The North West Anglia NHS Foundation Trust serves approximately 700,000 residents of Cambridgeshire, South Lincolnshire, and the neighboring counties. This recently created trust, formed in April 2017, includes three hospitals—Hinchingbrooke, Peterborough City and Stamford, and Rutland—plus community clinics in Ely and Doddington.
Jim McWilliams, Associate Director for Technical Services at Hinchingbrooke Hospital in Huntingdon, understands the benefits of standardization of medical equipment for clinicians and the North West Anglia NHS Foundation Trust. Together with a colleague at Peterborough City Hospital, McWilliams is responsible for all the medical equipment used within the trust. He explains:
“Our role in technical services is to look after equipment used on patients, ensuring that the most appropriate systems are purchased and that any routine maintenance or repairs are performed on schedule, as well as decommissioning each device at the end of its lifetime.
Whenever clinical staff need new equipment, we work with them to look at the different options available and make the right choice for the trust. This decision is based on a combination of clinical utility and factors such as logistics, maintenance requirements, and capital and ongoing costs. If we receive a request for replacement equipment, we also look at the reliability of the existing system—and the clinical team’s opinion of it—before making the final purchasing decision.”
With staff and equipment split across multiple, diverse sites, the advantages of standardizing equipment should not be underestimated. McWilliams continues:
“The Hinchingbrooke and Peterborough sites are quite different—the main building at Hinchingbrooke is over 30 years old, whereas Peterborough City is a purpose-built facility which opened in 2010—so they have surprisingly different equipment needs. For example, the theater suite at Peterborough uses Sonosite X-Porte POCUS systems for anesthesia, but these are simply too large for the much smaller—or sometimes non-existent—anesthetic rooms at Hinchingbrooke, which has the more compact S Series systems instead. However, there are still benefits to both hospitals using instruments from the same supplier. One big advantage of having equipment from one manufacturer is for staff working at both hospitals. For example, if an anesthetist from Peterborough comes to cover a shift at Hinchingbrooke, they will already be familiar with the equipment and can just get on and use it.
This familiarity is also beneficial from a maintenance perspective, as it means that our technicians have fewer different systems to learn to maintain, reducing training requirements, and we have just one point of contact rather than several manufacturers to deal with. It makes life easier for everybody when the same systems are used throughout the trust.”
System reliability and maintenance requirements are also important when considering the total cost of ownership for any piece of equipment. Jim continues:
“From a maintenance perspective, my basic philosophy is to avoid having equipment in my department—it should be out in the clinical environment being used on patients. From experience, we know that some systems come in for repair far more often than others, and so we can advise against the purchase of devices that have needed a lot of maintenance in the past, guiding the trust towards systems with a good track record for trouble-free operation.
This has certainly been the case with Sonosite ultrasound systems which we have used at Hinchingbrooke for many years now. As primary care ultrasound-guided procedures became more common—especially after the relevant NICE guidelines were issued—we invited other companies to demonstrate their ultrasound systems to us. Sonosite was still the clinicians’ preferred choice, and we’ve stuck with the company ever since. From our perspective, it paid to stay with devices with demonstrated reliability, and our numerous Sonosite systems rarely need attention—the original 180PLUS is still working after 13 years! This has allowed us to develop a good working relationship with Sonosite’s engineers, which is very beneficial. It’s a good situation to be in."