More groups join call for fairer deal for social care

By Gabriel Blaazer

As the race to become the next Conservative leader and Prime Minister of the UK heats up, and the government accepts the recommendations from the independent NHS pay review bodies in full, Care England and Access for Social Care have urged the government to act to protect the standing of social care workers, in statements issued yesterday.

The calls echo recommendations contained in a summary document of a recent Public Policy Projects report on integrated care. The report argues that the social care sector should be placed on an equal footing with the NHS, both in terms of its representation within integrated care partnerships and investments made to accelerate digitisation and modernisation.

Representative groups are increasingly urging the government to ensure suitable plans are in place to protect social care, amid an increasingly dire workforce shortage that is threatening the sector’s ability to provide its services. Vacancy rates in social care (9.5 per cent in January 2022) remain stubbornly above the national average (4.4 per cent from December 2021 to February 2022), while more than 400,000 social care workers left their roles in 2021.

A fairer deal for social care must be a priority

On Tuesday 19th of July, the government accepted, in full, the recommendations of the independent NHS pay bodies, meaning more than one million staff who fall under the Agenda for Change contract will receive a pay rise. This includes nurses, midwives, and paramedics, who are set to benefit from a pay rise of at least £1,400 this year, backdated to April 2022.

Groups who represent and advocate for the social care sector are now urging the government to implement a similar deal for care workers.

While rates of pay for social care work have increased in real terms since 2014, the rate of increase has not kept pace with other sectors, decreasing the social care sector’s ability to compete in the jobs market. Data shows that when overall national employment rates fall, vacancies in social care rise, suggesting that the sector is struggling to attract and retain workers.

The King’s Fund cites “high levels of staff vacancies, sickness absence, turnover, and work-related stress [as] having a damaging impact on staff,” and calls “the case for a fully funded, multi-year health and social care workforce plan… overwhelming.” Although many of these factors were exacerbated by the Covid-19 pandemic, the King’s Fund and other groups maintain that they long predate the pandemic and are the results of successive governments neglecting the social care sector.

In October 2021, the Workforce Recruitment and Retention Fund made £162.5 million available to local authorities to help recruit and retain social care workers, along with a further £300 million in December 2021. However, both funds lapsed in March 2022.

A neglected care sector

Poor staff retention is being further compounded by increased pressure on the social care system. The number of new requests for social care support have increased by 5.6 per cent, while costs have risen by more than a quarter, with areas with higher levels of deprivation being disproportionately affected.

Lack of available social care capacity is also increasing pressure on the acute hospital sector as hospitals have fewer methods of discharging patients safely. This is causing unsustainably high hospital occupancy rates and serving to undermine the wider healthcare system.

In a statement issued yesterday, CEO of Access Social Care, Kari Gerstheimer, warned about a “complete lack of discourse about the future of the social care system,” in the current leadership race, and claims the outgoing Prime Minister, Boris Johnson, has all but abandoned his pledge to “fix social care once and for all.”

The concerns mirror those expressed by UNISON Social Care Lead, Gavin Edwards, who said on Wednesday that “the scale of vacancies is alarming, and not just for those who rely on care and their families. The sorry state of social care is having a disastrous effect on the NHS, causing massive treatment waits, letting down patients and putting unbearable pressure on health staff.

“The care sector is acutely underfunded. Wages are way too low leaving staff unable to cope with the rising cost of living. Supermarkets are paying better rates without the stress, so it’s no surprise that people are jumping ship.”
In Care England’s statement, released on Thursday, Chief Executive Professor Martin Green OBE, said: “The adult social care workforce is our biggest resource. The lack of government action has had an inevitable consequence on the nature of employment opportunities within the sector and has hampered providers’ efforts to recruit and retain staff, as evidenced by the 52% increase in vacant posts in the sector over the past year. This has not only affected the overall financial attractiveness of the adult social care sector as an entity, but also providers’ ability to compete with the NHS.

“As a first step, Care England suggests the Government accepts the recommendations of the Low Pay Commission for the 2023 rates, however, this increase must be properly funded. Simply applying National Living Wage inflation without appropriate funding undermines the ability of providers to aid workforce pressures, especially given the fact that providers are having to pay increases above the National Living Wage annual uplifts as a means of recruiting and retaining staff.”

Kari Gerstheimer added that ”as Sunak and Truss fight it out, there is everything to play for by way of their approach to Health and Social Care. The Association of Directors of Adult Social Services has warned that the year ahead will be the most challenging people needing and working in adult social care have ever faced. I am saddened, however, to see social care being kicked down the road with little mention of any commitments from either leadership contender about the future of the social care system.

“Failure to invest in social care amounts to poor fiscal planning and inefficient use of taxpayers’ money – it harms our productivity because people with unmet social care needs can’t reach their potential, and unmanageable caring roles keep people out of work. It harms those working in social care, who are choosing to leave the sector because of problems with pay. And it harms our health system because a failure to invest early in preventative social care leads to more crisis admissions in critical care.”

Reducing trauma for radiotherapy patients

By Capita Healthcare Decisions

The London Clinic is pioneering temporary markings as a replacement for alignment tattoos to help reduce the lasting trauma of radiotherapy treatment.

The London Clinic is one of the UK’s largest independent hospitals, providing medical care to thousands of patients every year and treating a range of diseases and conditions including cancer. As a charity, it continually reinvests in its facilities and technology, seeking to offer the latest advances in cancer diagnostic, treatment and support services.

However, it was not pioneering new technology that saw The London Clinic win the 2022 CHKS Top Hospitals award for innovation. Rather, it was their out-of-the-box thinking, allowing radiotherapy patients the options of having non-permanent alignment tattoos, which caught the attention of the judges.

Challenging the requirement for permanent alignment markings on patients receiving radiotherapy treatment

In its cancer management, The London Clinic declares that it is committed to giving patients choices in their care and always seeks to apply the latest technologies available to facilitate this. Radiotherapy provision is an innovative area, but one aspect of treatment has not moved with the times. This is the practice of tattooing patients who are undergoing treatment.

During the treatment process, radiographers can make between one and five permanent tattoo marks on a patient’s skin to help line up the radiotherapy machine and ensure the same area is treated each time. These tattoos can become a lasting reminder of a traumatic time and can negatively impact body image.

The London Clinic heard from some breast cancer patients who were unhappy with the aesthetic outcome of these tattoos given their location and especially as on occasion the ink can run or bleed under the skin. Patients said this constant visual reminder and effect on aspects of everyday life, such as clothing choice, had a negative psychological impact on their recovery. Their experience was mirrored by one of the keynote speakers at the 2019 Radiotherapy Society Conference.

As a society member and radiographer who had undergone a personal cancer diagnosis herself, the speaker was able to candidly describe the lack of choice or alternatives to tattoos. The London Clinic’s Pre-Treatment Superintendent attended the conference and was motivated to ask on her return: “Why do we still do this?” and “Is there something else we could be doing?”

While sophisticated Image Guided Radiotherapy (IGRT) and Surface Guided Radiotherapy (SGRT) techniques exist, which are less reliant on tattoos, the majority of cancer treatment centres still use them. Over the last few years alternatives have been explored and are in use such as ultraviolet (UV) tattoos and surface-guided radiotherapy and non-ionizing optical devices. However, uptake of these alternatives has been slow, either due to the additional resources or investments required.

By thinking of novel solutions, the radiotherapy team at The London Clinic was able to come up with an innovative way of marking patients for treatment.

Instead of permanent tattoos, pen marks were drawn onto the skin and covered with transparent film dressings. A map of the exact positioning of the marks on the body was reproduced on a sheet of clear acetate as a guide. Daily online imaging was implemented and acted as a control for positioning and verification of treatment accuracy.

This innovative alternative enabled the radiotherapy team to offer tattoo-less treatment which neither compromised patient care nor was constrained by resource or investment pressures. Through extensive auditing, the team identified no additional or significant difference or issues in set up, and that the new method was as accurate as tattooing.

“This innovation in practice has made a significant impact on the way we deliver breast treatments at The London Clinic. It is not the latest or the most expensive innovation, but it provides the patient with a better journey and more choice.”

Deirdre Moran, Quality and Development Superintendent for Radiotherapy and Medical Physics, The London Clinic

This meant that they could confidently tell patients that going tattoo-less would in no way compromise their treatment. Treatment times did increase slightly, but it was concluded that it was not of a magnitude which would outweigh the benefit of providing patient choice.

”Winning the 2022 CHKS Top Hospitals award for innovation helps convey that with very little investment it is possible to change the landscape of cancer care. The ability to offer tattoo-less breast radiotherapy has made a significant impact on our patients’ experience and will contribute to improved body image and self-esteem post treatment for years to come.”

Deirdre Moran, Quality and Development Superintendent for Radiotherapy and Medical Physics, The London Clinic

The tattoo-less option has featured positively in patient feedback and generated numerous patient enquires leading The London Clinic to share its technique and methods with other radiotherapy departments to further encourage those who were considering making the change.

To find out more, please get in touch healthcaredecisions@capita.co.uk or visit capitahealthcaredecisions.com

Innovation uptake in West Midlands reduces A&E visits from care home residents by 30%

By David Duffy

The West Midlands Academic Health Science Network (WMAHSN) has released its 2021-22 Impact Report, highlighting the innovative solutions that have contributed to improving health and generating income growth across the West Midlands, and nationally.

Key achievements outlined in the report include a 30 per cent decrease in A&E visits from care home residents, across the West Midlands, as a result of the spread and adoption of deterioration management tools such as ‘Stop and Watch’.

Over 1,255 West Midlands care homes engaging in the test and adoption of deterioration management tools to improve safety for care home residents. More than 1,365 patients in the region are also benefiting from the prescription of PCSK9i inhibitors, a revolutionary medicine that helps lower cholesterol.

About the West Midlands Academic Health Science Network

The WMAHSN is one of 15 Academic Health Science Networks (AHSNs) across England and plays a pivotal role in ensuring innovations are shared faster regionally, nationally and internationally. Its goal is to make the West Midlands healthier, more productive and deliver the best possible clinical outcomes for patients.

AHSNs connect the NHS and academic organisations with local authorities, the third sector and industry, and create the conditions to facilitate change across health and social care economies.

Over the last two years, the organisation has grown to support the efforts around delivering its strategic programme themes, which includes cardiovascular disease prevention, mental health resilience, and workforce innovation and transformation.

The new report highlights the WMAHSN’s ability to adapt and pivot its services to address the region’s shifting needs and priorities, including supporting the region’s response to the pandemic. This not only demonstrates its ability to remain agile, but also how the organisation is uniquely placed to support the needs of its partners and future proof the region’s healthcare sector, for years to come.

Tony Davis, Director of Innovation and Commercial at the WMAHSN, said: “It is our mission to transform health and social care through innovation. Therefore, it is inspiring and positive to see organisations across the region adopting these innovations to respond to our complex health, and social care system.

“In collaboration with partners, and organizations around the West Midlands, we intend to keep strengthening our ability to work nationally, regionally, and locally, and maintain the environment we have helped create to improve the overall health and wellbeing of our communities.”

As the WMAHSN approaches its tenth birthday in 2023, the organisation continues to aid local health and care systems, looking at how its workforce supports NHS England and NHS Improvement, and the Office for Life Sciences priorities, ensuring that patients in the West Midlands have access to the best health and care services.

Other key highlights from the WMAHSN Impact Report includes:

Four providers in the West Midlands have adopted HeartFlow, a non-invasive, cardiac test for stable symptomatic patients with coronary heart disease. Over 5,000 scans were performed nationally during last year led nationally by the WMAHSN.
A 30 per cent decrease in A&E visits from care home residents, across the West Midlands, as a result of the spread and adoption of deterioration management tools such as ‘Stop and Watch’. Over half of care homes (63 per cent) in Staffordshire and Stoke-On-Trent have fully adopted the deterioration management tools.
The creation of the QI Notify-Emlap application and a pilot scheme in partnership with The Dudley Group NHS Foundation Trust. The app supports clinicians to use their National Emergency Laparotomy Audit data more efficiently to drive their emergency laparotomy quality improvement work. Early results from the pilot suggests regular usage could reduce ‘Door to Theatre’ time.
Promoting alternative forms of treatment to those from an ethnic minority background, living with a learning disability or autism with the STOMP project. The project aims to reduce the over prescription of antipsychotics, often oversubscribed to these groups, by increasing medication reviews.

To read the full impact report, visit the WMAHSN website.

Leading health charities highlight “untapped potential” of pharmacy services

By David Duffy

Leading UK health charities have highlighted the untapped potential of pharmacy services in tackling the nation’s major health conditions.

Just one in ten adults in Britain have turned to their local pharmacy for advice and information on lowering their risk of serious health conditions including cancer, heart disease and type 2 diabetes, according to a new YouGov survey.

The survey, commissioned by the British Heart Foundation (BHF), Cancer Research UK, Diabetes UK and Tesco, suggests that many people could be missing out on opportunities to access free advice via their local pharmacies that could help them make life-changing improvements to their health.

The findings come as the BHF, Cancer Research UK and Diabetes UK have been working with Tesco to deliver specialist training to Tesco pharmacists and pharmacy colleagues to support their conversations with the public. The training will help them provide more information and support as to how people can help lower their risk of these serious conditions through small changes to their day-to-day routine.

The survey also found that, of those who had visited a pharmacist for health-related advice or checks, 43 per cent said talking to a pharmacist had eased their concerns around wasting their GP’s time.

Meanwhile, 24 per cent of those who had visited a pharmacist for health-related advice or checks found it easier to speak to someone in a pharmacy than in other healthcare settings, while 53 per cent identified not having to book an appointment as a benefit of using a pharmacy for information and advice about a health-related concern.

The leading health charities say that supporting people to make lifestyle changes and seek referrals for concerning symptoms could “save thousands of lives” every year from some of the UK’s most prevalent and serious diseases.

More than 7.6 million people in the UK are living with heart and circulatory diseases, while 4.9 million are living with diabetes, 90 per cent of which are cases of type 2 diabetes, and it’s estimated that almost three million people are living with cancer (2020). Yet, around four in 10 cases of cancer, many heart and circulatory diseases and up to five in 10 cases of type 2 diabetes could be prevented or delayed.

Dan Howarth, Head of Care at Diabetes UK, said on behalf of the charities: “Thousands of lives could be saved every year through people making positive changes that lower their risk of type 2 diabetes, cancer, and heart and circulatory diseases.

Far more people could be taking advantage of the advice and support available to them from their Tesco pharmacy while they do their weekly shop, this includes tips and information on stopping smoking and weight management services”

The survey also found that only two per cent of adults in Britain had visited their pharmacist for a blood pressure check in the last twelve months, despite an estimated 4.8 million people in the UK living with undiagnosed high blood pressure.

The three leading health charities, in partnership with Tesco, are encouraging people to use their local Tesco pharmacies for information and support on lowering their risk of cancer, type 2 diabetes, and heart and circulatory diseases.

Tesco and the health charity partners hope that shoppers take advantage of the convenience of having their local pharmacist in store. Customers can easily seek advice when they do their weekly shop and get support for making positive changes or seeking information on concerning signs or symptoms.

Experts urge NHS to leverage position as England’s largest employer to help fight health inequalities

By Integrated Care Journal

Public Policy Project’s ICS Network has urged the NHS to leverage its position as England’s largest employer and to realise its potential for social and economic rejuvenation.

The calls came at a recent webinar, where PPP and ICJ released the latest findings from the ICS Futures roundtable series. The series saw ICS leaders from across the country convened for three Chatham House debates to identify challenges and opportunities in integrated care, to scale best practice and provide ongoing practical advice for system leaders and care providers. The series ended with an open webinar discussing the Next steps for integrated care.

The webinar was held to coincide with ICSs taking statutory footing on July 1st, and was chaired by Matthew Swindells, Joint Chair of West London’s four Acute NHS Trusts & former Deputy Chief Executive of NHS England. Mr Swindells was joined by Dr Penny Dash, Chair, NW London Integrated Care System, Paul Maubach, NHS Midlands’ Strategic Advisor on ICS Collaboration and Laura Stamboulieh, Partner, Strategic Advisory for Montagu Evans.

The role of the NHS

There was a particular focus was on the role of the NHS itself in tackling the wider determinants of health. One lesson from the pandemic that was learnt across the country was the impact of low trust – particularly among more deprived areas of the country. As is well documented, vaccination rates were significantly lower in parts of the country relatively high on the deprivation index, and these sectors of the population tend to have poorer health outcomes more generally.

“Part of the problem is not employing people from those areas”, suggested Paul Maubach, contending that a lack of representation from these areas has contributed to low trust of authorities and public services, healthcare included. It was agreed that choosing to adopt more proactive and inclusive recruitment strategies would align with the wider agenda to address and reverse health inequalities.

The need to differentiate between health inequalities and healthcare inequalities was also a central topic of the session, particularly in view of what the NHS and ICSs can feasibly impact upon. Many drivers of poor health are deeply rooted in socioeconomic trends far outside the purview of health and care professionals, but there is much that can be addressed in the short term with the right focus and the right policies.

For example, one of the greatest drivers of poor health in later life are educational outcomes. In turn, a crucial indicator of lower educational outcomes in the future is poor oral health at the age of two, so ensuring better access to NHS dentistry among more deprived cohorts would allow those more at risk to be identified, engaged, and supported by their local health and care systems, as well as improving access to dental services themselves.

This area of discussion highlighted one crucial, but often overlooked point; that all health and care services are interconnected, and ultimately, are trying to achieve the same outcomes. Part of the role of ICSs, therefore, is to create a culture where all stakeholders collaborate to achieve this shared goal (improving population health).

To this end, Dr Penny Dash argued the importance of those on integrated care boards (ICBs) having clearly delineated areas of responsibility and accountability, to create clarity over how different parts of the system fit together and to ensure that decision making does not become bogged down in bureaucratic hierarchies. “If you can’t answer the question related to your remit, you shouldn’t be at the table.”

The importance of data was emphasised throughout the session – both from a population health management perspective, as well as the effective planning and monitoring of estates and facilities.

It was posited by Laura Stamboulieh that “the role of the estate as an enabler is often overlooked. The ultimate delivery of ICSs will rely on a well-developed health and care estate.” On this point, it was noted that NHS estate planning has evolved little since the introduction of digital healthcare and the increase in remote working. As such, an updated, modernised approach to estate planning will be essential to delivering effective, integrated care, at scale.

Javid out, Barclay in…for now, as Johnson government collapses into chaos

By Gabriel Blaazer

(Disclaimer, story was accurate as of 15:00 on 06/07/2022. At time of writing, only 26 ministers have resigned. We will try to keep up…)

Steve Barclay, Chancellor of the Duchy of Lancaster and former Minister of State for Health, has been formally appointed as the new Secretary of State for Health and Social Care following the resignation of Sajid Javid.

In his resignation letter, which was widely circulated on social media, Mr Javid cited the public’s belief that the Conservatives are no longer “acting in the national interest”, and “that this situation will not change” under the current leadership.

With a slew of resignations following the departure of Mr Javid, including the former Chancellor, Rishi Sunak, it is unclear how long the cabinet will retain its new composition, with Labour welcoming Mr Barclay as the “shortest serving Health Secretary in history.”

Mr Barclay, who became an MP in 2010, will be in charge of overseeing the business and policies of the health department, but it remains to be seen how much divergence of policy there will be between the new appointee and his predecessor.

Of particular focus will be the government’s continuing response to Covid and the major reforms currently underway in the health sector, including the recent establishment of integrated care systems in England, as well as plans to tackle the deepening cost of living crisis.

A keen area of focus for Sajid Javid were plans to address the elective care backlog and put patient choice and the personalisation of care at the centre of health policy.

Recent policy announcements from Mr Javid include the proposal to offer private hospitals to people in England waiting over 18 months for surgery, as well as commitments to fund the modernisation of the health and care services.

Commenting on his appointment, Mr Barclay said: “It is an honour to take up the position of Health and Social Care Secretary.

“Our NHS and social care staff have showed us time and again – throughout the pandemic and beyond – what it means to work with compassion and dedication to transform lives.”

“This government is investing more than ever before in our NHS and care services to beat the Covid backlogs, recruit 50,000 more nurses, reform social care and ensure patients across the country can access the care they need.”

Commenting on the resignation of the former Secretary of State for Health. Matthew Taylor, Chief Executive of the NHS Confederation, said: “Health leaders thank Rt Hon Sajid Javid for the support he has shown the NHS during his twelve months in post but colossal challenges remain for his successor to resolve.

“Leaders recognise the work Mr Javid has done to put health inequalities on the map in a way that his predecessors in Government had not.

“The new health and social care secretary will be joining as cost of living pressures grow and as coronavirus and associated hospital admissions are on the up once again. After everything the NHS has been through over the last two years, health leaders need political stability from the Government alongside immediate acknowledgement from their new health and social care secretary that the present situation is understood and with no sugar coating.”

Also responding to Mr Javid’s resignation, Saffron Cordery, Interim Chief Executive of NHS Providers, the membership organisation for the NHS acute, ambulance, community and mental health services, said: “Trust leaders thank Sajid Javid for his service, particularly in seeing through the biggest health reforms in a decade in the shape of the new Health and Social Care Act and his initiation of the Messenger review of leadership in the NHS.

“All eyes will be on how the new health and social care secretary addresses major challenges including serious workforce shortages right across the NHS, the forthcoming NHS pay award amid the cost of living crisis, and the government’s New Hospitals Programme which promises to give the NHS much-needed capital investment to benefit patients and the quality of care.”

On the appointment of Steve Barclay to replace Mr Javid, Ms Cordery responded: “Trust leaders will welcome the rapid appointment of Steve Barclay as the new secretary of state for health and social care.

“Top of his in-tray must be the serious workforce shortages right across the NHS, with over 105,000 vacancies across the service and the forthcoming NHS pay award, which will be made against the backdrop of a soaring cost of living crisis.”

Digital Implementation, News, Siilo June 29, 2022

Digital communications tool provides solution for healthcare data protection

By Joost Bruggeman

Joost Bruggeman, former surgery resident at Amsterdam University Medical Centre, and CEO and co-founder of Siilo, discusses how secure digital communications tools can ensure patient confidentiality and solve healthcare data protection issues.

Instant messaging apps have become essential tools in our daily lives – their convenience, reliability and sheer ubiquity have transformed how most people communicate, both socially and professionally. At the height of the pandemic, their value within the healthcare sector became even more pronounced, as they enabled rapid information-sharing to help medical professionals learn how to deal with a hitherto unknown virus.

In these circumstances, medical staff came to appreciate the benefits of being able to share details about individual patient cases, including photographs and other sensitive medical data. It facilitated timely and seamless collaboration, without which many more lives would have been lost.

The benefits of ‘off-the-shelf’ messaging apps, however, don’t come without risks. Within the medical sphere in particular, a mistaken message could put patient confidentiality and data protection in jeopardy, while threatening one of the most fundamental aspects of healthcare ethics.

Overcoming data protection issues

Since instant messaging apps are clearly of value within the health and social care sectors, a solution is needed to overcome data protection issues. In fact, this challenge was understood some time ago, and was a key influence behind the development of specialist healthcare apps such as Siilo, which places data security and medical compliance at the heart of its development.

Designed specifically for healthcare professionals, Siilo undertook the task of preserving the usability that people expect from the technology, while simultaneously ensuring that patient data could be exchanged safely and compliantly.

Paul Cowley, Chief Information Officer at St. John & St. Elizabeth Hospital (HJE) in St. John’s Wood, London, recognised the importance of adopting a messenger service which has been tailored to the healthcare sector’s unique challenges. “Timely, effective and safe patient care often requires rapid communication with multiple clinicians and sometimes offsite. A secure, easy-to-use app is needed to facilitate this level of care.

“While temporary guidance was issued during the pandemic that allowed the use of well-known commercial messenger services to help reduce the risk of patient care being compromised, as a hospital we recognised that such services increase risk both in terms of patient data security and patient care, particularly because of the need to anonymise communications wherever practical.”

Security and compliance

Unfortunately, many health and social care professionals and organisations are unacquainted with these issues. Indeed, a survey by the European Heart Rhythm Association (EHRA) revealed that 88.3 per cent of its members regularly use commercial instant messaging apps, like WhatsApp, for sharing clinical information with medical colleagues, yet 29.3 per cent admitted they were unaware of EU data protection regulations. A further 46.7 per cent indicated there are no regulations in place at their institution regarding the sharing of clinical data via instant messaging.

Given that specialist tools have been developed, why are they not mandated among healthcare professionals? The problem is that many health and social care providers still don’t understand the risks involved with off-the-shelf messaging apps because of a simple failure to differentiate between security and compliance.

The basic promise of ‘end-to-end’ encryption, which is offered by the best-known messaging apps, certainly provides a strong element of security. It means the servers of the vendor cannot decrypt the message data even if they wanted to because they don’t have access to the encryption keys that belong to this encrypted data. However, this only applies to data while it is ‘in transit’ from one phone to another. What happens when the data is ‘at rest’, i.e. delivered to a phone or other device?

After a phone receives a message, several synchronisations take place with common messaging apps;photos and videos are synced automatically to the photo library of the phone, where the media is not encrypted; all conversations are backed-up by default and automatically go onto the cloud services of the phone provider – where message data is also stored unencrypted. As such, all these unencrypted conversations are exposed to unauthorized third parties.

Importantly, the professional who makes the decision to share information about their patient is always held responsible for protecting the patient’s confidential data. On a messenger app, this remains the same – the sender is always responsible and therefore needs to have control of what happens with the information on the receiving end of that communication. This control is often not possible and means many conversations taking place over common messenger apps are not compliant with medical confidentiality laws.

This is a huge problem because it becomes impossible for any healthcare professional sending an instant message on most services to be able to guarantee patient confidentiality. A way which is often used to get around this is to anonymise patient information within communications, but this also brings problems.

As recognised early on by Paul and his team at HJE, if healthcare teams cannot clearly identify which patient they are communicating about, it will almost certainly lead to confusion and mistakes. Since all healthcare professionals have sworn an oath to “do no harm”, this risk is often one not worth taking.

Communication and collaboration

For staff at HJE, Siilo has become a key tool in improving communication and collaboration between staff, and therefore improving patient care. A good example of this can be highlighted via its use in supporting the hospital’s Urgent Care Clinic (UCC), which is also helping to drive adoption in other departments.

“If a UCC doctor feels the need for input from a specialist consultant or the patient needs onward referral to a consultant, the UCC doctor can now use Siilo to contact a relevant specialist consultant rapidly and securely wherever they are.”

It is also proving to be an invaluable component in the day-to-day running of its medical team. “Siilo is now the ‘go to’ for some of our multi-disciplinary team meetings (MDTs). It solved a problem with a desire to increase the frequency of our MDT meetings without placing undue burden on the clinicians that contribute.

“It also allows ad-hoc MDT meetings where clinical circumstances dictate a patient’s case needs a review ahead of the next scheduled meeting. The messenger app allows clinicians to collaborate securely and contribute from whatever location they are working, regardless of their diary commitments.

We know the opportunities for the app are vast and since adoption, we are already seeing options becoming wider and wider, with more exciting use-cases being frequently put forward by staff.”

A growing number of healthcare organisations in the UK are recognising the tremendous benefits offered by digitalisation to the healthcare sector. While this is encouraging, it is essential that tools and technologies are truly fit to meet the standards expected. For communications technologies, this means applying absolute rigour to ensure patient confidentiality.

Joost Bruggeman is a former surgery resident at Amsterdam University Medical Centre and now CEO and co-founder of Siilo. For more information, please visit www.siilo.com.

For more information about St. John and St. Elizabeth Hospital, please visit: www.hje.org.uk

All news

NHS leaders offered free access to resource to help address air pollution across England

By Gabriel Blaazer

A new resource is to be offered to every NHS Integrated Care System (ICS) to support their development as ‘Clean Air Champions’.

Data confirms that everyone in the UK is exposed to the threat of air pollution, with more than 97 per cent of postcodes in breach of at least one World Health Organisation (WHO) limit for toxic pollutants.¹

This includes vulnerable environments such as healthcare settings, including the one million people who attend GP appointments every day in the UK and the approximately 16 million people who travel to major A&E departments in England every year.²

In the UK, 36,000 premature deaths per year are caused by air pollution, one in five of all premature deaths, and tackling air pollution will be a vital strand of integrated care systems’ (ICS) efforts to address and reduce environmental determinants of poor health.^3,4

Launched at the NHS ConfedExpo, the ICS Clean Air Framework is a practical tool that empowers healthcare leaders to take action on cleaner air and has been developed to support every ICS in England to become a ‘Clean Air Champion’. Joining forces to drive the initiative forward are the environmental change charity Global Action Plan, Newcastle Hospitals and Boehringer Ingelheim. The Framework is freely available to all 42 ICSs nationally to aid the development of an action plan to improve air quality around all healthcare access points in England.

The Framework links to the mandated requirements of Green Plans, the NHS Standard Contract, the Delivering a greener NHS report and the UN’s Sustainable Development Goals. The tool supports the newly established ICS healthcare leaders to incorporate air quality improvement measures around hospitals and health hubs as part of their broader commitment to address environmental challenges.

The Framework launch coincides with Clean Air Day on June 16th, which this year reveals how air pollution impacts almost every organ in the body. Professor Sir Stephen Holgate, Special Advisor on air quality to the Royal College of Physicians and UKRI’s Clean Air Champion, explains “Air pollution is an invisible killer and plays a role in many of today’s major health challenges. The ICS Clean Air Framework is a ground-breaking resource to support the NHS in implementing air quality improvement initiatives that will ultimately protect the health, wellbeing and economic sustainability of today’s communities and future generations.”

The Framework is being pioneered by Newcastle Hospitals, who are first to drive the development of an action plan in their region. James Dixon, Associate Director of Sustainability at Newcastle Hospitals, explains “The NHS has an opportunity to lead by example and set the benchmark for clean air and safe workplaces. Through the creation of an action plan guided by the ICS Clean Air Framework, here at Newcastle Hospitals, we are already making progress and seeing direct benefits to our communities.”

Larissa Lockwood, Director of Clean Air, Global Action Plan, explains how the ICS Clean Air Framework can support healthcare leaders in taking action: “Air pollution kills seven million people globally each year, which is more than malaria, HIV/AIDS and obesity combined.^5,6,7 It is a public health crisis that needs immediate action from the health sector. It also cannot be right that our most vulnerable are exposed to it in our places of care – is it fair that a baby must take its first breath in a polluted environment? By developing this framework and working at the Integrated Care System level, we have the opportunity to tackle some of those area-wide issues, empowering healthcare leaders to pursue action on air pollution to secure a healthier future for their region.”

Uday Bose, Managing Director at Boehringer Ingelheim UK & Ireland, explains the impact of the project both now and for future generations, “People who are already suffering with poor health are most at risk of the detrimental effects of air pollution, so this initiative plays an important role in addressing health inequalities. Our commitment to transforming lives goes beyond the provision of medicines, as this initiative clearly illustrates. It also demonstrates the power of partnerships and delivers a real opportunity to create a healthier future for families, the NHS and the planet.”

The ICS Clean Air Framework aims to provide healthcare leaders with a platform to drive positive change and support the implementation of initiatives to improve air quality, without adding to the administrative burden. The NHS net zero targets are as ambitious as possible and are supported by the need for immediate action and commitment to continuous monitoring, evaluation and innovation. It is therefore critical that key stakeholders and local authorities work collectively to turn ambition into action.

More information regarding the Integrated Care for Cleaner Air initiative and the ICS Clean Air Framework is available from today at www.actionforcleanair.org.uk/health/ics-framework.

¹ addresspollution.org. 2022. Providing the public with the most accurate air pollution data available. [online] Available at: <https://www.addresspollution.org/> [Accessed 26 May 2022].

_{2</sup)The Kings Fund. 2019. Key facts and figures about the NHS. [online] Available at: <https://www.kingsfund.org.uk/audio-video/key-facts-figures-nhs#what-does-the-average-day-in-the-nhs-look-like> [Accessed 12 May 2022].}

³GOV.UK. 2019. Public Health England publishes air pollution evidence review. [online] Available at: <https://www.gov.uk/government/news/public-health-england-publishes-air-pollution-evidence-review#:~:text=Air%20pollution%20is%20the%20biggest,lung%20cancer%2C%20and%20exacerbates%20asthma.> [Accessed 26 May 2022].

⁴Who.int. n.d. Air pollution. [online] Available at: <https://www.who.int/health-topics/air-pollution#tab=tab_2> [Accessed 25 May 2022].

⁵Who.int. 2022. Fact sheet about malaria. [online] Available at: <https://www.who.int/news-room/fact-sheets/detail/malaria> [Accessed 25 May 2022].

⁶Who.int. 2021. Obesity. [online] Available at: <https://www.who.int/news-room/facts-in-pictures/detail/6-facts-on-obesity> [Accessed 25 May 2022].

⁷Who.int. 2021. HIV/AIDS. [online] Available at: <https://www.who.int/data/gho/data/themes/hiv-aids> [Accessed 25 May 2022].

Award win for Keysource and CENTIEL for project designed to underpin world-class vaccine, cell and gene therapy manufacturing capability

By Integrated Care Journal

Global data centre and critical infrastructure specialists, Keysource, in association with Swiss-based UPS manufacturer CENTIEL, have been named as winners of the Edge Project of the Year at the DCS Awards 2022 DCS Awards Voting. The award winners were announced at a gala dinner held at the Leonardo Royal Hotel London St Pauls on 26 May 2022.

The team’s work has been recognised following the completion of an installation of a truly modular, scalable, and highly efficient UPS and Electrical Infrastructure solution to help underpin growth in the government’s efforts to develop world-class, innovative vaccine research and manufacturing capability.

Scientists and researchers based in the centre will accelerate the time taken for new treatments to be delivered to patients by developing cutting-edge therapies to treat life-changing diseases.

The edge data centre that supports the essential laboratory work, is responsible for ensuring that samples and vaccines remain in optimal condition. The installation is now the first medical facility in the UK to take advantage of Li-ion batteries in combination with CENTIEL’s fourth generation three phase, true modular UPS, CumulusPowerTM which offers industry leading 99.9999999 per cent (nine nines) availability translating to just milliseconds of downtime per year.

Louis McGarry, Sales and Marketing Director, CENTIEL UK explained: “The facility runs off different energy sources from the grid, to sustainable power. This means the UPS is called on more often to provide a clean, continuous source of power to support the laboratory environment and ensure optimal conditions. Li-ion batteries offered the perfect solution as they are highly capable of cycling many times over, unlike traditional VRLA batteries, where cycling shortens their design life significantly.

Richard Clifford, Head of Solutions at Keysource, commented: “At Keysource, we deliver the finest and most efficient facilities, utilising the latest in critical power and cooling technologies. Our solutions support the latest generation of high-performance, high-density computing and have been internationally recognised as examples of best practice. We are proud to support clients that lead the development of new, innovative technologies to bolster the UK’s medical research capability. This project is a perfect example of why investing in critical infrastructure, and its protection, is essential to ensure these vital services continue to operate, now and in the future.”

For more information please see: www.centiel.co.uk or www.keysource.co.uk

Report reveals 229% rise in social care needs assessment enquiries

By Integrated Care Journal

The number of social care needs assessment enquiries increased by 229 per cent in the year 2021/2022 compared to 2019/2020, according to Access Social Care’s annual State of the Nation report.

The report, released yesterday, paints a desperate picture of the English social care system, with a significant rise in advice demand far outstripping available resources.

Access Social Care is a nationwide charity providing free legal advice for people with social care needs. Its second annual State of the Nation report is based on a data collaboration project in partnership with Royal Mencap Society, Age UK, Carers UK and Independent Age.

With the use of 74,000 separate data points, the report outlines the key challenges facing people who need social care and looks at the extent to which advice demand and provision has changed.

The nationwide data in this year’s report also shows an increase in enquiries that were identified as needing specialist legal advice in the year 2021/22, compared to 2019/20.

The report also reveals that the number of enquiries regarding concerns about existing social care and support rose by 43 per cent in the year 2021/22 compared to 2019/20.

The wellbeing of both care users and care providers has continued to spiral downwards. According to Access Social Care, pressure on capacity has meant that helplines have been required to take on additional staff and expand opening hours to cope with the increased demand on their services.

Charging has also become an increasingly pressing issue, accounting for 25 per cent of the dataset. Local authorities have been pushed into further unsustainable cost efficiencies, increasing charges for social care to meet budget targets and causing further demand for advice on charging.

Kari Gerstheimer, Chief Executive of Access Social Care said: “Whether we are self-funders or in receipt of state funded care, we will all need social care at some point either for ourselves or for a loved one.

“The Government claims to have fixed social care and continues its promises to help ease the cost-of-living crisis, but the sums don’t add up. Millions of people are feeling the effects of an underfunded system.

“We want a social care system that is properly financed, readily available and fairly distributed. Currently, vital services are overstretched, and people are going without the necessary social care they so desperately need – something needs to change.”

Caroline Abrahams CBE, Charity Director of Age UK said: “The findings in this report provide clear evidence of a system under severe duress.

“Councils are struggling to discharge their responsibilities to people in need of care and support and are having to adopt explicit prioritisation measures to deal with the overwhelming demands they face.

“In these difficult circumstances navigating the always complex social care system is a real challenge. It makes the role of charities who provide information and advice about social care more important than ever, both for the people in need of help and by shining a light on what’s really going on in care services across the country.”

Access Social Care provides expert legal advice to disabled people, elderly people, and their family carers to ensure their social care needs are met.