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NHS Sustainability Day Cardiff Roadshow

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The programme of regional road shows allows NHS staff around the country to participate in the national campaign whilst minimising their travel time and carbon footprint. Each roadshow will identify key aspects of sustainable development within healthcare practice addressing the challenges and achievements along the way.

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NHS Sustainability Day Cardiff Roadshow

  1. 1. Welcome to the NHS Sustainability Day Cardiff Roadshow @dayforaction #sustainability
  2. 2. Morning Session 09:30 – Welcome and Introduction 09:45 - Up-date on the UK Plastic Pact Speaker- Susan Jay, Sector Specialist Circular Economy lead, WRAP Cymru 10:05 - Refill Wales Speaker- Hannah Osman, National Coordinator, Refill Wales 10.30 - Recycling and Repurposing Hospital Aids Speaker – Paula Massey, Director, Motorcyle, LGV, Mobility Training, Health Aids and Recycling, Social Enterprise 10:50 – Refreshments and Networking
  3. 3. Susan Jay – Circular Economy Sector Specialist WRAP UK March 2020
  4. 4. 4wrap.org.uk/ukplasticspact WHAT WRAP DOES Global Sustainable Development Goals Governments & Cities BusinessNGO’s Citizens WRAP is a not-for-profit organisation working with partners in 26 countries
  5. 5. 5wrap.org.uk/ukplasticspact WRAP’s work on Plastics….
  6. 6. 6wrap.org.uk/ukplasticspact Blue Planet effect…
  7. 7. 7wrap.org.uk/ukplasticspact 7 A world where plastic is valued and doesn’t pollute the environment
  8. 8. 8wrap.org.uk/ukplasticspact Tackling at a global and national level Global issue that requires global and national level action UK Plastics Pact is the first of a global network of national initiatives UK Plastics Pact is supporting Ellen MacArthur Foundation’s global initiative – New Plastics Economy.
  9. 9. 9wrap.org.uk/ukplasticspact • Plastic packaging focus • Plus single-use non- recyclable items • All plastic packaging placed onto the UK market • All polymers and formats • Whole plastics value chain • Citizen participation is key Scope
  10. 10. 10wrap.org.uk/ukplasticspact Targets - By 2025:
  11. 11. 11wrap.org.uk/ukplasticspact 80 businesses across the value chain + 41 supporter organisations Members are responsible for approx. 85% of the plastic packaging on products sold through UK supermarkets
  12. 12. 12wrap.org.uk/ukplasticspact Taking Action
  13. 13. 13wrap.org.uk/ukplasticspact Roadmap developed
  14. 14. 14wrap.org.uk/ukplasticspact New Guidance published
  15. 15. 15wrap.org.uk/ukplasticspact Members taking action … See : http://www.wrap.org.uk/content/uk-plastics-pact-progress-against-targets
  16. 16. 16wrap.org.uk/ukplasticspact Citizen engagement https://clearonplastics.com/ http://walesrecycles.org.uk/
  17. 17. 17wrap.org.uk/ukplasticspact 17 Guidance and support from WRAP Cymru Public Sector Procurement http://www.wrapcymru.org.uk/public-sector Supply Chain demonstrator projects http://www.wrapcymru.org.uk/recycled-content/pp-trial-medical- sector-houseware-product-sector Survey in England to determine current support for NHS recycling. Any ‘gaps’ identified – WRAP will develop tools and guidance for NHS across the UK.
  18. 18. 18wrap.org.uk/ukplasticspact • Embedding guidance on recyclability (across all sectors and citizens) • Recycling capacity growth • Increase use of recycled materials in products and packaging • Improve collection of all plastic • Lots more!! What next…..
  19. 19. 19wrap.org.uk/ukplasticspact 19 Thank You ukplasticspact@wrap.org.uk www.wrap.org.uk Susan.jay@wrap.org.uk +44 (0)7711199964
  20. 20. Hannah Osman: Refill Wales Coordinator Refill Empowering organisations to take positive action against plastic pollution
  21. 21. The Problem with Plastic Over the last 20 years we’ve produced more plastic than the whole of the last century – only 9% of which has ever been recycled.
  22. 22. Bottled Water Over 13 billion plastic bottles are used every year in the UK – that’s more than 35 million a day.
  23. 23. Refill is an award-winning campaign to prevent plastic pollution at source by making it easier to reuse and refill your water bottle on the go than buy a single-use disposable plastic bottle. About Refill
  24. 24. How it works?
  25. 25. Headline Stats 25,000 Refill Stations 120,000 App downloads 200+ Refill Schemes across the UK
  26. 26. Where can I Refill? PLUS at THOUSANDS of independent businesses, cafes and restaurants
  27. 27. How we started….
  28. 28. Who we’re working with Our Partners Our Supporters
  29. 29. Refill Across the NHS- Lets provide better options
  30. 30. Step 1: Put your taps on our map!
  31. 31. Step 2: Get more taps for our app! Refill can introduce Trusts to our product partners who have fantastic solutions. Making it easier for people to Refill their water bottle is one of the most effective ways to prevent the use of single- use plastics.
  32. 32. Step 3: Reusable Bottles • Just 1/3 of people own a reusable water bottle • 67% of people said using the Refill app made them more likely to carry a reusable bottle.
  33. 33. Step 4: Display signage to raise awareness
  34. 34. Step 5: Work Based Refill Champions •Refill is a grassroots, community- led campaign with over 160 local Refill schemes. •Help to raise awareness in your hospital or office and become a Work Based Refill Champion.
  35. 35. World Refill Day 2020
  36. 36. NHS WALES – have you got the bottle?! For any more information on bringing Refill to your Trust, please contact me via hannah@refill.org.uk
  37. 37. Paula Massey Director
  38. 38. • In 1980 I Joined the ARMY and served for 18 years as a medic and driver. Over 30 years experience in the training industry running two companies, motorcycle training & LGV, PCV. • In 2012 I started driving end-of-life fire engines to Serbia which were loaded with aid. • 2015 my mother bought a second hand mobility scooter. Out of duty of care for my mums safety and the general public I would take her out to ensure she was safe. • 2015 to the present date was the beginning of a new chapter of my life.
  39. 39. Experience My Experience
  40. 40. Unacceptable Waste
  41. 41. Donations All equipment was offered back to the NHS but was not wanted!
  42. 42. Donations from local companies
  43. 43. Refurbishing
  44. 44. Repurposing
  45. 45. Projects Thornhill Primary School Shire Hall Care Home Pink Beach club
  46. 46. Introduction to Carl Carl is homeless, he has severe arthritis from sleeping on cold floors. His wheelchair was taken by youths and badly damaged. He asked for help but was told he would have to buy a wheelchair! We sourced a wheelchair in less than an hour that was going to be scrapped!
  47. 47. UMT Upcycling & Mobility Training & Cefndy medequip are work together to reduce mobility equipment waste
  48. 48. Medequip instigated the Return, Reuse, Recycle campaign in partnership with West Suffolk NHS back in 2017 and has seen recycling rates increase significantly in line with this initiative. “Our vision is t
  49. 49. In the last three years Medequip have; Implemented - Lancashire, North Yorkshire, Gwent, Waltham Forest, Rotherham, Tower Hamlets, City of London and Shropshire Renewed - Derby City, London Consortium, Kirklees, Suffolk, Waltham Forest and Birmingham Extended – Wiltshire, Durham&Darlington, Derby City Derbyshire and Staffordshire • Economies of scale drive reduced equipment cost. • Broader pot of best-practice • Growth = investment in people, property, infrastructure, vehicles • Financial robustness – a family owned Company In the last three years Medequip have; Implemented - Lancashire, North Yorkshire, Gwent, Waltham Forest, Rotherham, Tower Hamlets, City of London and Shropshire Renewed - Derby City, London Consortium, Kirklees, Suffolk, Waltham Forest and Birmingham Extended – Wiltshire, Durham&Darlington, Derby City Derbyshire and Staffordshire • Economies of scale drive reduced equipment cost. • Broader pot of best-practice • Growth = investment in people, property, infrastructure, vehicles • Financial robustness – a family owned Company
  50. 50. Maximising Recycling • Highly trained recycle/refurbishment staff • Productivity is incentivised • Pressure on manufacturers to increase equipment life and recyclability • Best possible use of CTEs • High volume low value items MUST be made from recyclable materials • Paediatric Specialists (OEM Trained) • Shared Recycled Specials • Ordering by Attribute
  51. 51. Generating Retrieval • Focus on equipment recycling (24 Point RAG Plan) • Return Recycle Reuse initiative • Amnesty bins at key locations • Agreements with local waste/recycling plants • “Spread the word” with the Mobile Unit
  52. 52. CIRCULAR ECONOMY
  53. 53. Volunteering & Job Opportunities • Future job opportunities for veterans • Volunteer and job opportunities for disabled and less able bodied and people furthest from the workforce • Volunteering opportunities for veterans suffering with PTSD and mental health • Training & re-training opportunities • Workshops
  54. 54. Partners & Supporters
  55. 55. Contact Details Paula Massey UMT Up-Cycling and Mobility Training 36 Treforest Industrial Estate Treforest CF37 5UR www.umtcare.org.uk Tel: 07811 591771 Email: paula@umtcare.org.uk
  56. 56. Refreshments and Networking @dayforaction #sustainability
  57. 57. Mid-Morning Session 11.10- Reducing plastic waste and packaging in clinical environments Speaker - Nigel Armstrong, Armstrong Medical 11.30 Plastics and Sustainability Speaker - Mark Ellis, UK Sales and Marketing Manager, Intersurgical 11.50- Reduce single-use plastics in laparoscopic surgery Speaker - Hannah Shepley, Elemental Healthcare 12.00- Lunch & Exhibition
  58. 58. #NHSClimatechange Thank you for the opportunity to present. #NHSClimatechange Nigel Armstrong
  59. 59. #NHSClimatechange • Background to Armstrong Medical • Culture Change • How Can Armstrong Medical assist with the reduction of plastic waste
  60. 60. #NHSClimatechange 2% (590,000 tonne) of all UK industrial and commercial waste is generated by the NHS 20% from Theatres (118,000 tonne) 5% of NHS CO2 emissions generated by Inhalation anaesthetic gases
  61. 61. #NHSClimatechange
  62. 62. #NHSClimatechange Precision Engineering Manufacturing Cleanroom assembly 80%
  63. 63. #NHSClimatechange Projected Cashflow
  64. 64. #NHSClimatechange
  65. 65. #NHSClimatechange Reduce, Reuse, RecycleReduce, Reuse, Recycle
  66. 66. #NHSClimatechange Respiratory Care Pathway
  67. 67. #NHSClimatechange
  68. 68. #NHSClimatechange
  69. 69. #NHSClimatechange
  70. 70. #NHSClimatechange Rogers innovation adoption curve
  71. 71. #NHSClimatechange A - Accountable C - Consultative E - Explain (Inform)
  72. 72. #NHSClimatechange Hearing what you say
  73. 73. #NHSClimatechange Seeing what you mean
  74. 74. #NHSClimatechange “Tell me, and I will forget. Show me, and I may remember. Involve me, and I will understand”
  75. 75. #NHSClimatechange
  76. 76. #NHSClimatechange The Power of Marginal gains
  77. 77. #NHSClimatechange
  78. 78. #NHSClimatechange
  79. 79. #NHSClimatechange
  80. 80. #NHSClimatechange X 2g
  81. 81. #NHSClimatechange
  82. 82. #NHSClimatechange Inhalation anaesthetic gases contribute to climate change and account for 5% of NHS CO2 emissions
  83. 83. #NHSClimatechange
  84. 84. #NHSClimatechange
  85. 85. #NHSClimatechange Price to Value focused procurement Value = Price + benefits - costs
  86. 86. #NHSClimatechange Thank you for the opportunity to present. Nigel Armstrong
  87. 87. Marketing Update 2020 Intersurgical and Sustainability
  88. 88. Environmental Management System Intersurgical recognised that implementing an Environmental Management System (EMS) was important and can improve the way we work and reduce the Company’s environmental impact.
  89. 89. We are accredited with ISO 14001 • Our Environmental Management System is certified to ISO14001:2015 • Audits, communications, labelling, compliance, staff training and awareness, risk management etc. • Until 2018 there were only 300,000 certificates issued in 171 countries* (11,201 UK) • ISO 14001 is voluntary • We expect our suppliers to have ISO 14001 • All leading to us reducing our environmental impact *Source, https://www.iso.org/iso-14001-environmental-management.html
  90. 90. It is possible to recycle all Intersurgical products and the majority of our packaging However, the disposal of Intersurgical products depends on the customer’s waste disposal policy and if the product has become infectious in use. Local waste policy guidelines must always be followed.
  91. 91. Being aware of plastics • Not all plastics are bad for the environment… • If these are disposed of correctly • Intersurgical products are made from a range of polymers which ensure the products are effective and safe in use • We review our materials to make sure they are as sustainable as possible.
  92. 92. PVC (polyvinyl Chloride) • When incinerated PVC may form highly toxic dioxins (these can cause cancer and harm immune and reproductive systems). • *This makes PVC the leading contributor of chlorine and accounts for an estimated 80% of dioxin air emissions. * Reference http://www.pulpworksinc.com/dangers-of-pvc.html
  93. 93. Why do medical companies produce products in PVC? • From a manufacturing perspective it is a great material to work with • Clarity & transparency, durable, inexpensive, sterilization, chemical stability. • For the patient, the introduction of PVC medical devices in the 1960s revolutionised healthcare.
  94. 94. PVC is recyclable • If classed as non clinical waste there are some schemes that can recycle PVC
  95. 95. But there are alternatives to PVC Polypropylene shell TPE* seal * Theroplastic elastomer (rubbers) Kinder to the environment-kinder to the patient The technology is in the bonding
  96. 96. Total approx. amount of oxygen masks and anaesthetic masks used in the UK • 4.7m Oxygen & Aerosol masks • 3.1m Anaesthetic masks
  97. 97. EcoLite masks • Oxygen • Aerosol • EC02 • Venturi • Nebuliser • Tracheostomy
  98. 98. When incinerated non PVC products will give of Hydrocarbons • Water and CO2
  99. 99. Facts • Many of our products are produced in Lithuania where energy is produced from our own hydro electric power station • We pay a PRN (Packaging recovery note) to the Environmental Agency. (currently £35,000 p.a.) • Our own product waste material is recycled
  100. 100. What, no hook ring?
  101. 101. ClearLite = less waste 2.1g of polypropylene 43g of PVC 19g polypropylene & TPE
  102. 102. i-gel *SEBS Why is this needed? * Hydrocarbons
  103. 103. Disposable or reusable? There is a choice.
  104. 104. Product kits = less packaging, less waste and often a more cost effective option
  105. 105. =
  106. 106. =
  107. 107. =
  108. 108. =
  109. 109. ** The Intersurgical UK manufacturing plant and offices produced 338,312 kg of carbon in 2019. ** Source http://www.carbon-calculator.org.uk/ *The NHS is the UK’s biggest public greenhouse gas emitter, responsible for ~5% of all UK environmental emissions with over 20 million tons of carbon from NHS England alone. One in every 20 journeys on UK roads is healthcare-related. * Source https://sustainablehealthcare.org.uk/
  110. 110. EcoLite, as approved by… Morgan Freeman! ClearLite, as approved by… Shaun The Sheep!
  111. 111. Reduce, Reuse, Recycle, Resposable™ ELEMENTAL HEALTHCARE
  112. 112. WHY NOW?  A Global Issue  Personal and Professional Responsibility  Commercial Responsibility  NHS England Direction
  113. 113. WHAT IS RESPOSABLE™?  Unnecessary PlasticWaste Production  Quality  Cost saving
  114. 114. RESPOSABLE™
  115. 115. STERILISATION Category Description Average Price £ 1 Supplementary or any quantity of the same supplementary single wrapped in peel pouch 1.06 2 Supplementary or any quantity of the same supplementary double wrapped in peel pouch 1.38 3 Anaesthetic accessories or other limited life items 1.28 4 Power tools and endoscopes requiring manual hand washing 7.44 5 Ward/department type trays 3.19 6 InstrumentTrays with up to 10 items 5.32
  116. 116. A MOUNTING PROBLEM…
  117. 117. REDUCING PLASTICWASTE INTHEOPERATINGTHEATRE – POWER ET AL 2020 88,000kg 3.8 million Plastic Bottles
  118. 118. PACKAGING THE PROBLEM?!
  119. 119. THE ICING ON THE CAKE?
  120. 120. “If a surgical instrument is equally effective, costs less than what is currently used and has the crucial benefit of dramatically reducing plastic waste produced, then it is important to consider this change”
  121. 121. Lunch and Networking @dayforaction #sustainability
  122. 122. Afternoon Session 13:05 - WelLPRES - An effective greener Digital Healthcare Solution Speakers - Smita Shetty, Digital Project Manager, Healthier Lancashire and South Cumbria Integrated Care System & Zan Virtnik, Implementation Specialist, Parsek 13:25 - Sustainability in the NHS – Aneurin Bevan Health Board Speaker- James Griffiths, Senior Project Manager Value Based Procurement, NHS Wales Shared Services Partnership - Procurement Services 13:45 - Sustainability in the NHS – University Hospitals Bristol NHS Foundation Trust Speaker- Alexandra Heelis, Sustainability Officer, University Hospitals Bristol NHS Foundation Trust 14.05- Conference Close
  123. 123. Parsek © Confidential do not duplicate
  124. 124. BACKGROUND ▪ Health System Led Investment ▪ Aligns with ICS Digital strategy, NHS Five Year Forward Plan, NHS Long Term Plan (2019) ▪ Topol Review (2019), Health Education England ▪ NHS Sustainability, Climate Change and other national, global agendas
  125. 125. Parsek © Confidential do not duplicate OBJECTIVES AND BENEFITS ▪ Reducing unwarranted variation – improving/supporting co-ordinated care ▪ Improving patient experience ▪ Offering citizens access to their Personal Health Records and delivering personalised care ▪ Enabling clinicians to access their patients’ records and their personalised care plans, safely and securely ▪ Reducing paper-based transactions (also aligning to the broader national aim of achieving a paperless NHS) ▪ Reducing travel for clinicians and patients ▪ Reducing unnecessary out-patient appointments
  126. 126. WORKING COLLABORATIVELY WITH STAKEHOLDERS ▪ 5 Integrated Care Partnerships ▪ Number of suppliers ▪ NHS England and NHS Digital
  127. 127. Parsek © Confidential do not duplicate ▪ Vitaly Managed Care and Vitaly Patient ▪ Patient centric solution ▪ Co-designed with our citizens, clinicians and other stakeholders ▪ First Use Case – WelLPRES Managed Care: Breast Cancer Follow-up Pathway – 25 Oct 2019 WelLPRES PROJECT MANAGEMENT APPROACH ▪ Smarter ways of working ▪ Cloud based Project Management System ▪ Virtual Project Board meetings
  128. 128. MILESTONES ACHIEVED 25 October Change Management Technical Support User group/forum Post Implementation workshop
  129. 129. ▪ Colorectal and Prostate Cancer Pathway implementation ▪ Benefits Realisation - building a reporting capability to capture benefits and measure outcomes ▪ Local Person Record Exchange Service (LPRES) integration ▪ WelLPRES: Patient Portal ▪ NHS Login ▪ Other clinical pathways interest generated LOOKING AHEAD
  130. 130. The need of Continuity of care out of hospital walls “ ”
  131. 131. FACTS Up to 80% information is lost when a patient leaves the doctor‘s office 50 % of medication being taken incorrectly or not being taken at all 33% - 69% of drug-related adverse events result in hospital re- admissions Source: Kessels RP. Patients' memory for medical information. J R Soc Med. 2003;96(5):219-22
  132. 132. Digitally supported care coordination WelLPRES Breast Cancer SSMFU ”
  133. 133. Vitaly Managed CareVitaly Patient Patient access Professional access WelLPRES A comprehensive ecosystem of collaborative solutions on top of the interoperable platform.
  134. 134. Fundamentals of Vitaly Platform
  135. 135. Through an intuitive interface, Vitaly eHealth Platform enables patients and healthcare professionals a secure access to relevant data when and where it is needed. USER-CENTERED CARE
  136. 136. Vitaly collects relevant clinical data from various healthcare information systems in a standardised form. ATNA XDS XUAFHIR PIX INTEROPERABILITY AND ARCHITECTURE Our platform is fully healthcare IT compliant. Core of the platform is FHIR (Fast Healthcare Interoperability Resources) HL7
  137. 137. ARCHITECTURE
  138. 138. ▪ Automated security scanning ▪ Manual penetration testing ▪ Static analysis ▪ Manual code review ▪ GDPR ▪ OWASP Secure coding practices ▪ Common weakness list IEC 60601-1 ISO 13485 IEC 62304 ISO 14971 ISO/IEC 27000 IEC 60601-1-6 SECURITY & STANDARDISATION
  139. 139. Using responsive design, Vitaly offers the same user experience on all devices – smartphones, tablets and PCs. OPTIMAL USER EXPERIENCE
  140. 140. Room for improvement EASE OF USE
  141. 141. Room for improvement EASE OF USE
  142. 142. WCAG “WCAG is a set of guidelines for making content accessible for all users, including those with disabilities.” WCAG 2.1 for ICT (info. comm. tech)
  143. 143. Vitaly Patient Solution
  144. 144. Reminders Educational materials NHS Login PATIENT ACCESS
  145. 145. Tasks Questionnaire s Appointment s MY TASKS
  146. 146. QUESTIONNAIRES
  147. 147. DOCUMENTS
  148. 148. MESSAGING
  149. 149. HEALTH JOURNAL
  150. 150. Vitaly Managed Care Solution
  151. 151. Developed with and for care professionals ▪ Better quality of treatment. ▪ Increased compliance with the therapy. ▪ Less unnecessary hospital visits. ▪ Increased overall satisfaction of the patients. ▪ Continuity of care for patients involved in long term therapy. ▪ Increased patient engagement through joint decision making. ▪ Tailor-made healthcare services for all involved in the care process. ▪ Reduced number of complex cases due to faster responses allowing preventive action and better decision making. ▪ Healthcare professionals are no longer limited to hospital walls to provide the same, or even better, quality patient-care. Vitaly Managed Care
  152. 152. ▪ NHS guidelines ▪ Flexible DISEASE-SPECIFIC CAREPLAN Parsek © Confidential do not duplicate
  153. 153. ▪ All in one place ▪ Smart filtering ▪ Up to date Parsek © Confidential do not duplicate ORGANISED DATA
  154. 154. Other follow up programmes ▪ Colorectal cancer pathway ▪ Prostate cancer pathway FURTHER DEVELOPMENT Parsek © Confidential do not duplicate
  155. 155. Inclusion in active treatments More tasks More patient engagament OPTIONS FOR THE FUTURE Video collaboration (PP-HC, HC-HC) Remote patient monitoring Parsek © Confidential do not duplicate
  156. 156. healthcare@parsek.com Thank you. Parsek © Confidential do not duplicate smita.shetty@nhs.net @HealthierLSC @parseksolutions @imsmitashetty
  157. 157. James Griffiths Senior Project Manager Value Based Procurement NHS Wales Shared Services Partnership - Procurement Services Email: james.griffiths@wales.nhs.uk Tel: 01495 300808 / 07870 484672 NHS Sustainability Day Cardiff Roadshow 5th March
  158. 158. Capacity Why a Value Based Approach ? Our Challenges?: • Rising costs • Ageing population • Variation in care • Increasing demand whilst trying to • Improve quality of care for our population
  159. 159. Prof Sir Muir Gray’s “transforming healthcare by delivering triple value”: PERSONALISED VALUE – base decisions on the best current evidence, careful assessment of an individual’s clinical condition and an individual’s value. TECHNICAL VALUE – improve the quality and safety of healthcare to increase the value derived from resources allocated to particular services. ALLOCATIVE VALUE – allocate resources to different groups equitably and in a way that maximises value for the whole population. Michael Porter’s definition for “value:” “The health outcomes achieved that matter to patients relative to the cost of achieving these outcomes.” VALUE = OUTCOMES / COSTS Personal Technical Allocative Value Definition Recap A sustainable solution?
  160. 160. Exercise
  161. 161. 178 Procurement tasked with product price reduction. Encouraged to look at innovation to improve process efficiency without being sure of efficacy. Great effort and resource …but a disconnect from outcomes that matter to the patient! Value Based Procurement – in support of WG Value Based Healthcare agenda – Patient focussed Efficiency and Efficacy need to be at the heart of what we do to deliver sustainable procurement solutions. Value Based Procurement 3Ps
  162. 162. A Value Based approach LNW Wales.
  163. 163. OGEP – On the Ground Community Educators Project. Overview: • 2 dedicated Lymphoedema educators working directly with community nurses • Upskilling of community nurses To improve the service provision Lymphoedema Network Wales (LNW) , informed by patient need, has initiated value based initiatives on a project basis in different Health Boards across Wales: Benefits: • Decreased GP contact • Decreased cellulitis episodes • Reduced hospital admissions • Decreased dressing costs • Measured improvement in patient QoL.
  164. 164. Super Micro Surgery – Lymphatic Venous Anastomosis (LVA) Overview: • Innovative minimally invasive micro surgery • Offered to patient cohort to treat Lymphoedema / slow progression Benefits: • Episodes of cellulitis decreased from almost 500 to 20 • Hospital admissions reduced from 50 to 2 in targeted pop • Almost 600 days off work reduced to less than 60 • 50% less patients on prophylactic antibiotics
  165. 165. Procuring versus prescribing of compression garments Overview: • Compression garments are the mainstay of treatment • Collaboration with SMTL, Procurement Services and Medicines Management • National procurement contract and formulary moving away from prescribing • Local stock kept closer to nurses and patients Benefits: • 65% or patients receive their garments on the day (rather than up to 3 weeks later) • Right garments , right time, right place – reduced harm • Reduced demand on GPs (no GP appointment required for prescription) • Reduced errors due to streamlined process (previously 35% incorrect) • Reduced travel for patients to collect prescriptions • Significantly reduced cost of garments vs Drug Tariff
  166. 166. Why a Value Based Approach ?
  167. 167. Why a Value Based Approach ?
  168. 168. Why a Value Based Approach ? Process PatientProduct Capacity Demand
  169. 169. Why a Value Based Approach ? Process Patient PopulationProduct Capacity Demand
  170. 170. Rapid Respiratory Diagnostic Service • One test replaces many - PROCESS • Quicker diagnosis and treatment decision - PROCESS • Detects more pathogens in one test - PROCESS • Less nursing time – PROCESS • Reduced patient displacement – PROCESS/PATIENT Open Access Engagement • Targeted interventions for over 18s based on individual need - PATIENT • Recovery and harm reduction strategies - PATIENT • Development of transition protocols with other services - PROCESS • Supplier supporting data collection - PROCESS • Patient centred KPIs inform contract e.g. number of users entering education, training / no return to service after 1,2,3 years - PATIENT VBP Case studies from across Wales
  171. 171. Non Invasive Prenatal Testing • Invasive test replaced by non invasive blood test – PROCESS / PATIENT • Increased result accuracy – PROCESS • Significantly less risk of foetal harm – PATIENT • Rapid results delivered - PROCESS • Earlier diagnosis aids decision making reduces harm – PROCESS/PATIENT Dementia Friendly Community Project • Early diagnoses and awareness – PROCESS/PATIENT • Accessible local services and transport - PATIENT • Independent living prolonged – PATIENT • Potential to enhance QoL - PATIENT VBP Case studies from across Wales
  172. 172. Precision Molecular Pathology Services for Cancer Patients • Reduced number of tests, many replaced by one - PROCESS • Automated analysis increased reliability and shorter lead times - PROCESS • Increased ability to predict, better prognosis – PROCESS / PATIENT • Long term supplier partnership - PROCESS Framework for Adult Mental Health Learning Disabilities and Care homes • Information sharing portal across health and social care - PROCESS • Framework to reduce variation in standards and patient cost - PROCESS • Focus on patient outcomes linked to contract - PATIENT VBP Case studies from across Wales
  173. 173. Diolch yn fawr iawn James Griffiths Senior Project Manager Value Based Procurement NHS Wales Shared Services Partnership - Procurement Services Email: james.griffiths@wales.nhs.uk Tel: 01495 300808 / 07870 484672
  174. 174. University Hospitals Bristol NHS Foundation Trust Alexandra Heelis, Sustainability Officer alex.heelis@uhbristol.nhs.uk 0117 342 26360; 07825365520 @AlexandraHeelis
  175. 175. In September 2019 UHB were the joint 3rd NHS Trust to declare a climate emergency in partnership with North Bristol NHS Trust. UHB Chief Executive Robert Woolley: “There is strong evidence about the impact of climate change on health…..The quicker we can take action on climate change, the quicker we'll improve the health of people right now as well as for future generations."
  176. 176. Launched in November 2019
  177. 177. Specific goals
  178. 178. • Anaesthetic gases • Single-use plastics – Clinical – Non-clinical • LED lighting • Clean Air Hospital Framework – QI Gold • Active/sustainable travel • Green Impact Awards Existing projects
  179. 179. June 2018 • ‘UH Bristol is committing to becoming a more sustainable organisation by reducing our reliance on plastics’. • Commitment to reduce the use of single-use plastics e.g. straws, cutlery, cups, to only those that are medically needed by 2020. Plastic
  180. 180. Catering plastic • The catering department has: • Stopped buying plastic straws. • Replaced plastic cutlery and stirrers with wooden equivalent (beech). • Brewnel’s - Trust owned cafes: • Outlets with seating are using crockery instead of disposables. • Disposable food containers have changed from polystyrene to recyclable material. • Discount is offered when using a reusable cup.
  181. 181. • Trust water stations are mains fed, not bottle fed. • Encouraging people to refill their bottles, not buy bottled water • Sites to be added to the Refill Bristol website. Office plastic • Waste department are repurposing used food containers (boiled eggs!) as battery recycling containers. • Printer and toner cartridge recycling across the Trust.
  182. 182. • Catering department registered for ‘bread bag’ recycling scheme. • Numerous departments collecting: – Crisp packets – Writing instruments
  183. 183. • NHS England and NHS Improvement launched pledge. • NHS trusts who sign up commit to phase out avoidable single-use plastic items used in catering services and office spaces. NHS single-use plastics reduction pledge
  184. 184. NHS single-use plastics reduction pledge
  185. 185. Gloves off – Liaising with Great Ormond Street Hospital to emulate their highly successful campaign • Encourage healthcare professionals to reduce unnecessary use of non-sterile gloves. • Reduction in single-use plastics. • Savings – procurement and disposal. • Staff health – decreased dermatitis. • Patient benefits – reduces anxiety & benefits of ‘human touch’. Clinical plastic
  186. 186. Switch from disposable surgical hats to washable. Switching in St Michael’s has already saved 25,000 hats £2,700 per year. Clinical plastic
  187. 187. Clinical plastic Current pack used for epidural Items not used for procedure Instead use 3 individual items 40% cost saving
  188. 188. Clinical plastic 84 94 79 0 168 0 20 40 60 80 100 120 140 160 180 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Kilograms Month of collection Quantity of UH Bristol clinical plastic recycled by Recomed
  189. 189. Thank you, any questions? Alexandra Heelis, Sustainability Officer alex.heelis@uhbristol.nhs.uk 07825365520 0117 342 26360 @AlexandraHeelis
  190. 190. Conference Close Have a safe journey home @dayforaction #sustainability

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