Annex H: Strategic Review of Soft Facilities Management Services
The Strategic Review of Soft Facilities Management Services across NHSScotland (Catering, Domestic, Portering, Laundry/Linen and Retail services) was undertaken to identify how the current services operate and look at a number of service improvement opportunities to enhance efficiency, patient safety and user satisfaction.
The outcome of this work was a review report that was presented to the NHS Efficiency Portfolio Board and the Chief Executives' group in June and August 2014 respectively to agree which service improvement opportunities should be progressed.
National Catering Information System/ Bedside Electronic Patient Meal Ordering System
Following on from the all NHSScotland Boards independent Catering Review in 2013/2014 it was agreed that a bespoke IT catering tool, the Catering Information System ( CIS) should be introduced. The CIS system can produce accurate costs of provisions used in the production of patient meals. Additionally the system can calculate an NHS Board's non-patient surplus or deficit. The CIS system could also identify opportunities such as quality improvement, reduction of food wastage and aid control costs.
The initial CIS system operates on a Microsoft Excel platform and has been rolled out to a number of NHS Boards including Borders, Fife, Shetland, Orkney, Tayside and Lanarkshire. In 2014/15 the CIS system was also rolled out to NHS Lothian and NHS Highland. NHS Lanarkshire has also been piloting a Bedside Electronic Patient Meal Ordering System ( BEPMO) for over a year. NHS Greater Glasgow and Clyde has also trialled the BEPMO system in the new Queen Elizabeth University Hospital. The BEPMO system is designed to enable NHS Boards to reduce over ordering of meals and also allow the presentation of the daily menus in an electronic format.
The CIS can provide operational and financial benefits to NHS Boards. An example of the former is monitoring of food wastage and local stock levels. Financial benefits include a management reporting suite which can provide trend analysis and details of retail sales.
The majority of NHS Boards that have implemented this Excel based version of the CIS system have derived benefits from it, however more time will be required to fully quantify benefits. It is anticipated that a return on investment would be on 4:1 basis.
National Services Scotland ( NSS) on behalf of NHSScotland has initiated a procurement process for the implementation of a web based version of both the National Catering Information System ( NCIS) and BEPMO systems for In House operated A1 (teaching hospitals) or A2 (large general hospitals) locations.
Catering Production Strategy
The Soft FM programme continues the assessment of the most appropriate catering service provision for NHSScotland and is working with NHS Boards and other stakeholders to produce a strategy document.
NUTMEG menu analysis tool (Additional Module)
All NHS Scotland Boards have had access to the N4P Nutritional Analysis database since 2010. The system has now been updated with a bespoke module to aid compliance with EU Regulation ( EU) 1169/2011.
The N4P EU Allergen module provides NHS Scotland Boards with the ability to analyse their patient menus highlighting key allergen information as required by the EU guidelines. The Allergen module has been live from September 2015 and Nutmeg and system users have been trained on the functionality of the new module.
NHS Food in Hospitals updating in progress
The National Catering and Nutrition Specification for Food and Fluid Provision in Hospitals in Scotland (Food in Hospitals) was established in 2008. A review of the Food in Hospitals Specification has compromised initial feedback from key stakeholders as to where they felt improvements could be made on the existing content or to identify any clear gaps in the provision of Food and Fluid Provision.
The key areas for review were:
- Nutrient needs of the hospital population
- Menu Planning Guidance
- Therapeutic Diet Provision
- Special and Personal Diets
New sections were identified for:
- Paediatric diets
- Audit and monitoring of Food in Hospitals Standards
- Allergen information (to reflect EU guidance circa Dec 2014)
The review of the document is complete and is now due to be formatted before final sign off by the Chief Nursing Officer. Once agreed, the document will be printed and distributed to the Health Boards for implementation.
Key changes to the document include the introduction of standards and nutritional guidelines for Paediatric catering as well as the introduction of guidance on the auditing of nutritional standards.
The Soft FM Programme is also facilitating the development of a business case, which will identify the most appropriate provision of Laundry Production Units across NHSScotland and take forward previous recommendations on the reduction of double washing of infected linen and the frequency of linen changing.
The Strategic Domestic Review Group produced a generic domestic floor cleaning equipment and materials specification for the Domestic Expert Group to develop further with National Procurement for use in the future.
A national Domestic Productivity Tool (Time to Clean), which can provide accurate costs for the cleaning of existing and future NHS locations, is currently being developed with test task cleaning times being validated by a number of NHS Boards.
A pilot of a fully Automated Dispatcherless Porter Task Tracking System ( APTTS) took place in NHS Fife, the system identified improvements in efficiencies within the portering department. Following this pilot, a specification was produced for a full ADPTTS system within NHS in-house operated Hospital portering services with over 300 beds. A procurement process has commenced on a framework basis.
Following on from a Strategic Retail Review Group work, a Lease Guidance policy for all NHS Scotland boards has been created to be attached to all new Leases which will identify the following:
Catering outlets are those where most food is prepared before it is served to the customer either to be consumed on-site or taken away. An example would be a tea bar, restaurant or vending operation. Catering outlets in healthcare buildings should comply with the healthy living award ( HLA).
Retail outlets are those where food is not prepared on-site, rather it is ready for immediate purchase. Examples include a convenience store, newsagent, mobile or pop-up store or trolley service. Retail outlets in healthcare buildings should comply with the SGF Healthcare Retail Standard ( HRS).
Mixed outlets offer a combination of catering and retail provision. Mixed outlets in healthcare buildings should comply with both the SGF Healthcare Retail Standard ( HRS) and the healthy living award ( HLA). For these outlets, a single assessment will apply in accordance with whatever is the predominant activity - retail or catering.
Email: Alan Morrison, Alan.Morrison@scot.gov