MEDICAL EQUIPMENT SUPPLY


systems and critical care areas, and was talking to our local hospitals operated by Leeds Teaching Hospitals NHS Trust, as well as to scientists at the University of Leeds, early on about how best to set up extra oxygen supply lines to provide COVID-19 patients with oxygen, and where to get components from.” Graeme Hall explained that this first approach followed an initial request for help manufacturing ventilators, after the NHS identified that there would not be sufficient numbers of the machines available in the UK if the various emergency ‘Nightingale’ hospitals were at anything like full capacity. He explained: “I believe the shortage of ventilators nationally was apparent even before the shutdown on 23 March. According to press reports, there were only around 8,000 ventilators across the whole of the UK, with the Government warning that up to 30,000 might be needed. It’s easy in hindsight to say that some things didn’t work very well, but the Government’s initial approach – to increase the supply of ventilators from existing UK ventilator manufacturers, such as Penlon, Newpac, OES, BNOS Meditech, BREAS, and SLE – was quite sensible. Although we were not involved in the first discussions around ventilators, as we don’t manufacture them, we did get involved when the Government subsequently recognised the need to go out and source them on the international market. At the time, of course, the healthcare systems in many of the countries impacted by COVID- 19 were all trying to source ventilators.”


International collaboration In fact, one of Brandon Medical’s Far Eastern distributors is a main agent for one of the region’s leading medial ventilator manufacturers. Graeme Hall explained: “Our distributor in Indonesia has had a long-standing relationship with us, in fact for about 15 years, supplying products including Brandon operating tables, pendants, and theatre lighting in its


Follow-up interest


Brandon Medical Executive Chairman, Graeme Hall.


country. The distributor had orders in the pipeline with the ventilator manufacturer, but told us we could have some of its pre- ordered supply. We asked local acute Trusts in the north of England if they had enough ventilators, and explained that we had a supply if they needed them. Some were badly in need of more machines, and hadn’t managed to source them from anywhere else, so we were pleased to be able to help them. We were able to meet all the required demand from a number of Trusts in the north of England via this route.”


Graeme Hall explained that while a number of Brandon's distributors globally sell ventilators, the Indonesian one is ‘among the most professional’, and also specialises in respiratory care, as well as operating theatre equipment. He added: “We were also familiar with the ventilator brand – the company’s ventilators are considered among the best available in this region.”


While this was Brandon Medical’s first real involvement in the UK’s wider national response to the coronavirus outbreak, on the back of it a number of NHS Trusts began asking the company other related engineering questions, for instance about other components for oxygen supply. “We rapidly established that we would be able to help with this too, and were able to help the Trusts concerned find supplies of parts to extend their oxygen distribution network, as well as to give them some advice on how to do this,” Graeme Hall explained. I asked what type of parts Brandon had been able to help with? Paul Grainger responded: “In normal oxygen distribution, clinical staff take oxygen straight from a medical gas terminal to a device such as a ventilator or regulated flow meter, and thence to the patient. However, due to the considerable additional demand for patient oxygen, the hospitals either needed multiple devices to run off a single outlet, or a single device supplying multiple patients. The staff over in the Fluid Dynamics Unit within the Mechanical Engineering Department at the University of Leeds – with whom we were liaising – thus spent considerable time trying to identify how to divide up oxygen flow without impacting on flows and loads. Their aim was to design bespoke oxygen regulators and flow devices, and then print 3-D components to ensure that the finished products could be manufactured on a production line. Researchers and academics within the Department were providing general engineering advice and input to Leeds Teaching Hospitals as part of the COVID-19 response.”


Machining and manufacturing ventilator parts in response to the national shortage of such equipment.


Oxygen supply splitter units Paul Grainger explained that Brandon staff assisted the University team with some component design, for instance of oxygen supply splitter units. He explained: “Flow and pressure volumes are critical with medical gas systems, and our discussions with the University engineers involved talking through such key considerations based on our wider engineering expertise. We did this based both on medical gas pipeline suppliers’ readily available information, and our own experience and knowledge. It was a great meeting of minds and expertise of people from a diverse range of backgrounds. I got closely involved in this work.” Graeme Hall added: “As part of this work we introduced the engineering staff and students at the University to Precision UK, a British medical gas pipeline supplier, which traditionally exports about 90 per cent of its output overseas. At the time, the company had a huge capacity of parts not normally available to the UK market, and was one of the few companies that could actually supply. We are both major


August 2020 Health Estate Journal 63


©Monty Rakusen


©Monty Rakusen

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