January 2013 Issue No. 268 ISSN 1747-728XThe Leading Independent Journal For ALL Operating Theatre Staff

2 THE OPERATING THEATRE JOURNAL www.otjonline.com

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The Next issue copy deadline, Friday 25th January 2013All enquiries: To the editorial team, The OTJ Lawrand Ltd, PO Box 51, Pontyclun, CF72 9YY Tel: 02921 680068 Email: admin@lawrand.com Website: www.lawrand.comThe Operating Theatre Journal is published twelve times per year. Available in electronic format from the website, www.otjonline.comand in hard copy to hospitals throughout the United Kingdom. Personal copies are available by nominal subscription.

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Drawing new lines in the sand after the Mid Staffordshire Inquiry

The long awaited report of the Mid Staffordshire Inquiry is due to be published early this year [2013]. The Health and Care Professions Council (HCPC) was not asked to give evidence but we have been watching with interest and have engaged in the debates about many of the issues which have been highlighted during the Inquiry.

One of the questions we regularly ask ourselves is this: What more can we do as your statutory regulator to empower you to play a stronger role in maintaining standards, even where the culture of health and care organisations may appear to mitigate against this? One initiative we are supporting is the “Big Conversation”. This has been instigated by Karen Middleton, Chief Health Professions Of cer at the Department of Health in England, to encourage staff to comment on unprofessional behaviour whenever it surfaces.

Another initiative is the research we are undertaking into dispute resolution, for example between managers and staff, who may complain about each other’s conduct. We need to know more about the reasons for such disputes as well as the ways in which they can be resolved.

We are already aware of the importance of supporting staff and embedding the right values into working practices. The HCPC Standards on Conduct, Performance and Ethics (SCPEs) require those on our register to ‘effectively supervise tasks that you have asked other people to carry out’. But this may not be enough. Supervision provides the opportunity for a professional to voice concerns about standards of care or dif culties in doing the job. There might be questions about the need for more training, the safety of equipment, size of caseload, staf ng levels and procedures. Or there might be an issue with the conduct of a colleague. The SCPEs are currently undergoing a thorough review with input from service users and professionals. We welcome your views on whether or not they need to be strengthened.

Another area of concern for HCPC is the adult social care workforce. The skills mix in health and social care is changing rapidly and more health and care organisations delegate work to support workers who are not on a professional register. Support staff require appropriate education and training and supervision but they may need to be made personally accountable, too.

We are currently contributing to the debate by looking at models of regulating individuals who work in adult social care. Various options are being examined, including statutory and voluntary registers, and an Australian model which uses a statutory code of conduct and a ‘negative licencing’ scheme – effectively a register of individuals who are judged not t to practise against the code of conduct rather than a register of those who are. Any care worker who is found to fall below statutory national standards of behavior and conduct could be placed on a ‘negative’ register. The system could also impose a range of sanctions, for example, require speci c training or supervision to be put in place. The evidence from other countries who have a similar model shows that relatively few people are stopped from working in the sector permanently. However, the statutory nature of the negative registration scheme means that there is a clear deterrent, an enforceable means of holding care workers to account. This is what is missing at the moment.

Robert Francis’ report into Mid Staffordshire is likely to be challenging to all of us who work in health and social care, and rightly so. I would urge you to stimulate debate and discussion amongst your colleagues on these important issues and engage with us to ensure that we continue to be a robust and responsive regulator in times of rapid change.

Anna van der Gaag, Chair, HCPC

NOTES1) Robert Francis is due to submit the report2) Karen Middleton’s quote is at http://ahp.dh.gov.uk/2012/05/18/have-you-had-the-

%E2%80%98conversation%E2%80%99-yet/3) HCPC Council paper, Regulating the adult social care workforce in England, Sepember

2012: http://www.hcpc-uk.org/assets/documents/10003C64enc08-regulatingadultsocialcareworkforce.pdf

Progress in making NHS ef ciency savingsThe NHS made a substantial amount of ef ciency savings in 2011-12, according to a report published recently by the National Audit Of ce. These savings will need to be sustained and built on in future years if the NHS is to generate up to £20 billion of savings in the four years to 2014-15.

The Department of Health has reported that the NHS achieved £5.8 billion of savings in 2011-12, virtually all of the forecast total of £5.9 billion. Most of the savings were generated through the pay freeze for public sector staff, and reductions in the prices primary care trusts pay for healthcare. NHS bodies also made savings by cutting back-of ce costs.

However, there is limited assurance that all the reported savings were achieved. The chief executives of primary care trusts are required to con rm they are content with the accuracy of their savings data, but the Department does not validate or gain independent assurance about the data reported. An NAO review of the Departments analysis of national pay, activity and other data substantiated a total of £3.4 billion of NHS ef ciency savings.

The NAO found that, understandably, the NHS has started by making the easiest savings rst. Although the savings made by NHS providers as a percentage of operating costs are increasing, it is not clear what level of savings is sustainable over time. There is consensus that service transformation, such as expanding community-based care, is fundamental to making future savings but only limited action has been taken so far. Changes to transform services take time to implement and the Department has always expected that these savings will predominantly come in the latter half of the four-year period.

The NHS is seeking to maintain the quality of, and access to, healthcare at the same time as making ef ciency savings. In 2011-12, the NHS performed well against headline indicators of quality, including waiting times and healthcare associated infection rates. The indicators focus mainly on hospital care and the Department faces a signi cant challenge in monitoring quality across the NHS as a whole.

The Department does not know whether the demand for healthcare is being managed in ways that inappropriately restrict patients access to care. Reducing demand and redesigning care pathways to treat patients in the most appropriate setting are key ways of generating savings. The Department told the NAO that, where it has been made aware of speci c concerns, the relevant strategic health authority has been asked to investigate. It has also made clear that blanket bans on particular procedures are not permitted.

Amyas Morse, head of the National Audit Of ce, said today: The NHS has made a good start in making substantial ef ciency savings in the rst year of the four-year period when it needs to achieve savings of up to £20 billion. To build on these savings and keep pace with the growing demand for healthcare, it will need to change the way health services are provided and to do so more quickly.

Care Quality Commission – Our Latest ReportsEach week, on a Wednesday morning, we publish reports on our inspections of health and social care services all over England where our inspectors look at whether national standards are being met.

These can be found at: http://www.cqc.org.uk/public/news/our-latest-reports

On this page you can see a map showing all of the reports published this week. This allows you to zoom in and see all the services in your area we have published reports on during that month.

We also publish a spreadsheet at the end of each month showing all the hospitals, clinics, care homes, dental practices and other health and social care services we have published reports on. You can nd these on the right-hand side of this page.

If you click on any of the dots, you will see the name of the service, a link to its pro le page and information on whether it is currently meeting the national standards.

4 THE OPERATING THEATRE JOURNAL www.otjonline.com

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Fukuda Denshi attend the Association of Anaesthetists Winter Scienti c MeetingFukuda Denshi is a leading supplier of advanced patient monitoring and user-con gurable clinical information management systems, as well as cardiac monitoring and imaging technology. The company will be attending the Association of Anaethetists Winter Scienti c Meeting, being held at the Queen Elizabeth II Conference Centre in Westminster, London.

Comprising an industry exhibition, core topics sessions, scienti c sessions and hands-on workshops, WSM London starts on 16th January and runs to 18th January 2013; providing Anaesthetists with the opportunity to view and learn about the latest advances in anaesthesiology.

Fukuda Denshi will be attending the industry exhibition with their DS-8500 high end anaesthesia/critical care monitor incorporating Fukuda Denshi’s most intelligent user interface. It allows users to tailor the monitor to meet their speci c requirements by offering a full suite of modules as well as a full 5 agent gas bench.

The DS-8500 is highly versatile and can be mounted as a standalone system or alternatively attached to any anaesthesia machine. In addition, all patient data can be collected and viewed at the bedside or central station with its seamless patient record transfer from monitor to monitor via an HS 8000 super module.

Also on show will be Fukuda Denshi’s MetaVision Clinical Information System, the MVOR, which is speci cally designed for anaesthesia use.

Visitors will receive a warm welcome from the Fukuda Denshi team, who will be on hand to demonstrate these state-of-the-art products and provide full product information and answer any questions.

Fukuda Denshi: Healthcare bound by technology.

For more information visit www.fukuda.co.uk. When responding please quote ‘OTJ’

NATIONAL AUDIT OFFICE: Department for Health:

Progress in making NHS ef ciency savingsA statement from The Rt Hon Margaret Hodge MP, Chair of the Committee of Public Accounts:

The NHS is facing a four-year £20 billion squeeze that demands unprecedented levels of savings. Against a target of £5.9 billion for 2011-12, the Department reported that the NHS achieved ef ciency savings of £5.8 billion. This sounds like welcome progress, but over 30 per cent of these savings lack any kind of independent assurance to provide Parliament and the public with con dence that they present a true picture.

What also emerges from this report is that the ‘low hanging fruit’ - the easiest savings - have already been harvested. The NHS will have to search deeper and wider for future ef ciency savings. Fundamental service transformation is vital to unlocking savings, but progress to date is underwhelming.

The Government must ensure that the drive to cut costs does not compromise patient safety or quality of care. While, according to this report, overall quality indicators held up in 2011-12, I am aware that the Department’s own publicly available gures suggest that things have started to get worse. For example, they show that since April this year the number of people waiting for more than four hours in A&E has risen to half a million, compared to 432,000 in the same eight-month period last year. Data from the Care Quality Commission also shows that 16% of the hospitals inspected in 2011-12 were understaffed.

The Department is trying to reduce demand for acute services, but this must not lead to the NHS shutting the door to patients. Alternative provision must be in place to ensure that all patients wherever they live have access to appropriate care to meet their needs.

The Department must carefully monitor the impact of ‘demand management’ to ensure that healthcare is not being rationed and I am astonished that it does not yet have a mechanism in place for doing so. The NAO’s recommendation that the NHS Commissioning Board consider establishing national access policies should be taken seriously by the Department.

The road ahead for the NHS is steep. While the NHS may have registered a surplus in 2011-12, this disguises the nancial woes of 31 Trusts and Foundation Trusts in de cit and on life support from the Department. The need to pump money into these failing Trusts is the mark of an unsustainable system that is struggling to square growing demand with the scale of ef ciency savings required.

The Department must collect robust information to support and incentivise service transformation. It also needs to sharpen up the quality and reliability of its reported savings to provide greater con dence.

EU Court of Justice Rules on De nition of a Medical DeviceA ruling by the EU Court of Justice last month might make it less clear what the difference is between the de nition of medical devices and devices for general health, according to life science and IP lawyer Erik Vollebregt, who blogs about medtech matters on medicaldeviceslegal.com

The case Brain Products GmbH v BioSemi VOF concerns the de nition of medical devices in the Medical Device Directive and speci cally if Biosemi’s ActiveTwo, a device recording brain activity, is a medical device. The EU court ruled that a device is considered medical if it is “intended for a medical purpose.” The court further ruled that “…in situations in which a product is not conceived by its manufacturer to be used for medical purposes, its certi cation as a medical device cannot be required”.

The ruling is problematic because it relies on the manufacturer’s intent and de nition of a medical purpose, instead of a more objective measure, and it fails to de ne exactly what medical means, Vollebregt says.

“We still don’t know what ‘medical’ means as opposed to the more general term ‘health’”, says Vollebregt. The EU Court seems to mix up these terms in the judgment, and surely does not clarify the term medical very much except by saying that articles that do not have a medical intended purpose, like sporting goods, should not be regulated as medical devices.”

The ruling will potentially broaden the scope of the Medical Device Directive (MDD). It could also enlarge the scope of the proposed medical device regulations (MDR), says Vollebregt. The medical device regulations will enter into force in the next few years. “This dif cult borderline between medical and health will not be resolved in the MDR,” says Vollebregt.

For a more detailed look on what this ruling means, read Vollebregt’s blog post A medical device is medical – but what does that mean? At: http://medicaldeviceslegal.com/2012/11/26/a-medical-device-is-medical/

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Vale Healthcare Launch New South Wales Spine Centre

A specialist spinal centre has opened near Cardiff and will become home to some of the UK’s best spinal surgeons.

The South Wales Spine Centre will be offering the services of leading Spinal Surgeons: Mr Paul Rhys Davies, Mr Stuart James, Mr James Cordell Smith and Mr Michael McCarthy, four highly quali ed and established Orthopaedic Spine Surgeons, as well as Mr Iqroop Chopra, the only spinal fellowship trained Spinal Neurosurgeon in south Wales.

All ve spine specialists are fellowship trained and have advanced spinal surgery technique experience, including spinal cord and nerve decompression, spinal fusion, microsurgery and minimally invasive surgery of the lumbar, thoracic and cervical spine, as well as arti cial disc replacement.

The centre offers people in South Wales a rapid access, one-stop clinic for a multi disciplinary approach to patients suffering from spinal disorders and back pain. The recent acquisition of two new Spinal Surgeons has enabled Vale Healthcare to launch the South Wales Spine Centre

Speaking about the launch of the South Wales Spine Centre, Tim Atter, business director at Vale Healthcare, commented: “The launch of the Spine Centre marks an important step forward in the evolution of Vale Healthcare.

“It is our ambition to become one of the leading spinal units in the UK and with our combination of high pro le spinal neurosurgeons and spinal orthopaedic surgeons we are already well on our way to meeting this target.”

Mr Paul Rhys Davies, who is considered to be one of the top ten spinal surgeons in the country, is excited about the possibilities ahead thanks to the newly formed spinal team at Vale Healthcare.

“The launch of the South Wales Spine Centre offers the other surgeons and I the opportunity to really showcase our abilities and continue our pioneering work and research.

“South Wales already has a reputation as a centre of spinal excellence and it is my intention to fully develop this so we become truly established on the world stage.”

The Orthopaedic surgeons at the South Wales Spine Centre have particular expertise in dealing with procedures for scoliosis, degenerative conditions and spinal deformities, covering a signi cant number of common back and neck pain conditions.

In addition to this, Neurosurgeon, Mr Iqroop Chopra performs surgery within the innermost lining of the spinal column. Meaning he can perform surgeries on spinal cord tumors, cysts, spinal cord arteriovenous malformation, tethered spinal cord, spina bi da, nerve root tumors, and other more complicated nerve related surgeries.

To complement the services of the surgeons Vale Healthcare also offers a spinally trained rehabilitation team of physiotherapists and osteopath who work closely with the surgeons in developing the best treatment programmes speci c to their condition or symptoms.

The Osteopathy service at Vale Healthcare is led by Garry Trainer D.O. B.Ac, a highly experienced osteopath and acupuncturist who runs weekly clinics at the Vale Hospital.

Garry has 30 years of osteopathy experience specialising in back pain, neck, shoulder and joint pain, sports injuries, sciatica, stress and anxiety.

Clients include Gwyneth Paltrow, Paul McCartney, Emma Thompson, Johnny Depp and he has just returned from New Zealand where he has been treating Coldplay on their world tour.

Garry’s unique combination of Osteopathy, Massage and Acupuncture has become a signature treatment.

For more information on the Vale Healthcare South Wales Spine Centre call 029 2083 6714 or visit www.southwalesspinalcentre.com

6 THE OPERATING THEATRE JOURNAL www.otjonline.com

Exceptional chemical resistance offered by Chemtop®2 available exclusively from

Formica Group

Environments such as hospitals, clinics and laboratories demand special consideration in the speci cation of materials for interior t outs. Meeting this demand Formica Group has introduced Chemtop®2, 16mm Compact laminate with advanced chemical resistance. The result of cutting edge technical developments and manufacturing processes, Chemtop2 is available now from Formica Group throughoutEurope.

Chemtop2 is available as 16mm compact grade laminate ensuring that it caters for all applications including worksurfaces and splashbacks, cabinets and fume cupboards.

Ideal for use in high stress environments, where relatively harsh acids, alkalis, corrosive salts and other destructive and staining substances are used, the Chemtop2 range boasts outstanding performance properties.

Offered in designs selected for their suitability to these environments, the Chemtop2 range comprises three plain colours and ve patterns including Polar White, Grey Dust, Lava Dust and Mouse Gra x.

The sheet sizes are 3050x1300mm and 3660x1525mm which provide for economical conversion and minimising seams and joints.

Modern, t for purpose design is at the forefront of new building and refurbishment.

The use of materials that aid sterility and ensure practicality in school or college laboratories, or in public and private facilities where sophisticated and precise laboratory work is carried out, is a fundamental consideration.

Meanwhile opportunities to help tackle issues such as hospital acquired infections and cross infection through updating interiors and promoting fundamental cleaning practices are key factors in the decisions taken by designers for healthcare and scienti c sectors.

It is the hygienic properties of laminate that allow it to really excel in these environments, and with Chemtop2 exceptional chemical resistance is also offered.

The Chemtop2 range complements the array of laminate designs featured in the Formica® Collection that offers a selection of durable, easy to clean materials for an entire range of colour schemes.

Whether in the super-clean context of the operating theatre or pathology lab, in toilets and washrooms, along corridors or stairwells, on wards or in treatment rooms, products from Formica Group can help meet the stringent requirements of sterility, durability and easy cleaning. The non-porous, wipe-clean surface of HPL is inherently hygienic and can be steam cleaned or disinfected with no adverse effects. It can be used for all horizontal and vertical surface applications, including worksurfaces, splashbacks, and in the construction of cabinets and fume cupboards.

Chemtop2 laminate is also available on a made-to-order basis, in thin (0.7mm) postforming grade High Pressure Laminate (HPL).

This enables the creation of work surfaces and other bonded components with integral upstands and down stands, eliminating joints and seams at critical positions in the nished installations.

Chemtop2 samples and a dedicated laboratory range brochure are available to order via the website www.formica.com

Formica, the Formica anvil device, DecoMetal, ColorCore and AR Plus are registered trademarks of The Diller Corporation. © 2012 The Diller Corporation

When responding to articles please quote ‘OTJ’

Barbara receives recognition for

Academic Excellence with a Radiography Award sponsored by

Fuji lmFuji lm is a pioneer in diagnostic imaging and information systems for healthcare facilities, with a range of constantly evolving clinically proven products and technologies designed to assist medical professionals perform more ef ciently and effectively. The company are pleased to announce that Barbara Scott has been awarded a Radiography Award for Academic Excellence for her consistent dedication to her studies.

Barbara, a fourth year Therapeutic Radiography student, was selected for the Radiography Award for her continued academic excellence, as she has been the top student in her year throughout her entire degree course.

The award, sponsored by Fuji lm, was presented to Barbara after graduation on 6th July 2012 at the Festival Theatre in Edinburgh by Anne Laurie, Lecturer and Programme Leader at Queen Margaret University, Edinburgh.

Commenting on the Award, Ms Laurie said: “It was a pleasure to congratulate Barbara and award her for her outstanding commitment that has been consistently demonstrated year on year since she began her degree course. To be top student every year is an outstanding achievement in itself and shows real dedication to Therapeutic Radiography.”

General Manager of Fuji lm UK, Mark van Rossum, also commented on Barbara’s award: “We’re pleased to hear how well Barbara has performed throughout her degree course, and we are also delighted Fuji lm have been able to sponsor this award and support the recognition it brings to such a well deserving student. Well done Barbara.”

Fuji lm – pioneers in diagnostic imaging and information systems.

For further information, visit www.fujimed.co.uk...When responding to articles please quote ‘OTJ’

ORBIS Saves Sight Of Child With 200,000th SurgeryA blind teenage girl from Zambia was the 200,000th children’s surgery case by sight saving charity ORBIS. 14 year old Memory Chonga received a cataract operation at the recently opened ORBIS Paediatric Eye Care Centre in Kitwe.

Before the operation Memory’s condition, which developed overtime, caused severe clouding of her eyes and almost total loss of her sight. It caused her depression and to withdraw from normal life. But now Memory’s outlook is totally changed. Her vision is now good and she spends as much time as possible reading whatever she can lay her hands on, a pleasure that has recently been denied to her because of her gradual sight lost. When asked what she thought of her ‘new eyes’ she exclaimed: “Praises, praises, thank you, praises, thank you.”

Memory’s sight saving operation is just one of a raft of impressive milestones reached by ORBIS and its partners in its 30th anniversary year:-

18.8 million medical/optical treatments (5.6m children / 13.2 m adults) 869,000 eye surgeries / laser procedures 215,000 nurses and others trained / 90,000 doctors trained

Dr Robert Walters, ORBIS Chairman commented: “We work where the need is greatest and 90% of the world’s visually impaired people live in developing countries. Our work leaves a lasting legacy by training local medical professionals to treat and teach quality eye care in their communities. Many of the operations we perform on children like Memory are simple and incredibly cost effective. The results, of course, are priceless.”

At the heart of ORBIS’s work is the Flying Eye Hospital - a ‘hospital with wings’. It is staffed by an ORBIS team and medical volunteers and is a fully equipped teaching facility inside a DC- 10 aircraft. Hospital-based training programmes are carried out in the countries where the need is greatest including current long-term programmes in Bangladesh, Ethiopia, China, India, Nepal, Peru, Zambia, South Africa, Haiti and Vietnam. ORBIS is establishing cataract and paediatric services in parts of sub-Saharan Africa as one in ve of the world’s blind children live there.

To nd out more about ORBIS’ work visit: www.orbis.org.uk When responding to articles please quote ‘OTJ’

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HULL RESEARCH TEAM PIONEERS NEW TEST TO STUDY HEART TISSUENew technique that could aid heart surgery

A University of Hull research team has successfully developed a novel system for keeping human heart tissue biopsies alive whilst continuing to beat and otherwise function as though they were in the human body, thanks to a grant from Yorkshire-based charity Heart Research UK. The system can be used to study both healthy and diseased heart tissue in life-like conditions, as well as simulating disease conditions such as heart attacks or changes caused by surgery, in ways not currently possible. The system could become an important research tool to help scientists to understand more about the processes involved in heart disease and to develop new treatments. The team, led by Professor John Greenman, carried out the research thanks to a grant of £199,728 from Heart Research UK. This work led to Professor Greenman being awarded this years Heart Research UK Outstanding Researcher of the Year Award in recognition of this successful work. Living tissue needs to be continuously provided with oxygen and nutrients and waste products removed. The University of Hull study showed that a number of factors were critical in keeping the biopsies in a healthy state, and the researchers carefully created the conditions so that tissue samples could be kept alive for up to 24 hours in the lab long enough for relevant tests to be carried out on the tissue.

The researchers were able to measure levels of key chemicals released from the tissues to study in real-time the changes taking place in the cells - allowing fast analysis within minutes rather than hours as with current methods of testing. It could mean that clinicians can make a swifter diagnosis and introduce relevant and earlier treatment giving chance of improved outcomes. Professor Greenman, who has been working with a multi-disciplinary team of 9-10 people, said that analysing the patients own tissue meant a better understanding of what is happening clinically can be achieved. It all comes back to personalised medicine, he said. Knowing how a patients heart tissue behaves when subjected to certain conditions means you can more precisely select the relevant type of treatment or drug. The other bene t is that the tissue samples are very small, yet the chemistry under-pinning the device allows really small concentrations to mimic as near as possible what is actually happening in the heart. Professor Greenman and the team have been regularly consulting with clinicians during their work in a bid to both replicate the situation inside the body and ensure they address real clinical problems. The challenges now are to further validate the new technology and nd ways of packaging it for manufacture as a medical device for use in the clinic.

Professor Greenmans ultimate vision is that by directly testing patient samples in a hospital setting, the system could be used for rapid and accurate diagnosis and to help clinicians select the best treatment for individual patients although this stage is still a few years down the line.

Barbara Harpham, National Director of Heart Research UK said: We give over £1m a year in grants each across the UK. Prof Greenmans £200,000 project is part of the £1m weve given to Hull in the last ten years alone. The work the Hull team have been doing is not only exciting, but could ultimately make heart surgery even safer - one the aims of our founder, 45years ago, and still a big priority today.

We were so impressed by Prof Greenmans work and, to mark the importance of this particular piece of research, he was awarded the Heart Research UK Outstanding Researcher of the Year Award earlier this year.

Professor John Greenman

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Infection and contamination control experts, Tristel, have donated 5 years worth of disinfectants to Mercy Ships, a charity

providing essential healthcare to developing countries.

Since 1978, Mercy Ships have operated hospital ships serving some of the poorest countries in the world. Aboard these ships, people are able to receive free surgical operations, dental treatments and medical care. Mercy Ships partners with local communities to provide training, advice and materials, and to improve general local healthcare.

Mercy Ships approached Tristel with a major problem they were facing: how to give a high level of disinfection to their bronchoscopes in eld conditions. The solution is to use Tristel’s innovative Stella Disinfection System.

Using the charitable discount offered by Tristel, Mercy Ships purchased the Stella Disinfection System. Partnered with the donated Fuse for Instruments sporicidal disinfectant solution sachets, the Stella Disinfection System is ideally suited to Mercy Ships needs. It is easy to use, portable, battery powered and requires no special room to operate in. The System has a rapid cycle, effectively disinfecting instruments after just 5 minutes, enabling Mercy Ships to now perform a higher number of critical surgeries than was previously possible.

The equipment and disinfection solutions have initially been used on the Africa Mercy, a hospital ship docked in Lorne, Togo, where 1,200 surgeries, and 1,100 dental procedures were provided for around 5000 people, who would otherwise be unable to access this level of care.

Used widely in hospitals worldwide, Tristel’s chlorine dioxide based portfolio of infection control products offer easy-to-use, safe high-level disinfection solutions for surfaces and instruments. Tristel products are considered to be amongst the highest performing biocides available to healthcare and industry.

For further information on Tristel’s complete range of infection control products, please call 01638 721500 or visit www.tristel.com

When responding please quote ‘OTJ’

Newly expanded Neonatal unit acquires latest Mobile Digital X-RayJohn Radcliffe Hospital, part of Oxford University Hospitals NHS Trust, recently took ownership of a MobileDaRt Evolution Wireless mobile X-ray unit – supplied by Gloucestershire-based Xograph Healthcare.

The department’s expansion is central to a pioneering initiative at the Neonatal Intensive Care Unit (NICU) which has been successful in sending premature babies home to the care of the family earlier than had previously been possible. Imaging at the bedside is an important part of the care process of the newborn making the MobileDaRt Evolution, with Incubator size wireless digital detector, ideal for this busy environment as it allows easy positioning in restricted spaces and the high sensitivity of its detector ensures low patient X-ray dose without compromising image quality.

Debbie Tolley, Radiology Manager at John Radcliffe Hospital said: “The radiographers are delighted with the equipment that we chose for our newly expanded neonatal unit. We needed a DR mobile that would produce high quality instant images at the bedside with minimal disruption to the newborn; the MobileDaRt Evolution has delivered that. The small DR detector is compatible with all the cots and incubators that we already have in the department and the mobile unit is very easy to manoeuvre and importantly to keep clean.”

Paul Andrews Xograph’s Commercial Manager commented: “The incubator-sized Canon CXDI-80C wireless at panel detector allows Clinicians the ability to review instant, high quality images right at the incubator side enabling quicker diagnosis and less disruption to the baby.”www.xograph.com

Liam Neill, Territory Manager at Xograph Healthcare with Debbie Tolley, Radiology Manager and Adele Roberts, Radiographer at the John Radcliffe Hospital

Surgical study: ‘Never’ events like objects left in patients happen about 500 times a year - USA

These events are dangerous: When researchers analyzed data they found that 6.6 percent of patients experiencing a “never” event subsequently died.

They sound like some of the worst mistakes a surgeon could make: leaving an instrument inside a patient. Operating on the wrong body part — or the wrong person. They’re aptly named “never” events, the errors that should never, ever occur.

Turns out, however, these “never” events happen quite frequently, about 500 times a year. Between September 1990 and September 2010, new research in the journal Surgery found evidence of 9,744 paid malpractice claims for “never” events.

About half of those cases were ones in which surgeons left an object inside the patient (separate research suggests the most frequently forgotten items are sponges). The other half were cases where the surgeon operated on the wrong part of the body or performed the wrong procedure. A small number, 17, involved surgeons operating on the wrong person altogether.

These events are dangerous: When the researchers analyzed a smaller cohort of data, from 2004 through 2010, they found that 6.6 percent of patients experiencing a “never” event subsequently died. One-third had a permanent injury and 59 percent had a temporary injury.

Patients who received the wrong procedure were at highest odds of death or permanent injury. The research also found that younger

patients had signi cantly better odds of surviving a “never” event than did patients older than 60.

Keep in mind, these data draw only from malpractice claims that were paid. The data would not capture an event in which a patient did not experience harm.

It’s hard to know whether this study captures the full breadth of “never” events. As the study’s lead author, Winta Mehtsun, a surgeon at Johns Hopkins University School of Medicine, points out, their data cover only malpractice claims. They don’t touch cases never led.

“Although the data we utilized captured surgical ‘never’ events resulting in malpractice claims, many do not reach legal process and are then only voluntarily disclosed, with little coordination among reporting bodies,” he writes in the Surgery article.

What the data do suggest is that we do know a bit about which doctors are most likely to experience such events. They are doctors who had already experienced malpractice claims. Younger doctors also had higher odds of settling malpractice claims for such events.

As for a solution? Separate research has traced many medical errors back to a lack of leadership or communications.

Hospitals that have implemented checklists have seen success in increasing communication between health-care providers. Others have reviewed policies to see where patients might be slipping between the cracks, and made improvements. Source: Washington Post When responding to articles please quote ‘OTJ’

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 268 January 2013 9

NICE Guidance supports the caseto adopt Indithermpatient warmingsystems in the NHS• Clinical evidence supports Inditherm’s

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Bowel Cancer: Postoperative deaths fall for fourth consecutive year, says national auditCall to break taboo that locks symptoms behind bathroom door as emergency admissions continue to cause concern

The proportion of bowel cancer patients who die following major surgery has fallen for the fourth consecutive year, new gures from the National Bowel Cancer Audit show.

5.1 per cent of patients diagnosed in 2010-11 (the current audit year), had died 90 days on from their operation, compared to 6.4 per cent of patients diagnosed in 2007-08.

The audit shows that keyhole (laparoscopic) surgery rates rose in the same time period from 25 per cent to over 40 per cent. Keyhole surgery was found to be associated with both shorter hospital stay (six days, compared to nine days for open surgery patients) and a reduced risk of post-operative death (2.6 per cent for keyhole surgery versus 6.7 per cent for open surgery). However keyhole surgery is usually performed on tter patients, with less advanced disease, who come into hospital for a planned operation.

Todays audit report, which looked at data for just over 29,000 bowel cancer patients diagnosed in 2010-11, was commissioned by the Healthcare Quality Improvement Partnership and developed by the Health and Social Care Information Centre, the Association of Coloproctology of Great Britain and Ireland and the Royal College of Surgeons of England.

It also highlights that emergency admissions for bowel cancer continue to be a major cause of concern. Overall, 21.1 per cent of patients with bowel cancer were admitted as an emergency with severe and potentially life-threatening symptoms. Nearly one third of these admissions were not suitable for surgical intervention (29.5 per cent) and of those that had emergency surgery, more than one in 10 had died within 90 days of the emergency operation (11.9 per cent).

Through new data analysis, the audit today also highlights a delay in the closure of temporary stomas after operations to remove rectal (back-passage) cancer. Patients are commonly counselled that a temporary stoma after rectal cancer surgery (anterior resection) will be closed within six months of surgery. However todays new analysis (which links audit data to Hospital Episode Statistics (HES) information) shows 38 per cent of patients still had a temporary stoma 12 months after undergoing an anterior resection. Future work is required to determine if this delay is related to further treatments, such as postoperative chemotherapy, or a lack of operating time.

Operating Department Practitioners renew registration - HCPC

We recently invited all operating department practitioners to renew their registration with the HCPC for the next two years and 10,311 (93%) have successfully renewed.

We would like to thank the Association for Perioperative Practice and the College of Operating Department Practitioners, as well as all the human resources directors, service managers, trade union representatives and employers that have helped us in promoting the importance of renewing.

We are continuing to work closely with stakeholders, including the professional bodies of all the professions we regulate, to ensure successful renewal rates.

Nigel Scott, audit clinical lead and consultant colorectal surgeon at the Royal Preston Hospital, said: The National Bowel Cancer Audit continues to make a contribution to understanding and improving the patient journey with bowel cancer. However, bowel cancer emergency admissions are a persistent and very signi cant health problem.

Symptom awareness campaigns are useful to break down the taboos of bottoms and bowels that lock these symptoms behind the bathroom door. But emergency surgery continues to be the Cinderella of surgical practice in the UK.

A recent survey of surgeons highlighted that the NHS pressures currently work against emergency cases with 55 per cent of surgeons describing inadequate emergency theatre access. Only 15 per cent of emergency surgeons have a comprehensive interventional radiology service out of hours and this de ciency has a major detrimental effect on the use of colonic stenting for the emergency colorectal cancer admission. These ndings are also mirrored in a recently published report by the Department of Health and the Royal College of Surgeons.

10 THE OPERATING THEATRE JOURNAL www.otjonline.com

The surgeons who are not doctorsWhen patients go into hospital for surgery, they expect it to be carried out by a doctor.

Those wielding the scalpel will be assumed to have spent ve years at university and many years building up the wealth of experience and knowledge that surgeons usually have.

But this is no longer always the case.

More information at: Facebook.com/TheOTJ

A STRATEGIC ALLIANCE BETWEEN ENDOCONTROL AND TRUMPF

EndoControl is really proud to announce its new alliance with the international high-tech company TRUMPF Medical Systems.

One of the key goals of TRUMPF Medical Systems is to offer innovative solutions that optimize patient care procedures in and around operating rooms and intensive care units. With its products TRUMPF intends to make the work of surgeons and medical care staff easier, more ergonomic and more ef cient.

More information at Facebook.com/TheOTJ

MRI 3-WAY SAFETY MULTIPLE-INFUSION SETS

Global Components Medical Ltd are close to launching our new 3-Way MRI 10m Safety (Multiple-Infusion) Sets internationally. There has been a tremendous demand for such a set and with the full safety as on our other sets.

Each set will come with the following safety built in:

* International colour-coded drug labels(to match syringe contents)

* I-Lok(Sterile eye protection)

* 2xLineLoks® double-security to ensure cannula security at all times

If you think this product is going to be helpful to you (no more joining up of lines, valves, surgical tapes, & massive time saving in say, transfer from ICU to MRI etc) then we would be very pleased to know your annual requirements for these sets.

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See also the article: Anaesthetists Are Concerned About Safety In Theatre on the OTJOnline Facebook Page.

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CALLS TO CURB SURGERY SALES TECHNIQUES

People want to see tighter restrictions around the cosmetic surgery industry in a bid to protect patients from some of the more aggressive sales techniques according to an interim report published on the 31st December by the NHS Medical Director, Sir Bruce Keoghs review into cosmetic interventions.The report contains results from the Call to Evidence launched in August to provide suggestions from the public, the cosmetic interventions industry and patient groups to protect patients who choose to have cosmetic procedures. These will feed in to the work of Sir Bruce’s review which will publish its recommendations in March.

Suggestions that the majority of respondents wanted to see implemented include:

• Banning free consultations for cosmetic surgery so that people dont feel obliged to go through with surgical procedures.

• Ensuring consultations are with a medical professional, not a sales adviser.

• Imposing tighter restrictions on advertising including banning two for one, time limited deals and cosmetic surgery as competition prizes.

• requiring a two stage written consent for surgery so people have time to re ect before making a decision.

• Providing better information for patients including photos of expected bruising and scarring, and more detail on the risks associated with surgery.

Vivienne Parry, review committee member, writer and broadcaster said: “Aggressive marketing techniques are often used to maximise pro t. This may be the right approach for selling double glazing but not for people having or considering whether to have surgery. “Everyone who decides to have cosmetic surgery should have time to think about the risks. Time limited deals and offers on voucher websites pressure people to make snap decisions.” Dr Rosemary Leonard, review committee member said: “It is wrong that the rst consultation is with a sales person rather than a medical professional. Surgery - indeed any cosmetic intervention - is a serious step, and a patient must be told about the immediate side effects after surgery as well as any potential long term effects on their health.

The review was set up by the Secretary of State for Health following the PiP breast implant scandal last year. It was set up to look at the following issues:

• the regulation and safety of products used in cosmetic interventions; • how best to ensure that the people who carry out procedures have the

necessary skills and quali cations; • how to ensure that organisations have the systems in place to look after

their patients both during their treatment and afterwards; • how to ensure that people considering cosmetic surgery and procedures

are given the information, advice and time for re ection to make an informed choice; and

• what improvements are needed in dealing with complaints so they are listened to and acted upon.

Megadyne appoints Inter Global Surgical as new exclusive UK distributor of market

leading electrosurgical productsMegadyne, the US-based electrosurgical pioneer and product innovator, has appointed Inter Global Surgical as the exclusive UK distributor for its portfolio of products.

The strategic partnership was formed by Inter Global’s new managing director Paul Fransden, in a strategic move to further develop the presence of the Megadyne brand and market-leading product portfolio throughout the UK.

Inter Global Surgical was awarded exclusive distribution rights for Megadyne’s unrivalled product range including E-Z Clean® electrode tips and the Ultra VacTM Smoke Evacuation System.Ultra Vac

More information at Facebook.com/TheOTJ

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 268 January 2013 11

VisionOR from Starkstrom A new era of digital integrated operating room solutions - tomorrow’s technology available today. Offered in partnership with Richard Wolf. Total turnkey solutions

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A PARTNERSHIP WITH VISION - STARKSTROM AND RICHARD WOLF RECONFIRM THEIR EXCLUSIVE AGREEMENT IN INTEGRATED OPERATING ROOM SOLUTIONS

As part of its continuing commitment to providing world-class operating room and critical care area solutions, Starkstrom is pleased to reassert its partnership with endoscopy specialist, Richard Wolf. The companies have been working together in the UK for some time on an exclusive agreement and, contrary to recent suggestions that have appeared in the media, both Starkstrom and Richard Wolf are pleased to con rm that there has been no change to this successful arrangement.

VisionOR, offered by Starkstrom in partnership with Richard Wolf’s CORE system, is a multilevel audiovisual communication platform that is custom-designed, vendor-neutral and future-proof. It has been developed to allow maximum exibility and ease of use, enabling surgeons and the entire operating team to work in the most effective way possible.

After a successful installation at Circle Reading, further joint projects are underway, with both companies looking forward to continuing to develop this ourishing partnership between two market leaders.

Starkstrom offers a full range of products for the operating room and other critical areas including lights, clinical medical gas pendants and accessories, operating tables and accessories, media distribution/audio visual systems (VisionOR), Ultra Clean Ventilation (UCV) canopies, operating room control panels, PACS viewers, MRI, RF, CT & X-ray shielding. Engineering products include Isolated Power Supplies (ISP) and Uninterruptable Power Supplies (UPS). All products are supported by comprehensive service contracts, with work carried out by a network of fully trained service engineers.

Richard Wolf is one of the world’s leading manufacturers of endoscopic equipment, providing integrated solutions for minimally invasive surgery in all major surgical disciplines.

For more information on how this union between two leading companies can bene t your organisation, call Starkstrom on Tel: 0208 8683732 or visit the website www.starkstrom.com.

When responding to articles please quote ‘OTJ’

12 THE OPERATING THEATRE JOURNAL www.otjonline.com

Nuf eld Health to enhance disease detection by cutting-edge imaging technology investment in PENTAX Medical

David Moore (Managing Director, PENTAX Medical) with David Wylde (Regional Director – Hospitals, Nuf eld Health)

PENTAX Medical awarded signi cant contract for high de nition HD+ endoscopes by UK’s largest health charity

Slough, UK – 17th December 2012 – Nuf eld Health has awarded a signi cant contract to PENTAX Medical for state-of-the-art imaging equipment to enhance its detection of diseases, such as cancer, and enable earlier treatment which can improve patient outcomes. As the UK’s largest health charity, Nuf eld operates 31 hospitals nationwide, the majority of which will be re-equipped with the most advanced exible endoscopes and imaging technology on the market in order to meet the accreditation of the Joint Advisory Group on GI Endoscopy (JAG). PENTAX Medical’s HD+ endoscopes incorporate the world’s rst megapixel CCD to deliver exceptional high-de nition images to better support clinicians in their diagnoses.

PENTAX Medical has been providing some Nuf eld hospitals with its extensive range of cutting-edge endoscopy equipment for a variety of procedures for over 15 years and is world-renowned for the quality, reliability, innovation and simplicity of its products. The new national contract offers exceptional value for money within exible nancial solutions, enabling increased investment by Nuf eld Health in PENTAX Medical’s, high-de nition endoscopes and associated technology. This will be backed up by PENTAX’s best in class service, support and training to wholly ensure that Nuf eld’s patients are provided with the best possible care and clinical outcomes.

Use of PENTAX Medical’s revolutionary ‘i-scan’ imaging technology alongside the HD+ endoscope range will further improve imagery of tissues, such as those lining the stomach, intestines and bladder. Obtaining the best quality image possible inside a patient means disease can be detected earlier, before it reaches a serious stage, and treatment can begin without delay to improve a patient’s chance of recovery.

For example, colorectal cancer is one of the most common cancers worldwide, early detection of cancer, as well as detection and removal of polyps, using colonoscopy is vital to decrease disease mortality. Use of PENTAX HD+ colonoscopes in conjunction with i-scan has been shown to provide an enhanced resolution and visualisation of polyps1,2. This leads to a signi cantly higher detection rate of polyps, speci cally potentially pre-cancerous tissues or adenomas, compared to standard video endoscopy during bowel cancer screening programmes.

Many leading doctors already trust PENTAX’s endoscopes to improve the detection and diagnosis of tissue abnormalities1,2,3. According to David Moore, Managing Director, PENTAX UK Ltd. “By choosing the most technologically advanced endoscopy products on the market that offer such exceptionally high image resolution, compared to standard endoscopes, Nuf eld Health will be able to offer its patients signi cantly higher detection rates for cancers and other diseases, as well as enabling faster treatment turnaround times.”

David Wylde, Regional Director – Hospitals, Nuf eld Health commented, “The new national contract with PENTAX Medical will ensure we can diagnose our patients using the most advanced endoscopy technology available within Nuf eld Hospitals. We take pride in delivering an excellent service and being able to use the latest, cutting-edge technology means that we can deliver truly high class healthcare to our patients.

We are also extremely impressed with the expertise and knowledge held within the PENTAX Medical team who are evidently dedicated to delivering quality and excellence in both technology and after-sales care. The introduction of PENTAX technology supports our upgrade of Endoscopy facilities to meet the accreditation of the Joint Advisory Group on GI Endoscopy (JAG) to ensure that we continue to be a provider of services of the highest quality.”

References:1. Banks M.R. et al. (2011). Comparison of PENTAX Hi Line and

Olympus Lucera Colonoscopes for polyp detection in the UK bowel cancer screening programme. World Journal of Gastroenterology, 17 (38): 4308-4313.

2. Hoffman A. et al. (2010). High de nition colonoscopy combined with i-Scan is superior in the detection of colorectal neoplasias compared with standard video colonoscopy: a prospective randomized controlled trial. Endoscopy, 42(10):827-33.

3. Endoscopy and Early Neoplasia: Embracing the Future.

Gastroenterology Today (September 2012).

For more information please visit: www.pentaxmedical.com

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South West Surgeons Empower Patients with Expert App

An innovative new app designed to give patients access to information on knee conditions and treatment options has just been launched for the iPhone.

The app has been developed by surgeons at Spire Bristol Hospital and has a strong patient focus to ensure people are better informed to understand their injury and manage their own rehabilitation.

John Hardy, author of the app and knee surgeon at Spire Bristol Hospital, said: Patients want to learn about their knee injury and the options available for treatment. In the NHS they have little time in a clinic appointment to absorb the information they are given. Years later the patient often forgets who and where their condition was managed.

With this new app we wanted to provide patients with access to the information provided by their specialist and the hospital along with the diagnosis and treatment options offered to the individual. Patients are often asked by family when they get home What did the doctor say? Now they have the answer.

Putting the patient in control, the Knee Arthroscopy eSupport app offers a comprehensive guide to everything patients need to know. Four sections called My Information, My Condition, My Treatment and My Recovery cover everything from what to expect during a hospital visit through to advice on treatment options and recovery exercises.

Each section of the app contains a wealth of information and is easy to use as diagrams, images and checklists take the patient through every step of their treatment.

Patients personalise the app with their surgeons contact details, emergency phone numbers and hospital appointments so the information is always easily accessible.

Sally Norton, surgeon from Spire Bristol Hospital and one of the apps developers, commented: There are many apps out there which are aimed at surgeons and healthcare providers, but not many designed to empower the patient.

We’ve launched this app in response to patients too often being poorly prepared. It will take much of the stress out of undergoing a keyhole operation.

Available on from the iTunes app store for the iPhone and iPad (priced at £1.99), people anywhere in the world can download the app and access world-class advice and information. https://itunes.apple.com/gb/app/knee-arthroscopy-esupport/id584867294?mt=8

The Knee Arthroscopy eSupport app is the latest in a series of apps developed by Sally Norton and her peer Sharon Bates who have worked with specialist consultants to develop apps covering everything from cardiology to weight loss.

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 268 January 2013 13

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League tables could lead to a breakdown in trust among surgeons The NHS commissioning board has been warned that its plan to introduce league tables for surgeons could lead to a breakdown of trust in the profession.

League tables ranking surgeons by how many people die in their operating theatres will be published in 2013, the NHS commissioning board has announced. By next summer it plans to publish data covering survival rates and quality of care for 10 specialties including cardiac, vascular and orthopaedic surgery.

But Dr Pietro Micheli, who has worked as an advisor for the UK Department of Health and several NHS Trusts, believes publishing league tables may push surgeons to work less as a team and may provide a false sense of accountability to the public.

Dr Micheli, associate professor of organisational performance at Warwick Business School, said: The use of league tables is a controversial subject, especially in healthcare. Most problems with league tables are related to the behavioural consequences they lead to.

If the main aim is to generate competition and select out low performers - in this case ‘bad’ surgeons - then league tables will inevitably disincentivise collaboration.

Instead they will emphasise the role of surgeons as individuals rather than as part of a team. Surgeons could start working against each other rather than with each other and trust between them could be harmed.

Also, from a surgeon’s point of view, the easiest way to go up the rankings will be to deal with the least risky cases.

All of these and other behavioural issues must be considered up front; if the decision is to still go ahead with the use of league tables, then a plan to mitigate risks of low collaboration and a decreasing sense of trust should be put in place.

Dr Micheli, who has also advised the United Nations and was Director of the Italian Commission for public sector evaluation in Rome, also believes the tables will be open to misinterpretation by the public.

The main problem with league tables is that they very often provide a simplistic and misleading representation of reality, said Dr Micheli.

There are various concerns that should be addressed when designing and using league tables.

Transparency does not correspond to accountability (providing information to a party so that it can make more informed decisions), and the risk of misinterpretation is very high.

Also, there is evidence that most patients do NOT want to make certain choices, particularly as far as their health in concerned.

League tables offer a false idea of precision, as they are very rarely represented with ranges, which express uncertainty.

Rarely is it possible to demonstrate a statistically signi cant difference between people or organizations in a league table. For example, with a sample of 50 surgeons it will be very dif cult to differentiate between surgeons in positions, say, 10 to 40. This is quite different from a football league table, where points and scores are evident, and risk factors are not important.

NHS Consultant Contract Fails To Increase ProductivityAn employment contract for NHS consultants introduced in 2003 and including a 27 per cent pay rise over three years failed to increase productivity. The ndings emerge from a 10-year study of hospital consultant activity, published on the 14th December by the Journal of the Royal Society of Medicine, which looked at the levels of consultant clinical activity rates between 1999 and 2009. The researchers found that, despite an expectation by the Department of Health that the contract would result in year-on-year productivity gains of 1.5%, consultant activity levels showed a downward trend. There is a heightened need for productivity improvements in the NHS, which has been asked for ef ciency gains of £20 billion by 2014/15.

The research, which focused on inpatient activity, is the rst attempt to explore the clinical productivity of hospital consultants over time, and to analyse the effect of the consultant contract. Lead author Professor Karen Bloor of the University of York’s Department of Health Sciences, said: “Our trends are in general consistent with overall trends in NHS productivity, which have been reported as negative until 2008/9, and then slightly increasing. An increasing trend in patient episodes but a sharper increase in numbers of hospital consultants gives a plausible explanation for the overall decreasing trend in productivity.”

Commenting on the consultant contract, Bloor said: “The lack of an effect on NHS inpatient activity of the new contract is perhaps unsurprising given the nature of the contract, which remains a salaried system with supplementary bonuses that reward vaguely de ned merit.” Co-author Professor Alan Maynard added: “It seems that the tools within the new contract have not been used to increase consultant clinical activity. The contract has not been implemented fully by NHS managers.”

The standard contract for a full-time hospital consultant is 10 four-hour sessions per week. Consultants can be paid for 11 or 12 sessions in recognition of working over 40 hours a week. Bloor added: “In principle the reward for extra sessions may have increased the consultant time available to NHS managers, but in practice this may simply have provided extra reward for work that many consultants were already doing.”

Bloor concluded: “Claims made that the consultant contract, which resulted in substantial pay increases for hospital specialists in England, would result in increased clinical activity have not materialised. Indeed, in half the specialties studied, a reasonable interpretation of the statistics is that productivity has declined.”

14 THE OPERATING THEATRE JOURNAL www.otjonline.com

British Study Proves Chemical-Free UV Light Disinfects Hospital Environments in Minutes

Superbugs such as MRSA and C.Diff cost the NHS over £1 Billion per year. Hospitals are given strict targets which, if exceeded, result not only in unacceptable levels of life-threatening sickness to patients but also millions of pounds in nes, cost of extended care and even lawsuits.

The rst-ever UK study into a new chemical-free, superbug-destroying technology from the US; where over a hundred units have been snapped up by some of the top hospitals including Duke, Princeton and Cedar Sinai; was recently introduced at the Healthcare Infection Society (HIS) and Federation of Infection Societies’ (FIS) conference in Liverpool.

The automated Tru-D mobile device, which only uses concentrated UV light (effectively the same rays in sunlight) and no chemicals, has eight independent, peer-reviewed studies published in the US attesting to its ef cacy in “disarming” hospital superbugs. At today’s conference, the rst-ever clinical study conducted in the UK reveals that not only does Tru-D tackle 99.9% of pathogens – equally effective as the highly corrosive and poisonous Vaporised Hydrogen Peroxide (VHP) currently used in Britain’s hospitals – but it has a considerably shorter treatment time which saves resources for the stretched NHS.

According to Bill Passmore, Director of Operations at Rapid Disinfection Services (www.r-ds.co.uk), whose team is launching Tru-D in the UK;

“Despite being the most commonly used treatment to disinfect UK hospital environments, VHP is mainly used in a reactive manner - i.e., once an infection has occurred - as the likelihood of the next occupant of the room acquiring the same is on average 73% or more. Disinfection with VHP requires the room to be carefully and manually sealed and any connecting areas to be off-limits for several hours before and after treatment, meaning whole operating theatres (several if they interconnected through air vents) can be out of use for an entire day or longer. The environmentally-friendly Tru-D on the other hand, can tackle a 45 sq. metre room in as little as 40-50 minutes, and the only preparation needed is to move objects away from the walls so the UV light, via its unique 360-degree sensor, can re ect onto even shaded areas. As soon as disinfection is complete, a handheld ‘remote control’ device informs the operator that the room is ready for immediate use.”

A report published only last month by The Patients Association in partnership with the Royal College of Nursing and the Infection Prevention Society called for a renewed focus on infection prevention and control (IPC) services across the NHS. The survey of NHS staff found that more still needed to be done to address new risks. Almost 90% of respondents reported that compared to a year ago, the capacity to meet their organisations IPC needs had either remained constant or decreased, with almost half (45%) reporting a reduced capacity.

Dr. Tim Boswell, lead consultant microbiologist at Nottingham City University Hospital, trialled Tru-D over a two week period at their facilities, including operating theatres and intensive care units (ICUs), taking cultures before and after each disinfection took place. He is presenting the results of his study, which validate those published in the US, at the Infection Societies’ conference. He says;

“There is undeniable evidence that the healthcare environment can be a source for the acquisition of infections, which the cleaning of surfaces alone simply cannot tackle effectively. Our study further strengthens the premise that a simple to use, preventative system such as Tru-D that inactivates pathogens is an invaluable asset to a hospital’s infection control strategies. We have not only proven that the technology works in experimental conditions but that it can be easily and comfortably adopted by a busy, real-world clinical environment and is an interesting alternative for terminal decontamination of an environment.”

Bill Passmore concludes; “What is so unique about UVC light is that its wavelengths penetrate the bacteria, viruses and spore organisms and disrupt the DNA of the pathogen leaving them alive but completely neutralised, effecting a ‘kill’.”

Customers or interested parties can contact the company via 01572 756 913 or info@r-ds.co.uk.

SUPERBUGS GO INTO THE LIGHT

When responding to articles please quote ‘OTJ’

ULTRASOUND TO REPLACE LIVER BIOPSY IN DIAGNOSIS OF LIVER FIBROSIS ACROSS THE NHSA non invasive ultrasound test is set

to reduce the need for liver biopsy across the NHS following a guide published by the NHS Technology Assessment Centre (NTAC). The guide, commissioned by the NHS, will help all trusts across the NHS undertake the practical steps to implementing this non invasive and cost effective diagnostic procedure rapidly.The prevalence of liver disease is on the increase in the UK. One report from 2011 suggests that the number of people with liver disease in England is 2.3million, which equates to approximately 5% of the total population. Later stage liver disease, liver brosis, is associated with

signi cant morbidity and mortality. Establishing the presence and extent of liver brosis is therefore crucial in managing a patient’s health.Previously an assessment of liver brosis could only be determined by undertaking a liver biopsy. There are considerable downsides to this procedure, due to its invasive nature, an inherent risk of infection and the high costs of a surgical procedure and hospital attendance as an in-patient. The use of Ultrasound Elastography, a non-invasive method of monitoring liver brosis, provides a safer and quicker diagnosis with no discomfort or worries about a surgical procedure for the patient

as well as reducing costs by an estimated £520. The NHS Technology Adoption Centre (NTAC) studied the implementation of Ultrasound Elastography within secondary care at three NHS trusts: King’s College Hospital NHS Foundation Trust, The North West London Hospitals NHS Trust and East Cheshire NHS Trust. They then drew up the pack of information and practical tools based on their ndings that will help clinicians and managers in NHS trusts implement this new technology. Economic modelling based upon real life implementation was produced by York Health Economic Consortium

along with a bespoke costing tool that can help to inform local providers/commissioners of the potential savings that can be made.York estimated a gross saving of £520 each time a liver biopsy is replaced with an Ultrasound Elastography. When extrapolated across the NHS, this equates to a saving of £14.3m per annum based on current numbers.NTAC Technology Implementation Manager, Stephen Hodges, said “This technology has had a very positive impact both for patients and for the NHS. It enables doctors to diagnose and monitor liver brosis much more closely than ever before and does so in a pain-free, safe and cost-effective way.”

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