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November 17. 2015
Graeme Babbs

Hope all is well with fellow Designers in Health. How are you providing patient information? In particular, how are you informing patients about procedures/treatment - do you print and issue leaflets - do you provide web leaflets/information - is anyone using apps? Would welcome any feedback from medical illustration/design departments in the NHS. And if you have experience of successful cost-saving methods for patient information - please share. Would also welcome any proven research on the value of printed information.
I look forward to hearing from you.
Louise Tehrani


*Posted by Graeme on Louise's behalf

November 17. 2015
Graeme Babbs

I do very little patient information - it's all health promotion materials. Am very wary about the impact of web pages and apps - although they have their place - much of our stuff is aimed at areas of deprivation and we target it as such.

November 17. 2015
Brian Parkinson
Our local acute trust produces the bulk of its patient information using an automated system. www.interlagos.co.uk/sheffield-teaching-hospitals-order-system-automate-production-patient-information-leaflets Looking ahead I like the idea of giving patients a choice in how they receive information - print-on-demand or ? ebook link.
November 17. 2015
Ian Hirst

My 1st post - I am part of a print and design unit at The Leeds Teaching Hospitals NHS Trust. Patient Information is just part of what work we do for the Trust but is a significant part. Between ourselves and Medical illustration we do all patient info and print them all. Read-only PDFs are uploaded to the intranet.

Brian - how does the automated system work as each leaflet is different and its requirements and I wonder how automation caters for every eventuality. Seems a lot souless and not always practical for he customer. Also customers aren't necessarily very IT literate so expecting them to know how to use an automated system seems a bit much.

March 16. 2016
Ian Hirst

Well that's it. Our unit is to close after 25 years providing print and design to the Trust. Powers that be are outsourcing most work with a smaller less complicated in-house service that won't require artwork expertise. Maybe a move to similar department within Trust but guarantees. 

March 17. 2016
Graeme Babbs

Ian, that's awful news. How likely is a move and how many other such units does your Trust have? When does the unit close?

March 17. 2016
laura whittingham

Sorry to hear that Ian. We've just lost a great designer through redundancy in our team. It's so frustrating as we all know the work is out there. Who are you working for at the moment?

March 17. 2016
Brian Parkinson

I'm very sorry to hear this Ian - I hope they can find a way to keep you on. My old department closed its graphics service last year.

March 17. 2016
Calum Murray

Just to echo the comments above, that is sad to hear.  I do despair at a the current trends where Boards and Trusts seem to think that external sources can provide a better service than in-house people who know the organisation inside out.  Hope you do get kept on and they get a wake up call and change their minds about closing your service.

March 18. 2016
Michael Orr

Sorry to hear that Ian that is sad news, but unfortunately not unfamiliar.  I hope they can keep you, in house design support by dedicated staff is invaluable.

March 30. 2016
Ian Hirst

Thanks for all your kind words. A bit of a shock though not unexpected as there was no investment when we were moved under a different management team. Speaking with external companies though they say it's going to cost the Trust a lot of money as design and print for  hospital is not the same as commercial print and the whole reason for our being was we had a niche that external providers did not want to touch as it was not cost effective.

We produced low run cost effective work though this has changed quite dramatically from when I started and now we have full colour branded work that costs a lot more and usually has to be produced externally because of the print run. We provide a full design service and I don't see how an external provider will provide the same service. Staff come and see us on their way from work or on their way to work and work is amended quite frequently - we have 14 proofs sometimes. Can't see how the same will work with external provider as the service provided is different. We work for the Trust so do the best for the Trust. An external provider looks at what benefits them.

We've no idea at the moment what is going to happen. We have to have consultation with HR and the unions first and then they look to have individual meetings with each staff member to see what their work pathway will be. They don't make you redundant but finding a suitable alternative job is not easy. There might be an opportunity for myself and my colleague to mov to Medical Illustration because we do similar type work but there is no guarantee of that. And to be honest I would rather work where I want to work and not where I am fobbed off on someone. So I am looking outside the Trust but we all know that can take time.

April 07. 2016
Brian Parkinson

Ian - I've just emailed you about a new design post at the Leeds & York Partnership FT. If it doesn't arrive please contact me for details. 


April 08. 2016
Philip Johnstone

Wow sorry to here that Ian,  that is a shocker.  Have they already tendered out to another company?

Is there time to but a business case together, as these decisions are normal by people who have no knowledge and little understanding.  I have gone through this process many times before and so far have been successful in proving the value of in-house printing.

We basically did a report listing all work within a financial year at the costs charged internally at the volumes of each individual job. Order volumes are important, as low run work highlights the cost differences and if you are like us that accounts for a good 80% of all print.

We made specification sheets which covered about 90% of the work eg, A4 white single sided, hole punched;  A3 white 80gsm folded etc. in volumes 100, 500, 1000, 5000, 10000

48 specs covered our work here.  We then sent them to the external printers to provide prices for each sheet and volume.

Fill out the specs for in-house,  using your jobs sheets do a comparison of "actual work" then you have cold hard facts which cannot be brushed off. 

We showed that if the department was not there during that period, to provide the same work - with less accountability or flexibilty they would have paid an extra £210,000 a year on top of the cost of the dept for a poorer less responsive service.

Especially when there is less money, it makes it hard for them to justify added extra costs. 

To make sure it wasn't buried by the managers wanting to outsource I copied the report to the board members and chairman.  Any thing that puts more unecessary pressure on finances should be fought.

If you need any help just let me know my email and contact numbers are  philip.johnstone@nhs.net   tel: 01724 387754  Mob 07792 349015

April 17. 2016
Ian Hirst

Hi Philip

I thin the decision has already been made. We have been benchmarked on a consistent basis over the last few years and have always come out cheaper. They had a report done from an external provider about the Unit and what would needed to be done to improve it. We are not allowed to see it so we've no idea what's inside it. They say we need massive investment. Yes we need some investment but where they get the massive from I don't know but if people have an agenda they will say anything. My colleagues have just completed job specifications for all work created externally which we carry as stock and stock created internally; this will be part of the tender process for whomever will be providing this service.

April 18. 2016
Philip Johnstone

HI Ian, seems like you are being stitched up hidden reports etc.  We had a similar attempt via a company called Green & Kassab, never set foot in the department or talked to me and the staff, I wrote a report based on facts and blew them out the water.  At the time our director was desperate to get rid of us, I sent the report to him but copied in the all the Trust board members, so he couldn't hide it.  At the end of the day it ous OUR NHS and I want the best value for my money and service that puts the Trust first rather than profit.

Either way, you should be allowed to read the report, you and your staff are the professionals in that field for the Trust. If they are refusing then they have something to hide.  Talk to the unions I'm sure this comes under a  freedom of information act request.

If the tender hasn't started yet there may still be time.  If the report is misleading then draft a response, highlighting the risks/benefits and costs of sending it outside of the Trusts direct control.

They may be saying you need a new 6 colour press etc etc, which is not in the real world, any one can make it seem expensive.

Any offset work we send out, which to be honest is only the letterheads everything else is short run, but keeps out costs very low.  You many need to reconfigure and offer an alternative.

if you want a second opinion like I said be for I will be more than happy to help.

We had a poster in our department, when we told we were being disestablished... we are sparta! from the film 300.

If your going to go down, go down with a fight, and maybe drag some of the b**stards with you.

September 14. 2016
Ian Hirst

Well haven;t been on here in quite a while and it doesn't look like anybody elese has either. Am still employed by Leeds LTH and my colleague and myself have moved into Medical Illustration - quite a turn up for the books there. We are doing the same work as we were and over time will integrate more so we will have to see how it goes. We are meeting with external print provider next week so should be very interesting to see what they say and how they see it working.

September 15. 2016
Graeme Babbs

No, it tends to be a bit quiet these days. I wish it was as vibrant as it was in the past. I think we're missing that critical mass, both in terms of the site, but also in terms of bums on seats around the UK!

It's good that things look more stable for you - we haven't seen much of that recently. I know one person has told me that they don't come on here because it's all doom and gloom, which is both correct and reasonable, but that's also the reality of what we're facing these days.

September 15. 2016
Brian Parkinson

Great news Ian - thanks for letting us know. I hope it works out well for you.

Regarding this list - yes, it's been very quiet. I suppose we're all busy, and of course there are fewer of us around than there used to be. There has been quite a lot of doom and gloom, but I think that's where forums like this can really help in offering understanding and support.

September 16. 2016
Philip Johnstone

Good to see that you have been moved, but what about the print room has that all gone? or is it just reduced i.e. no litho just duplicators/copiers for non-stock print. Stock print is a small part of our work here.

We have been waiting for 2 years for our board to approve our re-equipment, we are down to one machine which failed, resulting outsourcing has cost the trust an additional £12k + a month over the cost for printing internally.  We have a new commercial director in post.

We always held you as proof that in-plants work!  This is the problem with managers with incomplete knowledge,  watch what happens when they  run out of forms when the ward uses the last one of a form that is not a stock item, or when a stock item changes and they get a bill for all the stock that needs to be written off and paid for.

It would be interesting to see how they perform, we had a print management company doing stock items a few years back, very patchy if it wasnt for us being here to bail them out they would have had serious issues.

September 24. 2016
Ian Hirst

The Print Room has effectively gone. They've haven't said it in these terms up to now and we all feel they have been very devious with it. They sold it as being the new print provider (APS) would hold the stock that the Print Unit does and would deliver to the Trust twice per week so turnaround is quick. They won't hold the amount of stock items we do which is about 400 but would print on demand for some items so they can get them to us quickly. There was still a massive amount of work that wasn't stock so when the designers signed off the artwork they would send this to supplies which is where the 2 managers from The Print Unt will be based and they would decide whether this was done internally or externally. They were keeping all the equipment in the Unit except the Litho presses and the booklet maker. That still left A4 and A3 jobs single and double sided, NCR work up to a certain amount, business cards, comp slips and forms. But having met with the print provider they said the Print Unit would be there just as an emergency supplier and nothing more. This had been mentioned but in addition to still doing other work. Now it doesn't seem the case. It all stinks as people who have worked there a long time have been basically shafted and now are in negotiations on TUPE or will be going on redeployment. The problem with both these options APS are based in Cheadle so nobody is going to commute to there every day or relocate and quite a few of the jobs are Band 4 jobs so trying to find a job on that banding is very difficult as it is all skilled professional work and you have to have skills, experience and qualifications with these roles. I know I shouldn't but I feel very guilty.

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