and their worries about possible injury to staff that had been forced to carry them at the time. They also revealed their feelings on how they felt when attending a clinic and the embarrassment it caused. A representative from the Health and Safety Executive went on to tell the audience that they had a duty of care to this patient group and they would be expected to provide the appropriate equipment etc. They also said that the client group was foreseeable and there was a need to plan, communicate and train staff for those occasions these patients required healthcare. The final presentation informed the audience of the need to escalate. The group had done a lot of work over the past three years but they were unable to take this forward without input from the right people. There were lots of benefits to signing up to working in partnership and sharing equipment and information. The group wanted to be proactive rather than reactive. Resources needed to be cost effective. Hiring equipment can be very costly to an organisation and there is the added risk it will not be available when it is needed. This could create a risk to staff and patients if someone is injured when equipment is not there. Essex County Fire and Rescue Service have the highest number of calls to bariatric people in distress or at risk in the uK. If equipment were to be shared this may reduce the number of occasions the fire service needed to respond to provide the manpower to assist with patient type. The ambulance services need to provide more re-enforced specialist vehicles for transporting this patient group. The private sector currently provides the bariatric ambulances in the county and this service goes a long way in improving the dignity and care of these patients. There are an insufficient number of vehicles for the number of patients and more are needed. This would reduce the length of stay in hospital for some

patients who remain for longer periods when appropriate transport is not always available when they are ready for discharge. This would reduce costs of bed blocking for Trusts. The day also allowed attendees to view some of the equipment the group had used during their practical exercises. This was to persuade those with responsibility for funding of the importance of these items in their organisations area of work. The purchase of equipment could be either for total use by the organisation or with a view to sharing the cost with other agencies. Ergonomics and working in partnership can make a difference to a patient’s dignity and reduce the risk of injury to staff. As the nation becomes larger more solutions are required to manage situations while maintaining dignity and safe systems of work. More manufacturers are listening to professionals and working with them in an attempt to problem solve. The project has been a learning curve for all those involved. The group are still enthusiastic and are contributing to the improvement of the service. There is much work still to be done if they are to complete the project. It is comforting to know they have the support of their organisations to take things forward.

References:Rush, A Use of specialised equipment to mobilise Bariatric patients. International Journal of Therapeutic Rehabilitation. Jun: 12(6): 269 2005 Bourne J Tackling obesity in England National Audit Office Report (2001)Palmer, R Moving and Handling Bariatric patients safely: a case study. International Journal of Therapeutic Rehabilitation. Jan: 11(1): 31 2004Health Services Administration. Avoid Risk from obese patients with specific policies. Healthcare Risk Management. Jun 28(6) 65 2006 Pheasant S (1991) Ergonomics, Work and Health 4 – 6Pepper C (2010) Corpes too heavy for the morgue Sunday Mail South Australia Feb 06 2010Randall S, Pories W, Pearson A, Drake D, 2009, Expanded Occupational Safety and Health Administration 300 log as a metric for bariatric patient handling staff injuries. Surgery for Obesity and Related Diseases, Vol 5, Issue 4 July – Aug 2009, 463-468

Liz Leigh, member of the Institute of Ergonomics and a manual handling adviser/clinical ergonomist, Southend University Hospital NHS Foundation Trust, continues her look at ergonomics and how it affects healthcare services


ERGoNoMICS


Pass Training Consultancy delivers a range of courses including civil enforcement officer, health & safety and notice processing training. The company also provides conflict management courses for clients in the private and public sector including local government, the parking industry and security sectors. Mark Cox, managing director of Pass, says the company’s Chartered Institute of Personnel and Development (CIPD) training consultants engage with its clients to ascertain their training and development needs. “Within these training programmes we offer the use of a variety of tools including psychometric testing,” Cox says. “These assist in producing self-managed learning resources and facilitate group learning, with training courses designed to meet your staff and organisations needs.” Pass works as a training provider for South Thames College, which has strong links with the security and parking sectors. Louis Ellis, business pocessing unit manager

at parking enforcement IT specialist, Imperial Civil Enforcement Solutions (ICES), has used the company’s trainers. “The quality of the training that ICES notice processing staff receive is very important to us,” says Ellis. “We entered into a contract in 2009 with South Thames College who put us onto one of their training provider, Pass Training Consultancy. We discussed our training needs with Pass, who agreed to provide an industry leading qualification in the form of the NVQ Business Administraion, which specialises in notice processing. The course was delivered in a timely and professional manner and has improved beyond doubt the professionalism of all the staff who have so far undertaken the NVQ. “Being an accredited City & Guilds NVQ, the qualification further enhances each individual staff member’s qualifications and is of value to them of the equivalent academic standard as five GCSE’s.”

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CAN BEST PRACTICE LEADERSHIP SAVE THE HEALTH SERVICE?

WEAK LEADERSHIP AND MANAGEMENT are considered to be a significant cause of poor organisational performance. The health service’s continued struggle to develop leadership could be a major factor behind the reports of NHS hospitals that are considered to be ‘failing’ could be handed over to private sector managers. So as health secretary Andrew Lansley looks set to announce new measures that will affect trusts’ financial health, it is time for better leadership, but what can be done? Given that priorities lie with delivering a comprehensive set of services on a day-to-day basis, with teams at all levels having headcounts challenged, it is no surprise that there is often little funding left over for training and development in leadership skills. However, this short term thinking, especially where what funding there is often gets allocated to senior positions, can see the problems being compounded. If this attitude is allowed to persist, there is the danger that the health service will continue to make the same incorrect assumption as many private and public sector organisations: that leadership and management skills are only required above a certain level. In the day-to-day workplace, however, whether you are talking about the shop floor or the ward, leadership and management is taking place all of the time. If weak leadership and management are a significant cause of poor organisational performance, does that mean that health organisations should be investing heavily in their leadership and management development? Not exactly, because the issues are more complex than simply to do more training.

KEY quESTIoNSThere are several key questions when considering the impact of leadership and management development on organisational performance. Has development improved the capability of leaders and managers? (Do they know how to perform effectively and how to put this knowledge into practice?) How significant is this enhanced managerial capability compared to other externalities in determining organisational performance? (Are leaders and managers able to apply what they have learnt? How much do factors like the government policy or technological change limit the effectiveness of managerial decision-making?) The evidence is well summarised in the report ‘The Development of Management

Poor leadership and management have often been easy targets for those looking for weaknesses in the UK health service, says David Pardey, Institute of Leadership & Management


TRAINING


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and Leadership Capability and its Contribution to Performance: The evidence, the prospects and the research need’. It suggests that the first relationship – between leadership and management development and capability – is clearer than the second – the impact of leadership and management development capability on organisational performance. This is simply because so many of the factors shaping the latter are down to externalities. However, that doesn’t mean that we have no idea, and organisations that don’t make sure that they are maximising the impact of their investment in leadership and management development may well be wasting much of their money.

EFFECTIVE DEVELoPMENTThe first, and most important step, is to ensure that a leadership and management development programme is designed to ensure that leaders and managers are more capable of performing their role. The three key factors

that need to be considered are: the quality of the development programme; the strategies for ensuring learning transfer; and the level of organisational commitment and support. There are so many dimensions of quality in the design and delivery of a learning programme, but a good quality programme will incorporate some form of assessment of learning need – what needs to be learnt – leading to clear and agreed learning outcomes. Clearly the people, learning materials and other resources used need to be able to deliver these outcomes to these learners, and the programme needs to be designed to use these resources effectively to achieve the agreed outcomes. Furthermore, there is little point in going to all this trouble if no effort is made to assess whether or not the learning outcomes have been achieved.

LEARNING TRANSFERPart of the programme design should be to ensure learning transfer. Learning transfer is the process by which what has been learnt is transferred into the workplace. Without careful attention to this aspect of the programme there

is no guarantee that individual performance will be changed. There are two broad dimensions to learning transfer, ‘hugging’ and ‘bridging’. ‘Hugging’ means making the learning experience more like the ultimate applications. To achieve this, development should address the realities of the working environment, be practical and encourage learners to use their own work tasks and problems as part of the learning process. Incorporating techniques into the programme like coaching (which takes learning into the workplace and focuses on application in specific work contexts), Action Learning Sets (which bring the workplace to learning, addressing workplace problems) and work based learning and assessment (to engage earners in practical tasks to stimulate and apply their learning), will help to encourage ‘hugging’. ‘Bridging’ is all about making conceptual connections between what’s learned and other applications. Development should not consist of fragmented elements of learning, but should be fitted into a broader picture to

enable greater understanding. This doesn’t preclude using short, focused learning activities, but requires those leading the development to fit it into the larger picture. It is clear that to achieve this, a dialogue between those delivering the training and those commissioning it is essential. The resources devoted to initial diagnosis, making sure that the programme is well designed, and to assessing the effectiveness of the programme in achieving the learning outcomes, is all money well spent. Furthermore, the support of the organisation is critical. This means that line and senior managers are committed to the programme and actively engage in ensuring that it works. This can mean using line managers and technical specialists as mentors to support learners or creating systems to provide 360o feedback to managers. This will help them translate learning into action and make L&M development part of organisational strategy.

IMPRoVED oRGANISATIoNAL PERFoRMANCEIt’s a lot easier to be prescriptive about what

it takes to ensure that L&M development improves capability than it is to say how this will affect organisational performance. The Institute of Employment Studies’s report ‘The Comparative Capability of uK Managers IES for the SSDA’ says: “The approach to management development emerges as of significantly greater importance than the amount of development which takes place. The clear message is that smarter working, such as embedding development within an overarching strategy of the organisation, reaps dividends.” Furthermore, the IES report concluded: “The management and leadership development that contributes most clearly to performance is that carried out in or close to organisations, and for managers and leaders who are in or entering posts.” So, if you want Leadership and Management development to have an impact on your organisation’s performance, don’t rely on what happens to be available locally, but treat it as part of your organisational development strategy and commission programmes that directly address your needs.

quALIFICATIoNSILM is the uK’s largest L&M qualification awarding body by far and we have made every effort to ensure that the characteristics outlined above can be built into programmes offered by our 2,000 centres worldwide. ILM has taken advantage of the opportunities offered by the new Qualification and Credit Framework (in England, Wales and Northern Ireland) to enable its centres to create flexible, tailored programmes that incorporate the features that ensure that the investment made L&M development is translated into enhanced capability and, as far as it is possible, into improved organisational performance. Furthermore, by offering qualifications for all levels of management, from team leaders to chief executives, there is consistency in the principles and practices that are being learnt. By making sure that every manager in the organisation has a similar understanding and a common vocabulary for communicating with others, the organisation can have greater confidence that its investment in leadership and management development will produce real returns.

David Pardey is the senior manager, research and policy for the Institute of Leadership and Management (ILM).

References:UK Competitiveness: moving to the next stage Michael Porter & Christian Ketels, DTI Economics Paper 3: 2003The Development of Management and Leadership Capability and its Contribution to Performance: The evidence, the prospects and the research need, John Burgoyne, Wendy Hirsh and Sadie Williams, DfES Research Report RR560: 2004



By offering qualifications for all levels of management, from team leaders to chief executives, there is consistency in the principles and practices that are being learnt. By making sure that every manager in the organisation has a similar understanding and a common vocabulary for communicating with others, the organisation can have greater confidence that it’s investment in leadership and management development will produce real returns

TRAINING

Roxym ConsultancyCHANGE IN THE PuBLIC SECToR The ILM report “Leading change in the public sector 2010” identifies a range of challenges facing the public sector.

PART oF THE PRoBLEMThese include: Managers showed underlying concern about their bosses’ capability, in particular, over half said senior management did not understand what their teams did. Half criticised senior management’s communication ability. Real concern over senior management’s ability to deal with budget cuts. Over three quarters worried that their senior managers are not up to the challenge. In summary, senior managers need help.

PART oF THE ANSWERTraining and development is not a panacea and one size certainly does not fit all. However, if the ILM’s research is accepted as an initial diagnostic, there is need for training and development. In particular:

1 – Coach senior management to address the above concerns.2 – Develop middle and junior management so that they can support senior management.3 – Evaluate both areas to establish added value.

In summary, all management need to be involved and the change needs to be measured.

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53THE BuSINESS MAGAzINE FoR HEALTH BuSINESS

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RAININGSKILLS4u.Co.uK’S managing director Carl Bennett, 50, spent more than 22 years in

the Met Police, until an operation to remove a brain tumour left him with significant hearing loss and coordination problems resulting in his early retirement from the elite Specialist Firearms Department So19. “It was devastating at the time,” he admits, “But feeling sorry myself wasn’t an option.” He took time out before hitting on the idea of opening a training business called Tradeskills4u, which specialises in Electrical Training. “My motivation wasn’t money,” he says. “I wanted to run a successful business and I wanted to do it properly.“ The element of danger in training may be substantially lower but Carl believes there are factors that link both his career paths – delivering a professional job, doing the best for your customers and making a difference. “My skills are organisational, communication and people-based and they translate,” says Carl. “Frankly, I can barely wire a plug, but that’s not what I do, I pull the expertise of my trainers together and make them into a team and they perform their roles and that makes us a success.” With a little bit of luck and a lot of hard work Tradeskills4u became the No.1 electrical

training provider in the uK. However, it wasn’t all plain sailing, Carl explains: “one of the most difficult areas of our business was recruiting good trainers, I had lots of good electricians wanting to work for me and become trainers but I didn’t have time to teach them. “The issue became very frustrating and I realised that this would be a common tale amongst many good companies who needed to train staff in house or training companies who needed to train their training staff to achieve PTLLS or A1 qualifications and deliver training in a better way. “My solution was to set up a train the trainer company called Trainingskills4u, it

draws on our expertise in training, and our experience as a trainer provider in the very competitive field of electrical training.” Trainingskills4u customers range from Rolls Royce to local health professionals to Sussex Fire service; we are teaching them how to teach adults, it fills that need of providing good training in house or other companies. It’s worked for us; we can make it work for you. Give us a call or visit the website for further information.


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Accredited training from Walking with Leaders

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powerful technique for developing staff and building capacity in organisations. Increasingly staff are being trained to provide coaching in their own workplace as a more sustainable alternative to providing external coaches. It is important that coaches are properly trained and Walking with Leaders provides ILM accredited coaching training up to the highest level, with particular emphasis on using coaching to create effective leadership at all levels. our flagship programme is the Level 7 (post-graduate level) Certificate and Diploma in coaching and mentoring. This is for senior leaders who want to use the power of coaching in their day to day leadership or who want to introduce a coaching culture into their organisation. It provides the necessary theory with sufficient practice to give the new coach the expertise and confidence to start coaching. We also provide additional “Carry-

on-Coaching” days to boost the skills of practicing coaches and customised ILM accredited Level 3 programmes for team leaders and less experienced managers. Walking with Leaders is an experienced provider of executive coaching to senior health professionals in universities, trusts and other agencies. our approach is collaborative and personal, focusing on the business need and the desired outcomes.


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Allen Partnership –transformational leadership

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written all over them, more often than not we miss or misinterpret the signals. Perhaps, you have not found the right decoder, until now! Allen Partnership has helped countless front line leaders in both public and private sectors to understand their people using the DiSC behavioural profiling tool to improve:• Day to day leadership interventions• Interpersonal skills and behaviour• Leadership potential• Coaching capacity • Communication • Team buildingKnowing how to be responsive to the communication and behavioral needs of others is crucial to improving leadership performance thus improving individual and team relationships, which in turn impact bottom line performance. our approach to leadership development is simply to raise

self-confidence, awareness of personal impact and to facilitate an environment for the growth of outstanding transformational leadership. We do not believe in hard sell – our aim is to enlighten you to the possibilities this behavioural tool offers by improving your leaders and how they lead and manage your people to improve performance.


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So MANY ARTICLES SuGGEST IT IS the manager’s fault that stress is a problem in the workplace and how it would be eliminated if managers knew how to manage and create effective relationships with their staff. Many stress professionals state that it’s the manager in the work place that creates stress, but how many of these ‘professionals’ know what it is actually like to work in an environment where a positive work culture is not happening? Where the manager is being hit from all directions and often being performance managed themselves, and a grievances culture seems the only way forward, no wonder the managers don’t want to engage in training to help them manage stress in the workplace more effectively if they keep reading that they are

so bad at managing and cause all the stress. The high incidence of sickness, absence and staff turnover continues to cause concern and the impact is all around us with the decline in standards, quality and effectiveness of public services. The economy is struggling, unemployment rising and budgets cuts are in progress. Stress levels are rising and tensions are increasing – but is it all the manager’s fault? PoSITIVE WoRK CuLTuREHow can a healthy and positive work culture that is essential for wellbeing and performance at work be achieved for both the manager and their staff? Promoting psychological wellbeing and performance at work relies on the creation of effective cultural foundations that encourage behaviours that lead to trust, commitment and engagement between individuals, and their manager. In November 2009 the National Institute for Health and Clinical Excellence (NICE) published guidelines for all organisations: ‘Promoting mental wellbeing through productive and healthy working conditions: guidance for employers’. The new coalition government has just arrived announcing £6 billion cuts this year, with years of cuts ahead. We now need to equipment managers with skills to engage

their teams in problem solving and not problem creating, if this doesn’t happen stress will become even more prevalent and drag down whole organisations. The wellbeing of staff need not be compromised even if organisations have to make significant changes to their workplace environment and teams. The underlying change that would support any manager to manage effectively is to develop effective Emotional Intelligence (EI) skills. Steven Stein PhD, author of Cutting edge research on management practice, states: “The organisation needs to demonstrate strong and Visionary leadership through intelligent management, and invest in employees so they know they are being

treated with respect and can be proud of their purpose and role in contributing to superior performance for a company who cares.’’

EMoTIoNALLY INTELLIGENT oRGANISATIoNThere are seven keys to an emotionally intelligent organisation:• Hire capable people who love the job they do and show how they contribute to the bigger picture• Fairness• Don’t overwork/underwork people• Build strong team with shared purpose and viable goals.• Make sure managers can manage• Treat people with respect and leverage their unique talents• Be proactively responsible by doing the right things to win the hearts and minds of your people.EI is an awareness based intelligence, and to be highly developed in EI it requires the manager to:• stop and think• control their impulses• use their innate intuition• be authentic with themselves and others• manage their fears in leading others effectively.It is no soft option since it deals with hidden

areas of fear and gets to the root cause of any unproductive behaviour. However, it is very rewarding when relationships improve with their team thus creating a positive work culture. The following personal characteristics of managers need to be developed and applied in interactions with staff: • The demonstration of genuine attentiveness to others• Trustworthiness• Emotional Intelligence• A sense of humour• The demonstration of passion for the work of the organisation and the work of staff• The demonstration of meeting individual needs as they arise, nurturing staff to realise their potential• The demonstration of skills to resolve conflicts.Paying attention to these key areas of development will positively impact the bottom line in any organisation. To sustain success in difficult times, there needs to be a sense of purpose within the organisation, setting understandable goals which will help to set boundaries separating what is productive and useful behaviour from what is not. People are the key to success in today’s workplace, managers need to be allowed to lead their teams, however, they need to be supported in developing skills to enable successful change processes to happen in an extremely demanding economic climate. The building and sustaining of a positive work culture needs to be seen as a priority to enable managers to support changes that organisation will face over the coming years.


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www.healthbusinessuk.com Health Business | Volume 10.3

TRAINING

GETTING To THE RooT oF THE PRoBLEMPromoting psychological wellbeing and performance at work

Promoting psychological wellbeing and performance at work relies on the creation of effective cultural foundations that encourage behaviours that lead to trust, commitment and engagement between individuals, and their manager


NEGATIVE MANAGEMENT STYLESWEST MIDLANDS AMBuLANCE SERVICE staff were up in arms recently after their health authority spent an astonishing £10,000 on a survey construed by many as insensitive. The Making Leadership Cool research aimed to identify key characteristics of good leadership and asked staff to rate their chief executive, Ian Cumming, as well as historical leadership figures, including Hitler, on a scale of ‘coolness’. Badly handled from the outset, the survey has tarnished the authority’s corporate reputation. It has also raised further serious concerns about the standard of management within the healthcare sector. Crucially it highlights the very real possibility that similar poor management decisions could damage the sector’s future if something does not change. Managers within the health authority were short-sighted to approve the survey, and failed to consider its potential for negative publicity. The subsequent furore caused by the inappropriate subject matter rendered the entire exercise pointless and their commendable attempts to examine the leadership within the organisation, and how staff react to it, went completely unnoticed.

ADDRESSING MANAGEMENT ISSuESIn many ways, this could be written off as another example of health sector management gone bad, amid countless other stories of organisational and management failure that have dented the reputation of the NHS in recent months. That said, in commissioning the research, NHS West Midlands had made

the decision to proactively examine what styles of management work best, so they could create an appropriate leadership development programme. In doing so, they were acknowledging the importance of adequate management and leadership, and most importantly, conceding that there are areas for development. The problem is that, in the healthcare sector, bad management can cost more than just the reputation of an organisation. As the investigation into the management failures at Mid Staffordshire PCT showed, in the worst case scenario, it can even cost lives. Taking action to address management inadequacies, as long as it is properly handled, is an important step in the right direction. The West Midlands Health Authority was right to be concerned. Recent Chartered Management Institute (CMI) research revealed that more than half (56 per cent) of the health sector workforce thinks the dominant management style within their organisation is negative. The three most common styles according to healthcare workers are authoritarian (25 per cent), bureaucratic (19 per cent) and secretive (12 per cent). Hardly desirable management traits. These statistics are worrying. only six per cent of health sector workers describe their bosses as trusting and just four per cent think senior staff are empowering. With figures like that, we can be in no doubt that the sector’s management and leadership needs to change. Bosses who think that management styles have no bearing on business productivity and

profitability must think again. Managers must now get serious about their development for the good of their organisations.

VIEW oF MANAGERSConsidering the negative perceptions that the workforce have of their bosses, there is a danger that negativity will seep throughout the sector. If this continues, it could even affect employees’ desires to go on to occupy senior roles. CMI’s research revealed that almost one in five health sector workers (19 per cent) said the traditional stereotypical ‘suited and booted’ view of managers puts them off becoming managers themselves. If this is allowed to fester, and talented individuals within the sector shy away from senior posts, it could create a significant skills gap at senior level that would be difficult to bridge. At a time when the sector urgently needs talented and innovative managers, it’s never been more crucial to nurture the leaders of the future. The sector faces tough times ahead. As the private sector begins to recover, it is widely acknowledged that the public sector still faces something of an uphill struggle. The health service is already bracing itself for severe cuts, as the new coalition government prepares to slash public spending in a bid to reduce the deficit. Now, more than ever, strong, capable and talented managers are needed to help pull the sector towards recovery. CMI’s Economic outlook report, which tracks business confidence amongst the uK’s senior executives, reveals that the recession

Ruth Spellman takes a look at style and substance for a healthy management future


F You ARE LooKING for a training provider, you could be forgiven for feeling

overwhelmed by the number of options available. There are certainly lots of companies to choose from, but how do you know which will deliver the high impact, long lasting results you demand? You need a provider with a great track record, a flexible approach and health sector experience – along with fantastic, inspiring trainers who will offer delegates support that goes beyond the classroom. At Cambridge Executive Development, we believe we offering all of these things in abundance. Along with working with PCTs, in hospitals, and with medical providers, our trainers can draw on years experience

working with many of the country’s top organisations. our wide range of courses can be adapted to suit your specific needs and our

approach to learning is highly flexible. All of our trainers have first-class delivery skills, bags of enthusiasm, a flexible approach, and a wealth of practical experience from a variety of business roles. Courses include: management, presenting, negotiating, time management, project management, personal effectiveness and many more. Please contact us for testimonials from some of our clients, or to speak to one of our trainers about your specific needs.


Tel: 0845 2260624E-mail: [email protected]: www.cambridge-ed.com

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How do you choose a business skills training provider?

TRAINING

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In these challenging times it is vital that leaders and managers are willing and able to stand out and make a difference. This might mean taking action when there is uncertainty; speaking when it would be easier to keep quiet or making decisions that take in a bigger picture.

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Leadership Development, Coaching and AssessmentThrough our leadership programmes we help people develop the skills and discover more of the qualities such as courage, judgement and drive that they need to be ‘stand out’ leaders.

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For further details visit our website: www.Farsightleadership.com or call 0161 266 1090and ask to speak to David Parkinson or Rachel Day. Farsight is a CMI accredited leadership training centre

is still severely impacting on 51 per cent of public sector organisations and shows that job insecurity is at record levels. With the impending threat of cutbacks, levels of morale have hit an all time low. 78 per cent of managers say morale has worsened over the past six months. Strong leadership will be vital to pull the

workforce through, helping them to cope with challenges including the emotions of losing colleagues to redundancy and on a practical basis, coping with increased workloads to compensate for reduced teams. It’s not just about style though. It’s also about skills.

THE NEED FoR TRAININGAccording to CMI research, at best, only one in five managers in the uK holds a professional qualification. Managers cannot

expect to do a good job, and produce good results, without appropriate training. There is no excuse for managers who fail to take their personal development into their own hands, or employers that fail to support their management teams in developing. As a busy manager in today’s tough

environment, it’s all too easy to put personal development low on the list of priorities, but in fact, it’s the lynch pin upon which success or failure of both the individual and the organisation depends. Today, managers need to possess a variety of skills and abilities to stay at the top of their game. By identifying their strengths, as well as developing any weaker areas, people can take positive, proactive steps towards becoming better all-round managers.

once someone has got to grips with their personal development, the ability to lead and develop staff will follow. Staff satisfaction will naturally increase in organisations where managers provide a clear purpose and direction when delegating tasks and guide employees through any problems. By communicating issues clearly to staff and operating a ‘door is always open’ policy, managers can create a culture of trust and respect, allowing workers to instinctively feel more involved and motivated. Furthermore, goodwill and engagement not only improves people’s working lives but also adds to the bottom line in the form of productivity, retention rates and employee loyalty. Considering the current disillusionment of uK management, both in the general workforce and among managers themselves, the need for a drastic improvement in leadership is something that cannot be delayed. The statistics and recent negatives stories show that managers need to take the helm. Good leadership is something to be admired. Isn’t it time you lead by example?

Ruth Spellman is the chief executive of CMI, the UK’s leading professional body for managers.


Web: www.managers.org.uk



In the healthcare sector, bad management can cost more than just the reputation of an organisation. As the investigation into the management failures at Mid Staffordshire PCT showed, in the worst case scenario, it can even cost lives

TRAINING

Ivita Learning – a sound start in management

ANAGEMENT SKILLS are more important

than ever when we live and work in difficult times. Young managers and those new in post particularly need support to become established in positions of authority. With a sound start, they may well go on to be the leaders of tomorrow. IVITA Learning offers management training and qualifications designed to get new and aspiring managers firmly established on their careers in management:• ILM Level 2 Award and Certificate in Team Leading• ILM Level 3 Award, Certificate and Diploma in First Line Management• NVQs at Levels 2, 3, 4 and 5In August 2010 we will be offering the BRAND NEW qualifications from ILM:• ILM Level 2 NVQ Certificate in Team Leading• ILM Level 3 NVQ Certificate in First Line Management• ILM Level 5 NVQ Diploma

in Management• ILM Level 7 NVQ Diploma in ManagementThese offer a greater flexibility to respond to employer need, retain the focus on developing and recognising competence but have a greater emphasis on knowledge and theory designed to link behaviours and skills.


Annie Weir established IVITA Learning in 2004. Please call her on 07919 542143 or enquire through www.ivitalearning.co.uk for more details.

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Enhance leadership and effectiveness with the help of Pauline Drissell

oACHING IS a collaborative

and one of the most powerful forms of leadership development, permitting individuals to work at a much deeper level, on a 1:1 basis. My role is that of Thinking Partner; listening and providing challenge and support to help clients to reflect and consider new perspectives. A confident senior executive with well-formed ideas, self-awareness and honed people skills usually means enhanced leadership and effectiveness for the whole organisation. I’m a qualified independent coach with over 4,000 hours of coaching gained over the last 10 years. My experience encompasses the not-for-profit, public and private sectors. I bring an appreciation of motivation, leadership and teamwork. My

experience has been gained mostly with senior, executive management and chief executives in specialist, technical and generalist roles. Previous clients have valued my honest feedback

and challenge, my ability to make them feel comfortable, willingness to listen, and my insights and intuition. A Fellow of the Chartered Institute of Personnel and Development, and Member of the Institute of Directors, I’m licensed by the British Psychological Society to use psychometrics. I’ve also been a trustee of a national charity for eight years.


For a confidential discussion without obligation, call Pauline Drissell on: 07733 005034 E-mail: [email protected]

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Leadership and management skills for the future in the NHS

HE PEoPLE DEVELoPMENT TEAM

believes that the drive and passion brought to an organisation by its leaders forms the basis of its success, culture and sustainability. It is from this belief that the People Development Team has dedicated itself to developing leadership capabilities and management skills to the highest of standards for its clients. Every NHS employee has a responsibility to contribute towards resolving the immediate challenges faced in the NHS whilst reaching their full potential. How do we ensure that we have a strong and flexible leadership presence in the NHS to enable this to happen? over the last few years, the People Development Team has worked across the NHS to translate pragmatic leadership and management development into more effective workplace practice and improved results. our high impact development

programmes result in genuine long term change. Therefore we are delighted to be running a complimentary seminar for strategic managers in the public sector on Tuesday 29 June 2010 in London to discuss how leadership, empowerment and innovation can help managers to meet the challenges that the public sector now face. We will be joined by a number of experts, including David Pardey (ILM).


Tel: +44 (0)1920 485569 Fax: +44 (0)1920 485528E-mail: [email protected]: www.people-development-team.com

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ILM Accredited distance and workshop learning

HG CoNSuLT IS a rapidly expanding management

and training consultancy based in the East Midlands. In addition to offering management and personal development training, we also provide a range of ILM accredited qualifications. Qualifications we provide include:• Team Leading – level 2 • Leadership and management – level 3, 5 and 7• Management – level 3 and 5 • Coaching and Mentoring – Level 3 and 5We currently deliver accredited courses to the MoD, Fire and Rescue Services, and the Highways Agency. This gives us a unique understanding of providing qualifications to large multi site organisations working in a pressurised environment with an emphasis on risk management and personal safety.

our flexible learning packages allow us to provide blended training courses that can either lead to a full or partial ILM qualification. We offer both traditional based learning in a classroom environment and distance learning using podcasts, web cams, online videos and forums. We can also offer you a mixture of both for ultimate flexibility. our training is practically based allowing easy transition from classroom to workplace. Effective results are seen immediately providing a recognisable return on investment.


For an informal discussion or more information call Lee 0845 603 9311E-mail: [email protected]: www.rhgconsult.co.uk

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NDREW LANSLEY, THE NEW health secretary, says there is a case for ‘efficiency savings’ of more

than three per cent...so the NHS…will have to do ‘more with less’. Randeep Ramesh, The Guardian website, 14 May 2010. Leaders are continually presented with significant challenges in meeting and demonstrably achieving aspirational targets and goals for their organisation; the need to impart a clear vision and road map for success, to encourage line managers to take ownership of their teams’ performance and to build individual confidence in a manager’s own capabilities, are critical elements in ensuring effective managers are developed to become, in time, effective leaders for their organisation. This is never more pertinent as now, taking our first tentative steps towards economic recovery, and with the new coalition government intent on making essential cost savings right across the NHS, budget restrictions and retrenchment are factors that cannot be ignored by managers to ensure organisational sustainability. But how can the NHS do more with less? Capita Learning & Development’s leadership and management development courses can give NHS managers a head start. our short courses and modular programmes are cost

effective, flexible and practically focused to adapt to your professional obligations and work demands, giving you the opportunity to enhance your skills and knowledge as well as meet your organisation’s objectives. our Postgraduate Certificate in Managing Public Services, specifically for managers in the public sector, is a distance learning course run in conjunction with Newcastle Business School, ensuring you can maximise your study time whilst remaining committed to your work obligations. We also offer managers nationally recognised management qualifications with the Chartered Management Institute Level 7 Diploma in Strategic Management & Leadership, and Institute of Leadership & Management Level 5 Award in Management. These qualifications are run flexibly, and are tailored

to your own professional requirements. For those new to management we run our highly attended Successful Supervisory Management training, and three-day Management Fundamentals residential course. And for those equally new to leadership, there is New to Team Leadership.


So in this time of constant change, you can rely on Capita Learning & Development to help you lead from the front. For more information please contact us on 0800 022 3410, e-mail [email protected], or visit our brand new website on www.Capita-LD.co.uk. We are also happy to discuss any individual organisational requirements you may have.

Count on Capita Learning & Development to help you lead from the front

A


TRAINING FoR CHANGE

THE NHS INSTITuTE FoR INNoVATIoN and Improvement has recently undergone a major change programme, to enable it to pursue a more commercial business model. The IT skills consultancy optimum, which specialises in user focused training, worked alongside the NHS Institute’s team and their implementation consultants, Logica, to understand the organisation and to create customised training courses and materials. The new system aimed to improve resource management and generate income by providing services to NHS England and by also selling products and services to non-NHS customers in the uK and overseas. TIME FACToRA central part of making the new business model work was moving away from outsourcing its finance function to implementing its own. flanges This meant re-structuring the finance team, designing completely new business processes and building a system around them, then training all staff and project workers to use it, all within three months. Tim Reardon, assistant director of finance, said: “We were facing a tight and immoveable timescale to get the new system up and running and we needed to make sure our technical and finance people were free to concentrate on the build. We realised that we needed professionals to project manage the user training on the system.” The NHS Institute for Innovation and Improvement recognised that the new finance system in itself wasn’t the solution to working more efficiently; it was how the staff used it that mattered. If getting users to ‘buy-in’ to the system was critical to success, then the training had to be focused around them. “We had trained our own staff internally to use the previous system

but their feedback was that accountants aren’t trainers and if we wanted to get the most out of the new system, they needed professional training on it,” said Reardon. optimum designed, developed and delivered role-based courses for all users of the new finance system across several locations, as well as creating a range of back-at-desk quick help cards and reference manuals. James Webb, optimum’s project manager, noted: “This project involved new staff, new roles and completely new ways of working – NHS Institute had never had an accounts payable function before. So the training design and development really was an exercise in starting from scratch.” INVESTMENTThe investment in optimum’s services was well rewarded. Reardon observed: “We’d set up a working group of non-finance users as part of the change project and one of them said that optimum’s had been ‘the best training they’d ever been on’.” Eleanor Dennehy, the lead Logica consultant working on the change programme, added: “NHS Institute set some very tough standards but optimum tailored the training to mirror their processes and language, making it as user friendly as possible. The training delivery was very professional and the feedback during the courses extremely positive.” optimum held workshops for the project team, the implementation consultants and users to give specific training on additional elements of the system’s functionality that would bring efficiency benefits but which hadn’t been explored previously because of time pressures. As well as delivering role-based training to enable managers, budget holders and requisitioners to carry out their jobs, optimum also dealt with many of the

change management issues that surrounded the project. The training sessions became a forum where people felt able to raise their concerns about the new structure and roles. “The scale of the changes, both culturally and practically, was huge and very emotive for staff,” Reardon commented. “Because optimum was from outside the organisation, when people went ‘off-piste’ the consultants could handle these change issues and build confidence, so staff came away much more positive.” Dennehy noted: “optimum’s user focused training was absolutely right to ensure the basic knowledge transfer to allow the system to function was done without inundating users. The ‘business-as-usual’ is a great basis for refresher training.” Whilst implementing any new core business system is always a highly pressured and potentially risk-laden event, NHS Institute’s experience shows that the right level and right kind of training is a large part of the success. SuPPoRT“Timing and approach were both critical for us,” said Reardon. “using professional trainers made sure we delivered the project on time and that our staff were well supported at a time of massive change. using optimum was a very positive experience. They showed great professionalism and we had really good feedback.” optimum is an IT Skills Consultancy that specialises in highly effective user focused business systems training. our mission is to bring people and technology together to make change happen. All of our trainers are accredited by The Institute of IT Trainers.


Please call 020 7776 9876, e-mail [email protected], or visit www.optimum.co.uk

Bringing people and technology together to make change happen


TRAINING

Having spent many years working for large healthcare recruitment agencies, the founding directors of Red Professional Locums strongly believe in the need for a personalised, partnership approach to healthcare recruitment which is professional, reliable and cost effective. Red Professional Locums ultimately centre its company ethos around the relationship between agency, client and locum. For this partnership to be successful it must always be professional, open and realistic. Red believe our ability to listen and then provide tailor made solutions for all your recruitment needs will establish a successful long term working relationship with both our clients and candidates.

Red is built with highly experienced individuals who have worked in the healthcare market for many years. Our team are fully able to effectively manage all levels of volume business such as SLA’s, specific recruitment drives as well as ad hoc requirements and want to inspire you to have complete confidence in our ability to provide you with Locum cover as and when you need it.

At Red we strongly believe that one size does not fit all and that both clients and candidates are unique, each having their own specific reasons for using a locum agency. Our aim is simple; to identify yours and help you achieve your objectives.

CONTACT OUR RECRUITMENT TEAM | 0845 5390077Tel: 0845 5390077 Fax: 08455390117 Email: [email protected]

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A Partnership Approach for best value resourcing


PART oF THE SoLuTIoN, NoT THE PRoBLEM

IN RECENT WEEKS, THE CHANCELLoR has announced that £6 billion worth of cuts will be made to public expenditure over the next year. This cost-cutting exercise could have a series of ramifications for both services and staffing within the public sector. Rather than making knee-jerk reactions to these changes, public sector employers need to carefully consider the long-term impact of their actions to ensure that frontline services are not compromised and that existing staff are not put under undue pressure. one of the first areas that is likely to come under pressure is temporary staffing costs. However, rather than being an additional cost, flexible staff, such as locum doctors are actually part of the cost and resourcing solution. The NHS is already very reliant on these workers to fill staff absences or help deal with peaks in demand. Cutting them out of the equation to save costs simply won’t work. If anything, if the NHS is to become more cost efficient for the long-term it needs a flexible workforce that can grow and reduce to match demand now more than ever. In addition to public expenditure cuts, the new coalition government has also announced its key policies for healthcare and its vision for the future of the NHS. To successfully deliver these new policies and to provide constantly improving service for patients, having the right staffing solutions in place will prove essential.

MANNING ouT-oF-HouRS CAREone of the key challenges for the new government is to assure the public that they will receive quality care around the clock. The recent case of a German doctor who accidentally killed a patient on his first out-of-hours locum shift in this country very publicly highlighted not only the resourcing challenges already facing the NHS but also the complexities of using health professionals from the Eu. According to the plans outlined by the health secretary Andrew Lansley, family doctors will be forced to take back responsibility for out-of-hours care, although this will not be a straight forward return to the old system where GPs had to be on call around the clock. The intention is for budgetary responsibility to be handed back from Primary Care Trust to GPs who will commission services or provide them by working on a rota system through local groups. Despite the focus on new rota systems, careful consideration must be given to all forms of flexible working arrangements that would allow patients to receive the right level of

care in the most cost-effective way. Specialist recruitment agencies continue to provide cost-effective means of ensuring that the right staff are in the right place at the right time and that every patient receives the care they need. Locum doctors and other temporary staff provide crucial front line services and their contribution must not be marginalised, especially as working time rules now place strict limits on individual GP working hours.

RESouRCING INTERNATIoNAL TALENTAt the end of 2008, figures issued by the Department of Health showed a shortage of 2,000 doctors. The British Medical Association has attributed this to the implementation of the Working Time Directive. The NHS has in the past used flexible working arrangements to fill this gap, drawing on the skills of both temporary workers and talent from Europe. The government’s plans to tighten immigration however could pose some problems for healthcare professionals. While the government’s

new policy aims to allow skilled migrants into the country where there is a specific need, changes to the immigration system will undoubtedly add pressure on resourcing. As part of the policy on migrant workers in the NHS, the government has announced plans to introduce language requirements for foreign healthcare professionals. GMC’s Chairman Professor Peter Rubin has recently spoken about the legal advice that the GMC has received on the issue of language testing. According to professor Rubin, the legal advice showed that “it is a consequence of uK legislation not the European legislation that we are currently unable to test the language skills of EEA medical graduates”. Professor Rubin indicated that, due to the new government’s policy priorities, a change in legislation that would allow the GMC to test language abilities is very likely. Even if such tests were introduced, there will always be a need for an effective assessment process at Trust level, which

A flexible workforce is key to the successful delivery of new NHS policies, says Tom Hadley, director of external relations at the Recruitment & Employment Confederation


RECRuITMENT


Locum doctors and other temporary staff provide crucial front line services and their contribution must not be marginalised, especially as working time rules now place strict limits on individual GP working hours

IT RECRUITMENT FOR THE PUBLIC SECTOR In the current financial climate, IT recruitment has become even more important to the public sector.

P.S.E Solutions prides itself on a cost effective recruitment process that will be beneficial to their clients. Paul Prince, Director (REC/FIRP) qualified has over 20 years experience in IT recruitment and has recruited for many blue chip organisations.

At P.S.E Solutions we pride ourselves on long term relationships with clients and have been supplying the same clients with employees for over 10 years UK wide. We feel that it is important to understand your clients needs fully and therefore providing an efficient and cost effective recruitment process. We are a REC member and adhere to their strict recruitment policies and procedures. Call now for an informative discussion on how our services can benefit you. Telephone: 0844 4780067 Mobile: 07810 201167Email: [email protected]

TechNET IT Recruitment Ltd has recently been approved as a Buying Solutions Supplier for non-medical temporary and permanent resource. We specialise in all aspects if IT recruitment and have a proven background recruiting into PCT’s and NHS Trusts. Please view our website www.technet-it.co.uk for further information regarding our services.

looks at whether the doctor has the right qualifications and relevant experience for the position, and which verifies references, and which runs ID and vetting checks. It is essential that these checks are carried out both to ensure quality of care and to put the public’s mind at rest about the use of medical professionals sources from overseas. NHS Trusts need to look at how they can achieve comprehensive recruitment processes that safeguard the patients and that ensure the right doctors is recruited in the right position, and how they can undertake this process in the most cost-effective way possible. Specialist recruitment agencies play a vital role in providing the Trusts with the support they need as they are already used to carrying out candidate checks across the healthcare industry as well as in teaching and childcare. By drawing on their expertise in this space, NHS employers can save time and money and be confident that all necessary checks have been done to ensure the quality of candidates.

SKILLS SHoRTAGESThe findings of the 7th Annual NHS Staff Survey for the Care Quality Commission were released earlier this year and underlined major resourcing challenges. As many as 45 per cent of those surveyed felt that there weren’t enough staff for them to do their job properly, highlighting current staffing levels as a key concern amongst NHS workers. unmanageable workloads can create a downward spiral of increased stress related absences which will only add to the resourcing challenge. The survey also found that only 44 per cent of NHS staff felt that their Trust was committed to helping its staff to balance their work and home life so there is clearly more work to be done by Trusts and other NHS employers to boost staff satisfaction levels and encourage staff retention within the NHS. As well as helping employers, flexible resourcing is also of benefit to individual workers in the NHS. Many already choose to work through agencies so they can pick and choose the hours that they work and fit work around family commitments, for example. The NHS and provision of healthcare in the uK has reached a crossroads. NHS staff already feel that there are not enough staff in order to provide quality care and with the public expenditure cuts now in place, this situation can only intensify. Rather than making random cuts across the workforce, and across temporary workers in particular, both the government and NHS employers should see this current chapter as an opportunity to bring about sustainable reform to public sector resourcing. A flexible workforce should be central to this and is part of the cost solution, not the problem.


Web: www.rec.uk.com



NHS Trusts need to look at how they can achieve comprehensive recruitment processes that safeguard the patients and that ensure the right doctors is recruited in the right position, and how they can undertake this process in the most cost-effective way possible

RECRuITMENT

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RIGHT PEoPLE, RIGHT SKILLS

EVEN WITH THE LIBERAL-CoNSERVATIVE Coalition planning to increase NHS funding in real terms each year, efficiency savings, demographic and inflationary pressures mean the NHS is facing lean times. But rather than looking to mass redundancies to make savings, NHS Employers, which represents trusts on workforce issues, is encouraging organisations to look for smarter ways to reduce costs. Ensuring that they recruit and retain the right staff is a central part of that. And it’s more complicated than you might think. The NHS and the rest of the public sector will be making efficiency savings at a time when the private sector is emerging from the recession. Demand for highly skilled workers will be intensifying and public sector pay restraint will mean that the NHS will need to work hard to make itself attractive to new recruits. Consider this alongside an ageing workforce and changing patterns of work – to include more part-time and flexible working – and it’s clear that recruitment and retention in the NHS will become a considerable challenge. Many NHS professions are likely to lose some of their most experienced practitioners through retirement over the next few years and fewer school leavers will be coming through to replace them. The ageing population also means increasing demands will be placed on our healthcare system and its staff.

AN ATTRACTIVE WoRKPLACEThis makes it important to attract people with the right skills to meet the changing needs of the population and the flexibility to find new ways of delivering more care with the same resources. organisations will need to develop their talent “pipelines”, identifying skills gaps and promoting experienced staff from within, while looking to recruit the rising stars of the future. This means knowing:• where talent is now and in the future• what skills and experience that talent will need• what talent is currently available, where it is and how good it is• how to develop that talent to meet future needs.Attracting staff, and retaining them in a competitive environment, will depend on NHS organisations being able to clearly communicate the benefits of working in the NHS. The opportunity for training and development should be seen as a key benefit, alongside pay and conditions, pensions, and the chance to make a difference. Employers

In lean times like the ones we’re now facing, organisations need to ensure they recruit and retain the right staff, says Karen Charman, head of Employment Services, NHS Employers


RECRuITMENT


Demand for highly skilled workers will be intensifying and public sector pay restraint will mean that the NHS will need to work hard to make itself attractive to new recruits

will need to understand and explain the full reward package and emphasise the development opportunities within the NHS to attract high quality candidates. Many NHS organisations have already developed, or are currently developing, talent management strategies to help them attract and develop the talent they need for the future. The best of these plans cover staff at all levels and at all stages of their careers, identify the characteristics or competencies their future leaders will need, and take into account the need for a diverse workforce where the different strengths of individuals are appreciated and nourished. Successful talent management strategies in the NHS have the following core elements:• engagement from the chief executive and the senior team• alignment to the corporate strategy• performance measurement• succession planning• development programmes for identified ‘talent’• mentoring and coaching.They have a focus on clinical leadership and involve a wide range of stakeholders. They also put an emphasis on the individual to contribute to their own development and make the most of opportunities.

EXCITING FuTuRES IN BRADFoRDone organisation that is already making inroads with its talent strategy is Bradford District Care Trust, which has taken an integrated approach to talent management, organisational change and service improvement. They set out to develop and deliver their own in-house leadership programme, Exciting Futures, designed to connect with service users and to draw out the talents of staff from across the organisation, including clinical staff. The programme sees 40 staff participating in nine months of development activity including development sessions, project work and online learning. The driver for development is a stretch assignment based on five community projects working with service users. Professor Beverly Alimo-Matcalfe, who has conducted studies into the productivity of NHS organisations, has praised the programme. She said: “Service users and staff working together on different community projects within a structured training programme is an outstanding idea. “Motivation is fuelled by emotions. Through creating an emotional connection with the participant’s work, a stronger commitment and sense of belonging is created. Emotions fuel aspiration and people’s efforts increase: this is at the core of successful leadership.” Some of the successes of the

development programme have seen:• the In Touch with Art group organise a unique art exhibition created by people with learning disabilities to tackle stigma. • the Jumping Jewels group successfully reach their fundraising target to get a cheerleading squad for people with learning disabilities to the national finals. • the Social Sunshine Diggers well on their way to transforming an area of derelict land into a garden of tranquillity for service users. The hands-on-projects aims to provide future managers with a unique and powerful learning experience that will not only benefit the individuals, but also service users and the community. The trust sees this as a programme of cultural change that will involve step change and insists it isn’t a magic bullet. over three years, it is expected that as the numbers of participants grow, they will be better able to take what they’ve learned back to their workplace and change working practices. The work of the programme will also become more closely linked to service improvement.


www.nhsemployers.org/talentmanagement



RECRuITMENT

DO YOU HAVE A HOUSINGDEVELOPMENT PROGRAMME?

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ARE You PREPARED?

MoVING WITH THE TIMES AND A constant attention to members needs are key drivers for the Emergency Planning Society (EPS). Emergency planning within the uK Health Sector forms a vital part of the Society’s Membership Service strategy. uK health emergency planners are now living and working in dynamic times and their professional body, The Emergency Planning Society, can trace its roots back some 50 years with its origins being found in the Civil Defence Act of 1939. The Society’s modern day reincarnation was formed in 1993 by a merger of two existing professional organisations. The Civil Defence Act 1948 enabled the previous Second World War organisations to form the Civil Defence Corps to prepare and protect the civil population from a wartime nuclear attack. The first professional organisation, the Association of Civil Defence officers, was formed in 1952 by those members of the Corps. The reduction in the then nuclear threat together with a greater focus on safety and a realisation of the potential for major disasters, particularly in transportation and hazardous industries, broadened the Association from its public sector origins to encompass the private sector. The Association changed its name to The Association of Civil Defence and Emergency Planning officers (ACDEPo) in 1973. Following the end of the Cold War the emphasis on civil defence finally disappeared and the Association was renamed the Emergency Planning Association (EPA) in 1992. The EPA merged with the County Emergency Planning officer’s Society in 1993 to become the Emergency Planning Society of today with around 800 members. The Society became a company limited by guarantee on 16 December 2003 and continues to grow with a membership now standing at 2,400.

ADDRESSING THE CHALLENGESThe days have long passed when the emergency planning officer was accommodated in a basement cupboard to be shown the daylight only if a disaster occurred along with a general perception of the Society being an informal gentleman’s club of ex-military officers. Since the Y2K alert in the late 1990s the Society has had to re-align drastically, tailoring its service focus to the increased demands of member’s own organisations, additional pressures of legislation, advice and guidance, coupled with the degree of professionalism expected by our members. The Society’s small full time secretariat at Cardiff is dedicated to providing the required advice and guidance by phone or e-mail with a regularly updated Internet site. As the largest organisation for uK emergency

Mike Lees of the Emergency Planning Society talks about how they can help form a resilient NHS response to major incidents and business continuity events


EMERGENCY PLANNING


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planning professionals it continues to aspire to Chartered Institute status and its medium term business planning reflects this, along with an increased emphasis on governance, the professional development of its members and an ability to influence key decision-makers in government and business. As the majority of Health Trusts in the uK are categorised responders (Category 1 or 2) under the Civil Contingencies Act 2004 it is imperative that all the legal duties under the Act are addressed by a qualified emergency planning/business continuity lead. It is difficult to be totally objective about the Society’s progress but a number of issues do speak for themselves. The membership has increased by almost 12 per cent since March 2009, a very passable achievement considering the economic climate and recent period of recession. Additionally the delegate registrations for this year’s annual conference in Glasgow are excellent and the take-up the recently introduced online CPD scheme has been exceptional.

AFFoRDABLE TRAININGThe Society is currently expanding its business arm for the benefit of members. one such area being vigorously pursued is reasonably priced training, organised internally or in partnership with a training provider. The Society has recently endorsed its first training provider, Skills 2 Share of Newark, with courses covering crisis management, incident room response and corporate manslaughter being particularly relevant to health sector emergency planning leads. A number of other providers including Link Associates International and the Emergency Planning College have also indicated a real interest in participation. As there are both non-

technical and technical grades of membership the Society proactively encourages members to upgrade and mentor support is readily available. In 2008 the Society introduced the Core Competences Framework based on the National occupational Standards for Civil Contingencies and this provides an essential level of assurance for health service senior managers when linked to an emergency planning lead’s professional development. The Framework is seen as a key stage in recognising and assessing the competent emergency planning practitioner. In many cases the uK health sector has shown other organisations a way forward in the dual role adopted with regard to NHS emergency planning and business continuity responsibilities. Although considered heresy by some, for many NHS organisations this ‘double badge’ works extremely well. Chief executives and trust boards should recognise, however, that this approach carries a huge responsibility for them and the respective post holder. As the EPS has extensive experience and a membership drawn from across the entire resilience community it can provide advice and guidance on possible resourcing issues as well as support and professional development for the organisation’s respective emergency planning lead. Close working relationships with a number of key organisations has led to the Society working on a number of different professional development initiatives including

leadership training for senior NHS managers, foundation training for emergency planning officers and a Masters degree in health emergency planning. The transferability of CPD points and the mutual recognition of CPD schemes within the uK resilience, risk, fire and security sectors are both proposals the Society is currently seeking agreement with a number of partner bodies.

RISK MANAGEMENTAn aspect of the role of emergency planning lead often missed or ignored by many organisations is an open door provided to holistic risk advice. The emphises and core foundation of emergency planning is a constant engagement with risk, response and consequence management. It also has to be acknowledged that health emergency planning leads have role limits with time and duty constraints but their expertise in risk environments, even in just an advisory capacity, can provide that invaluable engagement in the preparation of corporate risk registers and the mitigation of strategic risks. Many strategic risks such as climate change which is closely associated with extreme weather events and Hazmat or CBRN are the common fare of all uK health sector emergency planning staff. These stated risks, along with others, should be included in the corporate risk registers of most NHS organisations. The



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EPS provides both a pathway and advice to its members on these and a number of other issues via its local Branch and national Professional Working Group (PWG) networks. The following are major points that the Society is committed to taking forward with the uK health sector in the short term:• A full recognition of the role of the emergency planning professional and embedding the resilience culture within the uK health sector.

• Society support with advice and guidance to assist in successfully resourcing emergency planning posts.• To encourage continuing professional development (CPD) in the health emergency planning role and attendance at multi-agency events.• Full support for endorsed vocational and academic qualifications relevant to the health emergency planning role.• To work closely with all the relevant bodies to ensure the current Knowledge & Skills Framework links closely with the role of the emergency planning professional.All the obvious advantages outlined above should prompt senior health service managers to not only actively encourage membership of the Emergency Planning Society but ensure that a small part of their budget is reserved to subsidise the membership of a professional body. Societal risk is increasing and to successfully plan for, or indeed manage, the consequences of a major incident or business continuity event require the input of a competent, well trained, dedicated emergency planning professional. The Emergency Planning Society is there to fully support that professional and their employer. Comments about the EPS approach to CPD

“Essex has always embraced a positive approach to professional development and personal achievement, whilst encouraging innovation by staff engaged in the field of emergency planning and business continuity. The Society’s CPD Scheme provides us with a nationally recognised system that demonstrates our commitment and professional competence. It not only offers tangible benefits for an individual’s career progression but is of value to a range of employers and partners. Additionally it provides a level of assurance to our communities,” said June Thompson, head of Emergency Planning & Business Continuity, Essex County Council. “The Regional Resilience Teams recognise the importance of developing the skills and knowledge of their staff and are working as a network to improve opportunities for RRT staff. Part of this is encouraging staff to take an active role in their own development and the provision of a CPD system will help stimulate and record this as well as promoting them to improve their EPS status. The work carried out by the RRT’s also seeks to link this system into their Civil Service appraisal. For the RRT at Government office East the benefits of the CPD system were sufficient to justify all members of the Team becoming members of the EPS,” commented Jeff Stacey, resilience team leader for Government office East of England.



ABouT THE AuTHoR

Mike Lees is the director of Membership and Professional Development for the Emergency Planning Society and is a full time resilience manager (Emergency Planning/Business Continuity) for Barnsley Hospital Foundation Trust. He has previously served as a contingency planning manager with two police forces (South Yorkshire & British Transport Police), holds a Master degree in Risk, Crisis & Disaster Management from the University of Leicester, is a fellow of the Society and Member of the Business Continuity Institute, Institute of Risk Management and Institute of Healthcare Management.

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FLEXIBILITY AND MoBILITY

WE’RE JuST EMBARKING oN A NEW experience within uK politics, with a coalition government that is having to make tough spending decisions. None of these should be more difficult than those affecting healthcare. Today in the uK we spend around 9 per cent of our GDP on healthcare. That’s at the bottom of the international scale. In the uS it’s closer to 19 per cent. By 2050 the uS figure, if it continues to grow at current projected rates will hit 75 per cent – a figure that is evidently impossible. In the uK a few years ago, the Health Technologies Scenario report anticipated that if we continued to have strong economic growth we might manage to afford 10.3 per cent for healthcare in the uK by 2025. Events since that report suggest that its optimism is misplaced and we’ll struggle to continue to afford our current 9 per cent. Instead, we need to look hard at how to reduce costs. The uncomfortable reality is that healthcare demand (and expectation) is growing inexorably. The consequences are already a known fact – a few years ago at a Continua

Health Alliance meeting in London, Margaret Hodge, then Minister of State for Industry and the Regions, stated that the growth in Type 2 diabetes would, by itself, bankrupt the health service by 2017. She was right – something needs to be done. Yet the reaction of the new government is to ring-fence spending on health. It suggests a major reality gap.

A DIRECT APPRoACHThere is always a problem in politics when the numbers involved become too large. Instead of forming a basis for a reformulation of policy, there’s a tendency to take the ostrich approach of sticking one’s head in the sand. During the election campaign, all three major parties pushed leaflets through my door saying how they’d spend more on local hospitals and safeguard the future of the health service. None contained a single hard policy proposal, just bland words of reassurance. of course, during an election campaign, selling cuts, particularly with regards to the NHS is not going to be seen as a vote winner.

But after the election, it is worrying that health policy seems to be “more of the same”. unfortunately, I suspect that the problem is so big that politicians will avoid it for as long as they possibly can. Acknowledging increasing morbidity and the prevalence of long term chronic disease and then linking their rise to personal health culpability is not a vote winner, even when you may have five years to push it through. So healthcare remains too sensitive an area to touch, even when cuts are being made elsewhere. EVERY BIT HELPSA few countries, of which Japan is most advanced, are beginning to tackle this by linking health benefits to proof of healthy lifestyle. Most others will have to follow. The further behind we fall, the greater will be the medium term problems and the eventual culture shock. It is unlikely that the NHS or any other Health Authority will be able to tackle it by themselves. It is not just a case of cutting or even containing costs, but of

Nick Hunn of the Mobile Data Association, takes a closer look at the role of mobile and remote monitoring technology in healthcare


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changing expectations and society’s involvement in taking control of their own health. The size of the problem means that the solution is unlikely to be monolithic, but will come from a mixture of many different services that attempt to change different facets of personal behaviour. Mobile and personal web technologies can assist in this evolution. They are by no means a panacea, but healthcare will need to take advantage of all of the help that they can offer.

The reason for reiterating the issue in the paragraphs above is to emphasise the enormity and immediacy of the problem. There is a common consensus that mobile health applications will somehow solve the problem. They certainly have the potential to help. However, the bulk of trials of telehealth or eHealth applications generally have fewer than ten enrolled patients. The uK is pushing ahead in starting some larger scale trials, with the current Large Scale

Demonstrator of 3,000 patients. The Assisted Living Innovation Platform is now funding around a dozen projects, building up to a deployment that aims to enrol upwards of 10,000 patients. However, by the time either of these delivers any significant results, we will be halfway to bankruptcy. Mobile technology is a valuable part of the answer, but it is going to need to develop and be deployed alongside current strategies and initiatives if it is going to provide any timely changes.

THE BASICSThe simplest role that mobile technology can perform is in helping the smooth running of a health service. At the most basic level that’s reminding patients of their appointments. For GP appointments the cost associated with missed appointments has been estimated to be £180 million per year. For the NHS as a whole, it’s approaching £800 million. Surprisingly, the largest group missing appointments is the 16-35 year olds, either because they forget or get better and don’t cancel. A number of companies have developed appointment systems based on mobile phones. The advantage over traditional appointment letters is that this most culpable group is the one most likely to use their phone. Text messaging is simple, cheap and gives the opportunity for the customer to reply. It has the added benefit of guaranteed delivery in the 24-48 hour period before the appointment, when the patient is most likely to respond as well as freeing them from the struggle of getting through to the GP reception. A number of companies offer simple appointment reminder systems that link into appointment software, automating the task. As well as managing the patient, mobile technology is increasingly being used to track assets within hospitals, whether that’s equipment or staff. Wireless LAN technology is being employed in the form of small tags to log where equipment is located. The benefits are twofold – it’s a powerful tool to prevent theft, as an alarm can be generated if equipment is moved outside its expected location – a technique called “geofencing”. It’s equally valuable to track down the closest piece of equipment in an emergency, which can include a member of the medical staff. These monitoring tags are typically small, battery powered units the size of a box of matches that run for several years between recharging. Locating staff can also be important when they’re working out in the community. That’s



ABouT THE AuTHoR

Nick Hunn is an executive director of the Mobile Data Association, where he promotes the development of eHealth. He is also involved in developing eHealth standards within the Continua Alliance and the Bluetooth SIG and advises on wireless connectivity and eHealth through his company – WiFore.

During the election campaign, all three major parties pushed leaflets through my door saying how they’d spend more on local hospitals and safeguard the future of the health service. None contained a single hard policy proposal, just bland words of reassurance

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where lone worker alarms come into play. An extension of a mobile phone, a lone worker alarm typically includes a GPS (Sat Nav) system and mobile network connection that can alert a control centre when the worker pushes a panic button. It’s essentially a more mobile version of the fall alarms that are used by over a million people in their homes in the uK (which accounts for over 60 per cent of all fall alarms deployed worldwide – a figure to be proud of).

ASSISTED LIVINGAs the population ages (by 2025, 20 per cent of the uK population will be aged over 65), more needs to be done to allow them to remain living safely in their own homes. Wireless technology can help that by providing a monitored environment that will warn of any issues. A key component to this is a new low power version of Bluetooth wireless technology, know as Low Energy Bluetooth, which will start to appear later this year. It’s designed to connect a wide range of simple home sensors that can connect to the internet. These will allow monitoring services, which may be run by local authorities, independent companies, or even relatives, to ensure that the elderly are living safely. other monitors, which include basic

medical monitors in clothing, can perform the same job using a mobile phone as a link, providing personal monitoring without institutionalising someone within their home. The longer a person can remain in their own, familiar environment, the better. once they are admitted to care or hospital the cost of treatment escalates.

HEALTH 2.0The web will have an increasing effect on how we treat health information, and who we trust with our own health information. NHS Direct has been one of the pioneering sites for providing trusted information to patients. The web is now seeing the arrival of more interactive sites, often referred to as Health 2.0 sites, which invite a patient to enter their information to allow them to track their health or the course of a disease. Amongst these, the most prominent are www.revolutionhealth.com and www.google.com/health. These sites will grow as consumer devices for measuring blood pressure, heart rate and weight become available which can connect directly to the web. As well as recording data, these websites are likely to evolve to provide feedback about your condition. The business models behind these will vary. What they

will do is to generate an increased amount of medical data, which is located outside the preserve of current healthcare suppliers. This dissemination of patient information will present a major challenge for today’s healthcare providers, as it breaks the structure that has been built up by the medical profession over the past few centuries. As such it will be disruptive – it has the potential to repeat the effect that MP3 and Napster had on music – and could change the whole landscape of healthcare and its ownership.

CoNCLuSIoNSChanging demographics mean that the status quo of healthcare needs to evolve. New ideas from small companies, new technology, mobile networks and web businesses will offer a range of products and services that stand to complement or disrupt what we know and use today. The challenge for the NHS and others is to embrace what is useful and to engage in directing its development. There is a massive problem to be solved. The best route to that solution will be to combine the best of all worlds without indulging in bouts of “not invented here” syndrome. And to persuade our political masters to bite the bullet and change the way we interact with the NHS.



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CoMMuNICATING WITH PATIENTS

MANY HEALTHCARE oRGANISATIoNS are now incorporating text messaging into the way they communicate with patients. Hospitals, clinics, GP surgeries, smoking cessation, sexual health and the National Chlamydia Screening Program are all feeling the benefit. It is widely known that text messaging is socially and digitally inclusive, over 98 per cent of uK adults now have a mobile phone. Many organisations are adopting simple to use interfaces from companies such as txttools. co.uk. This service allows the user to send and receive SMS text messages from their computer and track the delivery, much like e-mail, but with audited delivery. Having the ability to create discreet groups of clients, patients or staff can have major benefits when you want everyone to be notified with a single message. KEY AREASIn healthcare txttools is used in four key areas: sending out test results, reminding patients of appointments, nurse bank and general staff communications, and for public health campaigns. The txttools system works standalone on the Internet and data can be uploaded from any existing clinical management system, additionally txttools has been integrated ‘seamlessly’ within many clinical systems. In our experience there are a few key issues in healthcare that are simple to fix. Missed appointments cost the NHS millions of pounds every year – simple appointment reminders by text message cost pennies and are proven to work. Not getting timely results back when patients have been tested,

causes untold anxiety for the patient and increases pressure on frontline staff. Test results can be sent instantly by text with 100 per cent satisfaction, we can prove it. organisations are choosing txttools for a number of key reasons, including the fact that an unlimited number of contacts can be stored and unlimited numbers of messages can be sent, messages can be scheduled to arrive hours, days or weeks before an appointment or at anytime in the future. Contacts can be uploaded from any existing system. txttools offers unlimited support where help is less than a three-ring telephone call away. Two way messaging allows patients to cancel and rearrange. This really is simple to use, clever technology. Working in partnership with one of the leading Sexual Health System suppliers Mill Systems, txttools is fully embedded within the MillCare system delivering automated results and appointment reminders by text. Mill Systems are currently in the process of developing SMS further with txttools and will soon be offering clinics two-way messaging with the option for patients to book appointments by text anytime of day using an automated appointment booking system – a truly innovative solution to tackling the issues of sexually transmitted diseases – giving patients access to clinic appointments 24/7 (www.millsystems.com). 24/7 ACCESS“We put ourselves in the shoes of our target audience and quickly recognised SMS text messaging met the needs of young people.

Providing 24/7 access to request a do-it-yourself screening kit via a simple text message works,” says Judith Ralphs, Chlamydia Screening Programme Coordinator, Worcestershire PCT. “Text messaging has delivered dramatic results for the Bradshaw Clinic and has reduced DNA rates by almost 50 per cent in its first month. We recognised that tackling the issues of missed appointments would also offer direct cost savings, avoiding wasted clinical sessions and reducing the risks associated with a break in patients’ medication because they forgot to attend their appointment. We have had an overwhelming response from our patients, who think text reminders are great and make them feel cared for. Some of the comments we have received to date include: ‘It’s fantastic – why has no one thought of this before’ and ‘I almost forgot my appointment until I received your text – thank u’,” says James Sutherland, manager of the Bradshaw Clinic in Derby. “Desktop messaging is quick and easy to use, I really like the ability to send results instantly to any sized group. As you can imagine patients are anxious about test results and they want them as soon as possible. using meditxt we can get results out to all mobiles within minutes of getting test results back from the lab,” commented Liz Dearden, Chlamydia, screening coordinator, Leicester City PCT.


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Why should I care how my

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TIM SEWART, A PARTNER AT commercial law firm Beachcroft LLP, explains why you should care when it comes to purchasing software, how it can protect your business, and how to decide whether it’s the right route for you In a time of budget cuts and significant finger pointing if anything goes wrong, it is baffling to see software purchasers continuing to buy software in such a way that leaves them at the full mercy of their suppliers. options such as escrow should be a key consideration as part of any basic risk management strategy, and yet the majority of software users don’t care about, or simply don’t understand the full benefits.

WHAT IS SoFTWARE ESCRoW?If you use software that is important to your organisation and it crashes, you could find yourself completely reliant on the supplier to fix it – and if the supplier goes out of business or fails to maintain and update the software as promised, your organisation could very quickly be paralysed by software failure. For the supplier however, the source code in their software is their trade secret. It reveals precisely how the software was built and if it was widely available there would be a danger that all, or part of it, could be copied, and identifying and prosecuting all the copyright infringers would undoubtedly prove to be an unnecessary and costly ordeal. Escrow presents both users and suppliers alike with a middle ground. The supplier agrees to deposit the source code with an independent third party – an ‘escrow agent’ – and under the agreement, the escrow agent will release the source code to the user in the event that a ‘release event’ occurs. A

release event is typically the insolvency of the supplier, or the default of the supplier under its support and maintenance agreement.

Do I NEED SouRCE CoDE ESCRoW?Escrow comes with many benefits, however, it should not be bought blindly. If you own the intellectual property rights in the software, then escrow is not for you. The source code belongs to you, so the supplier should keep delivering copies to you. However, if the software is owned by the supplier and is licensed to you with the provision of maintenance and support, it is something that is worth serious consideration. The biggest escrow cost of all is the cost of taking source code maintenance in-house. It really is no mean feat. unless you have a big team of developers with not much to do then you need to consider this cost very carefully. Software that is provided “as a service” (e.g. software that you access through a web browser) can be quite cheap (generalisation), often has many competitors (generalisation), and is geared-up for rapid data migration. So, escrow benefit might be quite low. In addition, such software is going to be a bit more difficult to re-build into a locally run application in the event that you take source code maintenance in-house. So escrow cost might be quite high.

CoMMoN PITFALLSuse an escrow agent that allows you to tailor the escrow contract to your particular requirements. For example, you might need more than just one or two release events. Make sure the escrow contract addresses the licence that you will be given to use the source code. usually, this licence is not

adequately dealt with in your software licence and maintenance agreement so the escrow contract gives you another opportunity to get it right. You will want the right to change the source code and to engage an IT consultant to maintain the source code on your behalf. Don’t sign an escrow contract with cumbersome procedures that apply if you want to trigger release of the source code. If the supplier is not performing, the last thing you want is a couple of months of arguing about whether or not you are allowed to trigger release of the code. The escrow contract needs to give you a rapid remedy. Make sure you ask the escrow agent to check that the deposited code is indeed the code for the application that you are licensing and can be recompiled into a workable application. This will cost more, but you could feel foolish if you trigger release and there is nothing on the CD, or it’s the wrong source code. Finally, do your research. Meet with a number of different ‘agents’ in order to explore all the options, and seek legal advice on your contract. Escrow has the potential to help you make significant cost savings, have greater independence and flexibility with your software, and give you an immediate solution if something goes wrong – but it will be an entirely pointless purchase if it is made as part of a rushed risk management ‘tick box’ exercise.


There is plenty more to software escrow. If you wish to discuss, call Tim Sewart on 020 7894 6040 or e-mail [email protected]


ICT

If Escrow Cost

Escrow fees+

Cost to your organisation of taking

maintenance of the source code in-house

+Cost to your

organisation of the time-lag in taking the source code in-house

is less than

then, yes, you would be well advised to take out source code

escrow

Escrow Benefit

Cost of migrating to a completely new system if you never had

software escrow+

Cost to your organisation of the time-lag in migrating to a new system

+Value of threat of source code release to encourage the supplier to comply

with its maintenance obligations

YouR quICK GuIDE To SoFTWARE ESCRoWTim Sewart, a Partner at commercial law firm Beachcroft LLP, explains why you should care when it comes to purchasing software, how it can protect your business, and how to decide whether it’s the right route for you

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F


CHoICE AND FLEXIBILITY IN VENDING

HEALTH AND WELLBEING HAS undoubtedly had a huge impact on the vending sector. The type and variety of products people want from vending machines has never been greater and it is important that the food industry is able to deliver these products and adapt to changing consumer preferences. The focus on ‘healthy vending’ began with schools and is now spreading to other public sector establishments. The new vending guidelines for NHS hospitals in Wales are a prime example of how health and wellbeing policies are having a dramatic impact on what can be obtained in vending machines and, worryingly, also show how consumer choice is being restricted as a result.

WELSH GuIDELINESThe new Welsh hospital vending guidelines in fact severely restrict the types of products that can be vended to staff, visitors and patients. In reality they are so restrictive they have effectively become a ‘no vending’ policy for Welsh NHS hospitals. The restrictions cover a wide variety of food and drink products, including packs of organic rice cakes, cheese and tomato sandwiches, drinking yoghurts, lighter versions of crisps and snack products, and would mean that even drinks such as hot sweet tea – possibly much enjoyed by a nurse after a very long, tiring shift - would no longer be available through the hospital vending facilities. Arguably, the regulations will have the biggest impact on hospital staff who work long hours and often want to buy food and drink products at times when canteens are shut. It seems ludicrous that someone working a 12-hour shift is not allowed to enjoy their break period by relaxing with a cup of hot, sweet tea and a Fairtrade fruity cereal bar bought from a vending machine. There is on average, five times more staff than patients in hospitals, and where vending provides a much needed 24/7 food offering where hospital canteens can’t, the introduction of such guidelines is extremely concerning. However, staff are not the only people to suffer. Hospital caterers will also be impacted – with some predicting they will suffer from hundreds of thousands of pounds in lost revenue this year.

VALuE & CHoICEVending machines offer a valuable service that complements the main catering provision by providing choice and flexibility. And these machines are used to provide a wide range of products including snacks (from confectionery to cereal bars to dried fruit), sandwiches and

soft drinks (from water to fizzy drinks to juices). Another area for concern is that these guidelines are based on the Food Standards Agency’s nutrient profiling model, which was actually developed for the sole purpose of supporting ofcom’s rules on TV advertising to children. The Food Standards Agency itself advised Welsh Ministers against the use of the tool in relation to vending in hospitals – but its advice was rejected. What’s more, Welsh Ministers also applied guidance specifically developed for school food on top of this nutrient profile model. Surely it doesn’t make sense to take policy tools designed for children and apply them to adults, who should be allowed to make their own decisions about the food and drink products they want to consume. To challenge the vending guidelines for Welsh Hospitals a coalition of leading business organisations has been set up: The Vending Choice Coalition (VCC), which comprises the Automatic Vending Association; British Soft

Drinks Association; British Cheese Board, British Sandwich Association; CBI Wales, Dairy uK; Food and Drink Federation; National Farmers’ union Cymru; and the Snack, Nut and Crisp Manufacturers Association. our coalition is in full support of the Welsh Assembly Government’s objective of improving hospital food and nutrition and we appreciate it is important to look at hospital catering overall, but the hospital environment is unique in terms of the diversity of food and drink needs – for patients, staff and visitors – and we believe these guidelines fail to recognise this challenge. As a coalition we want to stop a ‘healthy vending’ policy from becoming a ‘no vending policy’. We are calling on Welsh Ministers to review their ‘no vending’ guidelines and agree to work with industry to develop a more realistic approach – before there’s another consumer backlash against excessive nanny state interventions.

The Food and Drink Confederation writes on healthy vending in the health sector, and looks at new vending guidelines for NHS hospitals in Wales and whether this works or is too restrictive


CATERING



HEALTHIER CHoICES – A CATERING DILEMMA

BALANCING CoNSuMER DEMAND for unhealthy high fat, salt and sugary foods versus healthy choices and a good return on investment puts constant pressure on catering teams to make the right decisions. How do they overcome this difficult challenge and still deliver high quality, healthy snacks and drinks without compromising consumer choice? There have a been a number of articles over the years about the part vending plays in hospital catering, many arguing that it does not fit in with the healthy image that hospitals should portray to their customers. After all, shouldn’t hospitals practice what they preach? Many still have pre-conceived ideas that traditional beverage and snack vending machines promote unhealthy food and offer only high fat, sugar and salt products. The truth, however, is that the humble vending machine as we know it is only the receptacle that the goods are sold through. Vending machines can be filled with any choice of product but do consumers really want healthier options? With so much controversy about obesity in children and adults, diabetes, heart disease and the cost to the NHS in treating people with symptoms associated with unhealthy eating it is no wonder hospital caterers feel they need to take the lead in providing healthy options to customers. So what products should be served? And how can this be managed? There is no doubt that vending machines play a vital role in delivering a fundamental service when cafeterias and restaurants are closed or when high volume puts demands on the catering team. So what part can vending suppliers play and how can we encourage a more positive image?

EMoTIoNAL REFRESHMENT Firstly, let us consider the emotional choices that consumers make when wanting light refreshments. We have all heard or have said some of the following: “It’s really what I fancy.” “I really want some comfort food.” “I am in need of a chocolate fix.” “I am in desperate need of a cuppa.” “I need a coffee to keep me going.” The truth is that beverages and snacks are not only refreshment but are also used to support an emotional need when we are sad, when we celebrate, or when we want a pick-me-up to get us through the day. Taking that opportunity and choice away from someone when they are unhappy, stressed or elated is in fact denying them support at their most vulnerable time.

Put yourself in the situation where it’s late, the restaurant or canteen is closed, you may be waiting for news, have received bad news or you have just finished a difficult shift. Who is going to comfort you? FLoRENCE NIGHTINGALE oR DEVIL IN DISGuISE We are drawn to the alluring soft lighting and the colour display of the menu, we ponder for a while, taking precious moments to make our choices and, once made, feel a little excited and uplifted that our selection is on the way. We are teased by a visual display that engages us and confirms that our product is about to be poured. once dispensed we hold our drink carefully caressing the cup and staring gently at the warm liquid, we taste those exotic flavours of coffee beans from far off lands, with names we can hardly pronounce, or we feel refreshed by the fresh leaf tea that tantalises our taste buds and remind us of home. We select our preferred choice of snack and at that moment we want a product that is familiar to us as well as names of companies that we have grown up used to and trust.

PoSITIVE ACTIoN At Vendia, we know firsthand how to manage this difficult and sometimes emotive decision process without compromising the choice for healthier alternatives and supporting the social responsibility of many people today. We fill our vendors with products that give choices and we clearly mark the product selection area with clear distinct green and yellow labelling, marked Ho (healthier option). We can even add calorific values or Weight Watchers points on the display for the healthier items. We often place healthier products in a prominent position in the vendor so the eye is drawn to them allowing the consumer to make healthier choices, if preferred. In an effort to support healthier lifestyles and social responsibility without compromising consumer decisions, Vendia has for many years now included healthier choices of nuts, muesli bars and light savoury snacks and bakes in its vending machines, having found that this keeps the balance between consumer preference for recognised brands of confectionery and a healthy return on investment for catering departments. In 2004, in the spirit of corporate and social responsibility, Vendia launched its own premium range of fair and ethically traded

The humble vending machine, Saint or Sinner? With thousands of people now classed as morbidly obese what positive action can vending companies take to support the health sector?


CATERING

hot beverages under the Cafe Joe brand. The Cafe Joe product range has a fully fairtrade range of ingredients from coffee beans and instant coffee to tea and hot chocolate. In addition, one of our longstanding favourite products has been our Bogota Joe coffee, which is produced with the finest blend of ethically sourced Arabica beans from 100 per cent Colombian coffee, sourced through the Federacion Nacional de Cafeteros (FNC), which consists of over 500,000 cafeteros. Through this foundation more money is going back to the farmer and is made available for infrastructure improvements, as well as for other areas of the community. Vendia’s preferred selection of milk is Regilait, which is a revolutionary product consisting of granulated skimmed milk. This offers the best of both worlds – beautiful consistency in coffee and specialty drinks plus an excellent cup of tea with the authentic taste of fresh milk. on a healthy note, Regilait does not contain any added chemical products, nor any of the trans

fats or saturated fats that are found

in traditional

whiteners. The Cafe Joe brand has a strong following and is the preferred hot beverage option of thousands of satisfied customers throughout the uK.

CoMMoN SENSE APPRoACHVendia’s philosophy on the products we supply and sell through our managed vending machines is simple – we keep our vendors clean, well stocked and replenished at all times. We have good lighting and an inviting visual display, highlighting healthier choices and using only the best industry-recognised brands. We actively encourage and make it easy for our customers to adopt good corporate and social responsibility by using our Cafe Joe range, which support the farmers and their families helping them to improve the quality of their lives. So returning to some of our original questions: Do consumers really want healthier options? And what part can vending suppliers play and can we dispel vending’s undeserved negative image? To summarise, consumers need to make their own choices but be educated at the same

time to make the right choice to benefit them. There are thousands who have always used vending machines and are not overweight. Vending operators such as Vendia do take a socially responsible position and provide both recognised brands and offer healthier choices by identifying them accordingly. And the humble vending machine, in a hospital late at night when you need some comfort, could most definitely be deemed as Florence Nightingale in disguise.

In October’s issue of Health Business there will be an exclusive interview with the catering manager of a leading NHS trust where we investigate how he manages to keep his customers happy, keep an eye on the bottom line and continues to offer healthy choices.


We would love to hear your thoughts and learn how you manage this process. So give us a call on 0800 072 0100 or e-mail [email protected] or [email protected] and tell us what you think.



CATERING


WE Do LoVE To MEET BESIDE THE SEASIDE

FEW CAN DENY THAT THE IMAGE of many coastal resorts has changed dramatically over the last decade. No longer are they viewed as the ‘bucket and spade’ style destinations of the past, but more as chic, contemporary and vibrant alternatives to inland city centre destinations, which are proving to be hugely popular contenders in attracting business visitors. Peter Hampson, director of the British Resorts & Destinations Association (BRADA) explains: “According to the united Kingdom Tourism Statistics (2008), the volume of overnight business trips to the uK coast is estimated at around 3.3 million a year, bringing with it an estimated spend of just under half a billion pounds. of course, coastal resorts have not been immune to recent economic pressures but nonetheless, these figures clearly illustrate the scale and worth of business tourism in seaside resort towns.”

INVESTMENT IN CoASTAL RESoRTSThis increased popularity of coastal destinations with meeting and convention organisers can be attributed to a number of factors; most notably the continual upgrade of their business tourism product, combined with an improved coordinated marketing effort deployed by the convention bureaus. This has all been made possible by the government’s increased awareness to take the social and economic regeneration of the uK’s seaside resorts ever more seriously. This has been witnessed most recently in England by the Department for Communities and Local Government’s launch of the (government’s), ‘Strategy for Seaside Success.’ Peter adds: “The uK coastal resort sector has secured many hundreds of millions of pounds worth of investment over the last decade and continues to attract significant

public and private sector attention. “The improvement in public realm and private sector product, combined with the inherent pleasant coastal ambiance and the full range of tourism infrastructure encompassing fine dining, entertainment, heritage, retail and culture makes most of the uK’s well established coastal resorts the ideal place for business tourism.” Darren Johnson, Convention Bureau sales manager, Visit Brighton, adds: “Costal destinations are particularly popular with city-wide events, often spanning two or three days. The close proximity of venues, hotels and leisure offerings are a real plus, creating a ‘one stop shop’ style destination focused product for both the business and leisure traveller. This destination package often comes with the mutual cooperation of city stakeholders that give the ability to provide delegates with a real ‘wow’ factor.”

TIME To RELAXPerhaps a seaside destination’s biggest unique selling point is its connotation with being a relaxing destination, creating a fantastic motivational edge for those looking for team building opportunities and corporate incentives. Costal destinations often work closely with neighbouring city centres to create add-on packages that offer attractive incentives for business extenders. Steve Christian, marketing manager for Southport Conferences, explains: “For us, particularly located so close to Liverpool, we often work together with the city to complement each other’s offering. For those events that do prefer the city centre location, we provide several ‘add on’ options, often in the form of golf and other leisure activities that you cannot do in the city. This is hugely popular for the business extenders crowd.” He continues: “When compared with a city, coastal resorts offer an attractive draw in the

form of less traffic, air and noise pollution and better parking and public transport options. Many would argue that they are generally a more pleasant place to be.”

BouRNEMouTHDuring 2010, over £100 million is being invested in Bournemouth’s business tourism product, creating improvements in accommodation, transport, entertainment and dining. At the hub of the action is one of the uK’s premier conference and exhibition venues, the Bournemouth International Centre (BIC). A recent £300k refurbishment of its Tregonwell Hall was completed in March 2010, capable of hosting conferences of up to 1,000 delegates. Clive Tyers, head of Conferences, Exhibitions and Events at the BIC, comments: “I was asked recently about seaside resorts being old-fashioned and in need of a little tlc. I’m not talking on behalf of other resorts, just Bournemouth, but the notion that seaside resorts are old fashioned is an old fashioned one. We have moved on from that stereotype and Bournemouth has become a cosmopolitan and vibrant business and leisure resort.” Leading the way in sustainability will be Bournemouth’s first £5.5 million eco-hotel The Green House due to open later this year. The hotel will feature 32 bedrooms, conference and meeting facilities and a 60 cover brasserie. In addition the Park Central Hotel will be Bournemouth’s newest 4-star hotel opening in close proximity to the BIC. The Hermitage Hotel will be undergoing a £2 million complete refurbishment, including a new lounge and restaurant and a fully fitted corporate boardroom. Following a £500,000 investment Bournemouth’s newest restaurant, the Edge Restaurant, will offer panoramic private dining for up to

No longer the ‘bucket and spade’ style destinations of the past, coastal resorts have emerged as chic and vibrant destinations with much to offer the business visitor


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100 covers on the fifth floor encompassing 360º views. Finally, the £45 million redevelopment of Bournemouth Airport will put Bournemouth on par with other major uK airports and in a good position to attract more operators in the future. Due to be completed in the late spring, the work will include a new departures terminal, twice the size of the old building and with triple the amount of retail and catering space.

BLACKPooL Home to a number of high capacity venues, Blackpool is fortunate to benefit from a range of traditional conference hotels as well as a great number of unique and wonderful venues. The trend in reinventing the uK coast as a place for leisure, pleasure and for business continues with the recent announcement of a £39 million pound package in Blackpool, which amongst other things, will see its major conference and exhibition venue, The Winter Garden revamped.

BRIGHToN Brighton continues to evolve its business tourism product; new hotels and venues have added more choice and diversity to its hotel room stock and venue choice. In the last three years myhotel, Jury’s Inn, Radisson Blu and Park Inn have all opened in the city and existing hotels including the Thistle, Brighton Hilton Metropole and The Grand have all invested significantly in improvements to their properties recently. 2010 has seen £1 million of additional funding being invested in The Brighton Centre to better the visitor experience. The redevelopment plans will focus on improving the public areas of the venue, which will include an upgrade to the existing breakout areas and the addition of alfresco coffee shops. The conference centre’s Skyline restaurant will also benefit from the funding as well as new signage throughout and significant investment in the furniture and furnishings. The largest banquet and conference facility to be built in Brighton & Hove since 1992 is also planned. This comes as part of the Sussex County Cricket Club’s £8 million development, designed to drive the club’s non-match day facilities. The development will be phased over two years, with Phase one due to be completed in April 2010 including a new banqueting and conference facility. Phase Two will see new builds of the South and South West stands and redevelopment of the member’s pavilion increasing the capacity of the two current rooms and creating a new cafe/bar/private reception room in the old stables. VisitBrighton recently announced a new marketing campaign ‘Seeing Brighton Through Business Eyes’ aimed at underlining the city’s outstanding business product as well as its famous leisure offering.

EASTBouRNEDelegates choosing to visit Eastbourne this year will be amongst the first to use the newly installed Wi-Fi at the resort’s main conference venue, Devonshire Park Centre. Coupled with its facilities for up to 1,700 delegates, 3,100sqm exhibition space, recent refurbishment of the Gold Room and opening of state of the art gallery last year, the Wi-Fi is another significant addition to what’s available in Eastbourne as a business destination. offering thousands of bed spaces at a wide range of accommodation including England’s only 5-star coastal hotel, a celebrity owned designer budget hotel, and smaller, friendly guesthouses, Eastbourne is well positioned to offer an attractive destination for delegates and organisers on all budgets. An Eastbourne Borough Council spokesperson comments: “As a major event town hosting several large events every year including Eastbourne Airshow and the AEGoN International Tennis Championships, Eastbourne is well suited to large events with a great reputation for delivering successful events while giving personalised service at the same time.”

SCARBoRouGH Scarborough is a long established conference town, recently winning the title of ‘Europe’s Most Enterprising Place’ in this year’s European Enterprise Awards. This year again will see some exciting developments



CoNFERENCES & EVENTS

for the area, with a £6 million refurbishment to its leading conference venue The Spa, the opening of the new 6,500 seater open air theatre in July and the continuing success of the Regeneration Programme.

SouTHPoRT In recent years, Southport has successfully rebranded itself as ‘England’s Classic Resort’, combining the traditional aspects of a seaside town which visitors, both business and leisure, still expect to see, with boutique hotels, high quality restaurants and world class golf facilities. In the last five years, the area has seen massive investment in its business tourism product, principally in the £40 million refurbishment and extension of its flagship venue, the Southport Theatre & Convention Centre. This combined with the introduction of new hotels and other major infrastructure improvements has led to a wave of new restaurants and shops. other facilities include the resort’s newest hotel the Ramada Plaza situated on the recent waterfront development, the contemporary Vincent Hotel, luxurious Formby Hall Golf Resort & Spa and Aintree Racecourse, home to the world famous John Smith’s Grand National, situated just outside the resort and offering conference facilities for up to 600. In addition, Southport’s reputation as England’s Golfing Capital is well and truly justified with 15 top courses just 30 minutes drive from the resort centre and six of them within Southport itself. For the future, Southport will see a £12 million redevelopment of the Southport Arts Centre, which will create a new Cultural Centre for Southport. Due to be completed in 2012, it will encompass an art gallery, theatre/performance space, library, tourist information and several meeting spaces.

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agreement for the maintenance of Moving and Handling Equipment (Hoists, Beds and Baths). We are totally dedicated to maintenance within hospitals, residential units and the community. Visit our website www.caretech.co.uk or call us now on 01268 775585 for further information. our companies experience spans some 25 years during which time we have expanded from a small local service company to today where we offer national coverage and a service that can’t be beaten.


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manufactures of the British Pendulum Skid Tester. The Pendulum is the only machine sanctioned by the Health and Safety Laboratories for accurate testing of pedestrian walkways in both dry and wet conditions. Wessex Test Equipment Ltd undertake independent testing of your floors supported with a full report, if needed recommendations are given as to how you can resolve any problems that may arise from these tests. We have carried out tests in a number of varied locations, e.g: railway platforms, football stadia, NHS clinics in Scotland as well as numerous shopping centres and office blocks country wide.

Wessex Test Equipment Ltd also manufactures the Tortus 3 Floor Friction Tester, this can be used for ongoing monitoring of your floors, allowing you to pick up any changes in the floor surface at an early stage and thus remedy it before any problems occur. If you would like an independent and confidential test carried out on your floors then contact our office to arrange a visit from one of our test engineers.

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W


WATCH WHERE You’RE GoING

IN 2008/09, IN THE HEALTH AND social care sector alone, there were more than 1,800 major injuries caused by slips, trips and falls in the workplace and more than 3,500 that resulted in workers having to take more than three days off work. Failing to manage risks effectively can shatter lives, leaving employees and their families to pick up the pieces and businesses paying a heavy price. Slips, trips and falls in this sector cost British society around £50 million every year. Although, over the last 10 years there has been a sustained reduction in the number of fatalities caused as a result of falls from height in the workplace, it still remains the most common cause of fatal injury, with slips and trips the most common cause of major injury. The Health and Safety Executive’s ‘Shattered Lives’ campaign aims to reduce unnecessary slip, trip and fall incidents in the workplace by encouraging managers and duty holders to do more to stop them happening by taking simple, often cost effective, measures. Peter Brown, HSE’s head of Division for Work, Environment, Radiation and Gas, said: “Making improvements doesn’t need to cost the earth and we are encouraging people to visit the Shattered Lives website, where they will be able to get simple and cost effective solutions to help manage slips, trips and falls hazards in their workplace.” As part of the campaign HSE has developed two e-learning tools to identify risks and manage hazards in the workplace. STEP deals with slips and trips and WAIT with work at height. To use these tools visit www.hse.gov.uk/shatteredlives. Taking sensible measures to keep workplaces safe, protects staff and helps to give patients a good level of service. The cost of incidents may affect the delivery of high quality patient care and viability of the business. For example:• patients being seriously injured through falls leads to additional medical costs and an increased stay in hospital, with implications for waiting lists and service delivery• staff sickness absence due to slips, trips and falls at work, and other associated costs, such as staff replacement costs, will have a detrimental effect on budgets• people may experience hardship as a result of loss of wages, as well as pain and suffering.These incidents can be cut dramatically through planning and positive management during refurbishment and new build, together with good housekeeping.

Employees should be consulted at an early stage, as they will have useful experience of areas where problems arise.

CAuSES oF SLIPSThe main causes of slips and trips incidents in healthcare are: slippery/wet surfaces – caused by water and other fluids; slippery surfaces caused by dry or dusty floors; contamination, such as plastic, lint or talcum powder; obstructions, both temporary and permanent; uneven surfaces and changes of level, such as unmarked ramps. other factors include

poor levels of lighting and external glare; human factors such as employees rushing; running or carrying heavy/cumbersome items; the wearing of unsuitable footwear or the use of improper cleaning regimes. In order to reduce slips trips and falls, it is recommended that you:• Follow the free practical guidance offered by the e-learning tools, STEP and WAIT, at www.hse.gov.uk/shatteredlives• Depending on the degree of risk and the size of business, develop a policy document but crucially ensure practical arrangements are in place, such as quickly cleaning up spillages and better still preventing spillage of water, oils, cardboard, waste etc onto the floor in the first place• Remove any obstructions• Avoid creating trailing cables• Store goods safely• Keep workstations clear of obstacles• Make sure flooring materials are level and secure• Mark slopes and changes of levels• Ensure you have adequate lighting• Wear sensible footwear• Think about visitors to your workplace, what do they need to know? Do you need to do more to protect them?

WINCHESTER AND EASTLEIGH NHS TRuSTAfter monitoring health and safety records, bosses for Winchester and Eastleigh NHS Trust recognised they had problems with slips and trips on wet hospital floors. Between 2002-

2004 the Trust had to tackle in the region of 100 slips and trips from staff, all of which could be blamed on floors left wet after cleaning. The Trust’s safety adviser had attended an HSE slips, trips and falls workshop in 2004, which reinforced the belief that more could and should be done. This prompted the Trust to look again at the areas where falls were occurring to identify trends. Around the same time the Trust was unfortunate enough to have a member of staff fall in a ward area after the floor had been mopped. An inspector from the Health and Safety

Executive recommended that changing the way mopping was done could reduce the risk of slips and trips. He suggested using a dry mopping system using micro fibre, would limit the amount of fluid on the floor. The staff were also advised to mop and dry the floor in sections before moving onto the next part of the ward, to provide safe access around the area. Dean Bailey, Trust safety advisor for Winchester and Eastleigh NHS Trust, said: “At first the housekeeping staff were reluctant to change to a system that they believed would take much longer. However, once we started to see a decrease in the number of people slipping and how easy it was to implement, they were more than happy with the new way of working.” The Trust purchased 11 systems and trialed them for four weeks. The results were so dramatic they bought another six so they could roll the method out across all wards. Since the Trust implemented the system in April 2005 it has received one report of a slip/trip to date as a result of wet floors which was reportable under RIDDoR, and an 85 per cent reduction in falls from the 100 reported in the previous two years. Dean Bailey said: “using HSE’s online risk assessment tools and having HSE on board was fundamental in reducing the slips and trips within our organisation. Without these tools and HSE support we wouldn’t have seen such dramatic results and made our wards safer for our members of staff and patients whilst maintaining our clean environments.”

The Health and Safety Executive discusses how managers and duty holders can do more to prevent slips, trips and falls incidents in the workplace


HEALTH & SAFETY


Failing to manage risks effectively can shatter lives, leaving employees and their families to pick up the pieces and businesses paying a heavy price



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Acting Out 23

ADAS UK 28

Adey Solutions 18

Aid Call 56

Allan Dyson Asbestos Services 40

Allen Partnership 53

Antec Contracting Services (Anglia) 43

BIFM 20

Blutek 66

Brandon Medical Company 22

Britspace 21

Business Furniture Online 44

Cambridge Executive Development 55

Capita Business Services 58

Capita Total Document Solutions 76

Charity Gift Vouchers 64

Chellgrove 46

Cordtape Energy Management Systems 33

Cordtape Environmental Services 34, 42

Craemer UK 20

Cranfield Management Development 6

Crown Trade 16

DDC Dolphin 14

Dutton International 62

Easibathe 22

EHS 10, OBC

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Energy Institute 31

Energy Monitoring Services 38

Envex Company 70

Environmental Water Systems 20

Roxym Consultancy 52

F16 Consulting 80

Farsight Leadership 56

Forget About IT 80

Frithwood Management Services 22

Future Facilities 46

Future-Tech SCI 68

GID-Quantor 64

GMC Landscapes IBC

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Green Running 32

GS1 Healthcare UK 13

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Harland Simon 16

Holmes Group 84

Hoval 39

i2i Development Solutions 52

Ideal Heating 36

Indigo Art 22

Inenco 30

Intellect Enterprises 82

Ioni 73

IP UserGroup 26

IVITA Learning 57

JJ Food Serice 84

Jo Bird & Company 72

Jolly Energy 37

Jones Nash 37

Kodak 74

Metropolitan Electrical Services 2

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Monodraught 8

Müller Dairy 4

NBC Group 70, 72

Nichol Associates 43

Nimlok 67

North West Castle 90

Odyssey Arena 91

Optimum 59

Outreach Organisation 73

Panther Interiors 44

Pass Training Consultancy 48

Patientrack UK 13

Pauline Drissell 57

People Development Team 58

People Opportunities 50

PES Group 33

Phoenix Private Ambulance Services 14

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Premier Life Skills 54

PSE Solutions 62

Quantum Training Services 52

Qube Vocational Development 14

RED Professional Locums 60

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Rhodar 42

SecuriCare International 71

Simply Drinks 86

Solid State Security 72

Static Systems Group 9

Systematic Energy 36

TechNET IT Recruitment 62

Teknomek Industries 23

The Safety Supply Company 92

Time & Data Systems International 79

Training Skills 4 U 53

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TXT Tools 81

UK Plumbing Supplies 36

Village Hotels 88

Volvo 24

W Shuttleworth & Co 44

Wales Millennium Centre 90

Walking With Leaders 53

Wockhardt UK 17

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Transcript of Health Business Volume 10.3