Cleaning in a clinical
environment, how difficult can
it be?
An NHS Scotland
Perspective.........
Neil Redhead
Health Facilities Scotland
Health Facilities Scotland are....
• Part of NHS National Services
Scotland
• Accountable to Scottish
Government
• We provide strategic support to
NHS Boards
• We play a crucial role in the
delivery of effective healthcare
to patients and the public
• Challenges with the
environment
• Financial Challenges
• Sickness Absence
• Roles and Responsibilities
• Generational Issues
• Systems and Process
Aims and
Objectives
Cleaning the Healthcare Environment
How difficult can it be?
Cleaning the Healthcare Environment
Figures are approximate
•
•
•
•
•
•
1900 Patient beds
250,000 Sq Meters to be
cleaned
9,500 total staff
450 Domestic Staff
5,000 visitors per day
8 entrance points
NHS Scotland National Cleaning Services
Specification
Challenges with old NCSS
• Frequency based Specification – defines when elements
need cleaned, what if they don't ?
• Defined the minimum standard NHS Boards had to
achieve, evidence showed some NHS Boards developed
work schedules based on this standard which had a
negative affect on the healthcare environment.
• Specification Codes had large degrees of duplication,
causing confusion which contributed to negative HEI
inspections.
• Rigid methodology to cleaning the healthcare
environment
NHS Scotland National Cleaning
Services Specification (2016)
• Risk based approach to
deploying resources
• Innovative way of working
• Focuses on the infection risk to
a patient vs public perception if
an element is not cleaned.
• Drives skill development of
staff members.
Bedarea/day
room/clinical
cleananddirty
utility
areas/ward
corridorand
stairs
A1
CleaningSpecificationCode
SanitaryArea
Ward
Pantry/Kitchen
Offices
Storeroom
Diningroom
Domestic
ServiceRoom
(DSR)
A3
A5
A6
A8
A10
A12
ItemChecked
IC PP RAG
IC
PP RAG IC PP
Floors
1
3
1
3
1
Toilet/Washhandbasin/sink
3
3
3
3
FurnitureandFittings
3
3
3
LowLevel
1
3
HighLevel
1
3
Telephones
2
3
Paintwork
1
2
1
2
1
Glasswork
1
2
1
2
1
CurtainsandScreens
2
3
2
3
WindowBlinds
1
1
1
2
1
Soap/Handtowels
3
3
3
3
Refuse
2
3
2
3
IC PP RAG IC PP RAG IC PP RAG
IC
PP
3
1
2
1
1
1
3
1
2
3
3
3
3
3
3
3
3
3
3
3
3
3
2
1
2
1
3
3
3
3
1
3
1
2
1
1
1
1
1
2
1
3
1
2
1
2
1
1
1
1
1
2
1
3
2
2
2
1
2
3
1
1
1
1
1
1
2
1
2
1
1
1
1
1
1
2
1
2
1
1
2
1
2
3
1
1
1
1
1
1
1
1
1
1
2
3
3
3
3
3
3
3
3
3
3
2
3
1
1
2
1
2
3
2
3
3
3
CleaningEquipment
Appliances
2
2
RAG
RAG
The current economic climate
Wanting more for the
less…
Arguably hardest area in the NHS
today to clean.....
• Busy environments
• Poor communication
• Applying traditional work
schedules in these areas wont
work
• Domestic Staff struggle to
access areas to clean
• Areas targeted by HEI
Inspectorate
Sickness Absence.....
• NHS Scotland HEAT Target for
sickness absence is 4%
• Financial year 2016, NHS
Scotland was sitting at 5.16%
(stat taken from SG website)
• Since 2012 this has risen every
year.
Continued.......
• Results in huge pressures on
service delivery
• Standards could drop
• Inability to backfill due to
financial pressures
For the first time ever, Multi - generations
are working side by side
• Baby Boomers 1946-1964
• Generation X 1965-1979
• Generation Y 1980-1995
• Generation Z 1996-2010
( young bucks)
• All hold different values,
morals, desires, ambitions and
style of working
Bennett, Pit & Price (2012)
Continued......
• What does this mean when
delivering a service
• What does it mean when we
train staff
• What does it mean when we try
and introduce innovation into
service delivery
• What is the CULTURE within
the organisation.
Collaborative working... Could argue looks
like this!!
Collaborative... This is how it should look!!
Roles and Responsibilities
• Nursing staff clean one part of
an item, a domestic will clean
another part “ of the same item”
• Is it being cleaned following the
same process
• Is it being cleaned using the
same cleaning product
• What are the risks of two
different cleaning products
coming into contact
Roles and Responsibilities
• Its not my job its theirs
• Delays in cleaning
• Drop in productivity
• Negative effect on the
environment
• Who suffers............ The patient
Communication in the workplace
Communication in the workplace
• Communication is the cause of
a lot of our problems
• Sending an email has become
the “chosen method“
• Services need to improve how
they communicate with each
other if want improve the
healthcare environment
Frankly, if Collaborative working is not
taken seriously and driven up the
executive agenda then......!!!
Auditing the standards
• NHS Boards have been
auditing using the audit NHS
Scotland framework since 2006
• Paper based audit tool
• Duplication of effort
• Delays in data input
• Delays in accessing
information
• Not flexible
Auditing the standards
• Developed online FMT system
in 2011
• Paperless system
• Live data
• Tailored to each site
• Ability to trend analysis
• Supports reflective auditing
• Built on a platform that can be
built on
Continued.....
• Issues with self auditing
• Do we really get an actual
reflective score
•
System was designed to drive
service improvement.
Summary
• NHS environment is a
challenging environment to
clean
• We need to improve how we
communicate with colleagues
• We need to remove a lot of the
negative culture around them
and us
Quote of the Day......
“
A person who never
made a mistake
never tried anything
new
Albert Einstein