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Award winning improvement in cleaning at UK hospital10th of December 2013
Facilities services company MITIE has been recognised by the Association of Healthcare Cleaning Professionals (AHCP) in the UK for working in partnership with its client, the Hull and East Yorkshire Hospitals Trust in the north-east of England.
ECJ editor Michelle Marshall visited Hull Royal Infirmary to learn more about how cleaning standards have improved there.
Since it started working with the Hull and East Yorkshire Hospitals Trust in 2006 MITIE has implemented a number of initiatives to improve standards of cleanliness and hygiene there. Its focus has been investment in new technology, performance monitoring, training, and infection control.
These initiatives paid off earlier this year when it was recognised by the Association of Healthcare Cleaning Professionals (AHCP) in its annual awards. AHCP is the professional association for healthcare cleaning in the UK and Ireland and MITIE won its award for “Working in Partnership” with its client.
ECJ visited the MITIE team at Hull Royal Infirmary to find out why the cleaning team has been so successful. Responsible for the company’s regional operations there is Gill Pegg, who explained the background to the contract. This Trust was in fact one of the first in the National Health Service (NHS) to contract out its cleaning operation – it has been contracted out for over 20 years. MITIE tendered seven years ago, won the five-year contract, rebid for it and has now won it until 2017.
“This was MITIE’s first big hospital contract, and this is a very large NHS Trust,” Pegg explains. “At the end of the first term the hospital management wanted us to continue because we had built up such a productive and open relationship, the client was extremely satisfied with the improvements that were being made, and the staff were all content with working for MITIE.”
Pegg joined the hospital team in 2012, having worked for both the NHS and the contracting side. She is responsible for making sure the contract runs smoothly, performance standards are reached, the client is given the service it expects, overseeing the changing nature of the work, and managing the budgets.
The contract at Hull Royal Infirmary is indeed a sizeable one – there are 500 cleaning staff working across two sites. The A&E department alone sees around 120,000 people each year and the hospital is a major partner in the Hull York Medical School (HYMS). 2010 saw the opening of a new multimillion-euro renal dialysis unit and in 2011 dermatology and ophthalmology outpatients departments were improved as part of the new clinical skills facility. The site also accommodates a women and children’s hospital, and an eye hospital.
MITIE provides cleaning services across the two sites, which includes cleaning of theatres, all public areas, wards, treatment rooms, etc. Naturally, all cleaning operations must fit around the important work of the nursing staff and doctors so it’s imperative cleaners stay alert and aware of what is going on around them. It’s also vital they are aware of infection risks at all times – risks to patients and to themselves.
Each supervisor has a team of around 20 cleaners and must manage all aspects of their employment as well as their schedule, tasks etc. Each cleaner always stays in the same area. “They like to know exactly what they have to each day and each cleaner takes great pride in the area they look after,” Pegg explains. “They get to know the nursing staff and the nurses get to know them too.” It’s clear that cleaners are very much seen as being part of the team by all the hospital staff and that’s why they all work so well together and the contract runs so smoothly.
Alongside the regular cleaners on duty in their own areas, there is a rapid response team available at all times to cover incidents where there could be infection risk, for example. There is, however, a clear demarcation of tasks handled by MITIE’s cleaning staff and those carried out by auxiliary nurses. For example, the cleaners do not handle bodily fluids. They go in and do a clean after the initial removal of any hazardous waste by the auxiliary nurses.
The nature of the cleaning challenge has changed significantly in recent years, explains Pegg, and the staff have adapted well to that. “For example, in the drive to cut waiting lists on the NHS clinics now often run later than they would have in the past, and procedures take place at the weekends too. For the cleaning staff this means they have less time during the day to do the cleaning. So some tasks, such as floor cleaning in the public areas such as reception, day clinics, outpatient areas, A&E etc, are carried out during the night. Operating theatres are also cleaned at night, after the day’s surgical procedures have taken place.”
Having only joined this hospital last year, Pegg attributes much of the contract’s success to the previous site manager who retired in June of this year. “Between the Trust and the various contractors who had been at the hospital she worked there for 35 years and really set the scene. She had also worked extremely well with the client,” she says.
Why has MITIE been so successful at this hospital? “We are very responsive and reactive to our client’s needs,” she replies. “I also put our success largely down to the fact that staff are so well trained.” Eighty-five per cent of cleaners on the site are trained to NVQ (which is a government-funded scheme) Level 2. They undergo six months of in-house training, then go into the NVQ programme. All supervisors must complete a management qualification.
“Our induction programme is very detailed, even at basic toilet cleaning level,” Pegg continues. “At supervisory level we have a team talk programme, whereby every fortnight there is a short refresher course on a particular aspect of the job – it could be handling waste for example. And we may hold extra training sessions if a particular incident happens – could be a sharps injury because a needle has not been disposed of properly. Infection control is always a big part of the training.”
MITIE also makes every effort to be a fair and responsible employer to the cleaners at the site. “We have a policy of promoting from within, we always have a succession plan when someone leaves,” explains Pegg. “We try to offer all our staff opportunity for advancement, if that’s what they want. Staff turnover is really not an issue for us – many of the cleaners have been here at the hospital for many years under various contractors. If someone does leave, we try to offer opportunities to existing staff who may want to increase their hours for example.
“Because we have such a huge workforce we try to be flexible in accommodating employee issues such as maternity leave – new mothers often want to come back to us at reduced hours for example. We cannot be entirely flexible because of the nature of the contract, but we will be when it’s possible.”
There is an increasing number of male staff on the contract, which Pegg attributes to the high levels of unemployment in the local area. “The onsite laundry is run by men for example. On the wards, however, most cleaners are women. I would estimate 75 per cent of our cleaners are local people, from within the East Yorkshire area. We do not have many different nationalities living in the region so language is never a problem.”
After the supervisor there is the site manager and assistant manager. There is also a full-time auditing manager who is dedicated to monitoring and measuring standards, in co-operation with the Trust auditor. They adhere to the 49 elements in the NHS guidelines.
“Standards are of course driven by those NHS guidelines but they are also very much driven by MITIE – we have our own set of audited standards. The supervisors are continually monitoring, out around the site helping and advising the cleaners in their team.”
Modern cleaning technology has played a significant part in raising standards at the hospital, Pegg points out. A new mopping and trolley system, for example, brought significant benefits.
“Cleaning fluid is dosed through the mop handles, there is a tank of water onboard the trolley and we now use double-sided mop heads. From a health and safety and hygiene aspect it also made great sense because our cleaners can detach mop heads without touching them. And because they control the amount of water on the floor much more the floor can be left dryer after cleaning. This has resulted in fewer slips and trips around the hospital.”
Caroline Gorman is the facilities management contracts manager and she describes MITIE as being the best contractor that’s ever worked at the site. “We have a very open and transparent relationship, we really do work together to find solutions,” she says.
“MITIE is very approachable, keen to work with us, and has an excellent understanding of how the Trust works,” Gorman continues. “Cleaners receive outstanding training and we’re confident that we have the right staff working the right hours, etc. And if we do need to make changes, because of building works or wards closing etc, MITIE has always been very flexible in adapting to our needs.”
Equally importantly, she emphasises, the contractor is always responsive when the hospital management has any concerns about standards being met in particular areas. “MITIE is extremely open to us rectifying any problems together and finding the best solution – we are available to each other on a daily basis.”