MEDICAL DEVICE MANAGEMENT
anticipated £3.1 m over the devices’ 7-year lifespan. This demonstrated unequivocally that procurement conduct is the primary policy area influencing all other aspects of medical device management. Training inconsistencies and patient safety: The uncontrolled proliferation of device models directly compromised training effectiveness. Staff, including permanent and agency personnel, frequently relied on self-certification or informal ‘cascade training’ from peers, leading to questionable competency, particularly with high-risk devices. This systemic weakness was a documented contributor to medical device- related incidents and near-misses.16
The challenges in
medical device training, particularly in scaling training management and ensuring competency validation, remain a significant industry concern.17,18
The original research
highlighted that ‘the influence of the operator on the effective and safe application of medical technology is generally underestimated’, citing studies where a high percentage of incidents were due to incorrect operation and maintenance rather than equipment failure.10 Impact of redesign: Standardisation, driven by improved procurement, profoundly simplified training logistics. Reducing infusion pump models from 18 to 3 enabled comprehensive, organised training across the entire organisation within a three-month period, a task that would have otherwise required 18 months. This ensures that staff are adequately trained on the specific devices they use, directly mitigating the risk of misuse and patient harm.
Maintenance inefficiencies: The wide variety of equipment models placed an undue burden on the Maintenance Department. Technicians required a broader range of diverse spare parts, more extensive technical training, and a larger library of service manuals. Furthermore, user errors stemming from inadequate training frequently led to unnecessary service calls, wasting valuable technician time, and reducing the availability of critical equipment for clinical care. The original case study noted specific CQC spot-check findings from 2009, which uncovered ‘soiled mattresses, poor clinical practices, mould growing in suction machines, and out-of-date medical equipment’, directly illustrating the
consequences of poor maintenance practices.12 Impact of redesign: Standardisation significantly improved maintenance efficiency. Technicians developed deeper expertise on fewer models, leading to a reduction in spare parts inventory, and a decrease in unnecessary service call-outs. This, in turn, improved equipment turnaround time and increased device utilisation rates, potentially allowing for a reduction in the overall inventory size required. Strengthening governance and accountability: The case study highlighted a prevalent ‘tick-box’ mentality towards policy adherence, coupled with a perceived lack of ownership among some management tiers. The independent AE (MD) involvement, integrated with the participatory AR methodology, fostered a greater sense of ownership and accountability across the organisation. The CQC’s emphasis on proper maintenance and use of equipment underscores the ongoing need for robust governance.9 Impact of redesign: The redesigned policy, with procurement strategically positioned at its core, and the continuous, active engagement of the MDC, ensured that regulatory requirements (CQC, NHS Resolution) were not merely met on paper, but were effectively embedded into daily practice. This provided senior management
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August 2025 Health Estate Journal 37
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