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The Avensys Resale division can supply new, as well as pre-owned, equipment.

procurement. Rob Strange explained: “This includes advising the relevant personnel or department on equipment options based on their clinical and technical needs. As an example, if an acute hospital asks for new anaesthetic machines, why not include the EBME Department to provide a detailed technical report that includes through-life costs, clinical, financial, training, maintenance, and disposal considerations – a ‘cradle to grave’ approach that allows the Department to make a better- informed decision. In many NHS hospitals today, EBME departments (in whatever guise) are not involved in capital equipment replacement decisions. The result can be a sub-optimal choice of kit where, say, staff not fully conversant with the particular technology base their choice solely on familiarity with a particular manufacturer, and perhaps an aggressive marketing campaign, rather than looking more broadly at all the available options and factors to consider when buying.

“One of my biggest concerns,” he continued, “is that without the involvement of skilled and experienced ‘in-house’ (or ‘third party’) EBME personnel, biomedical equipment may be purchased without factoring in elements such as the lifetime cost of maintaining and servicing it. Unless they are specifically asked during the procurement, many of the bigger equipment suppliers will offer no technical training to EBME, Medical Physics, or Estates & Facilities personnel tasked with the upkeep of the equipment, but will instead charge substantial sums for a service contract. One upshot is that a poorly-resourced NHS EBME team may feel it has no choice but to continue paying for this external servicing, since its engineers do not have sufficient familiarity with the equipment to be able to do this work themselves. This is hugely wasteful financially, when the NHS should instead recognise the value of a well-trained and capable EBME team, instead of – as has happened in recent years – often

40 Health Estate Journal September 2020

Training courses run by Avensys utilise highly experienced training staff.

consigning the department to poor and unsuitable accommodation. Surely such a key department should be state-of-the- art, and located within premises that befit a unit maintaining ‘life-critical’ equipment – without which, of course, a hospital cannot function?”

Relationship cemented Rob Strange went on to explain that Avensys was awarded sole biomedical equipment supplier status at the NHS Yorkshire and Humber Nightingale Hospital because it had cemented its business relationship with the Harrogate and District NHS Foundation Trust as its sole biomedical equipment supplier for the past six years. He said: “Our model, employed at Harrogate District Hospital, is as close to a military ‘Med & Dent’ set- up as you would see outside the services. It has already saved the Trust substantial sums, thanks to the strong relationship, trust, and understanding, built up between the two parties over the years. We now not only maintain, service, and repair its equipment, but also regularly give advice on procurement of equipment. “One of the main differences between a military set-up and the civilian healthcare world, “ Rob Strange continued, “is that

generally, outside the services, medical engineers don’t get involved, or are not asked to get involved, in equipment procurement. Equally, when, say, a new medical device arrives from many of the major manufacturers, the supplier will be reluctant to offer any technical training to the onsite engineers – who are seen and perceived as third-party engineers – since by doing so, it feels it could damage its own business. Clearly, if the ‘in-house’ NHS EBME or Medical Physics engineers are sufficiently well-trained on equipment to service it themselves, the manufacturer loses out on a lucrative service contract. “We believe that a Trust should only select a manufacturer that offers accompanying technical training either free, or at a limited cost, and should bring the servicing in-house. We feel it is only it only reasonable that when a hospital buys new equipment at a considerable cost, the manufacturer should agree to provide the Trust’s in-house EBME/Medical Physics team with technical training on the equipment’s operation, servicing, and maintenance for free. However, you’d be surprised how few major manufacturers are happy to do this – often because they are simply not asked the question during procurement.”

An industry insider’s view

Dr John Sandham, FIHEEM, chairman of the website, told HEJ he agreed with Rob Strange that some EBME manufacturers offer little in the way of training to in-house NHS EBME technicians, but said his experience was that perhaps ‘only a minority’ of such equipment suppliers behaved thus. He said: “I know where Rob is coming from, but my view is that many of the successful and well-established EBME equipment suppliers will offer NHS EBME departments training when they sell them such machinery. There are, however, a number of such companies that sell EBME equipment incorporating software that an in-house EBME technician cannot access without a licence. If the manufacturer withholds either the software or the specialist tools that the ‘in- house’ Trust EBME or Medical Physics engineers, or alternatively the Trust’s service-provider, need to service/maintain the equipment, it renders the Trust almost wholly reliant on the OEM to undertake servicing, sometimes via quite expensive contracts. Interestingly, recent legislation in the US stipulates that such software must not be withheld from hospital engineers there wishing to service and maintain their own equipment.”

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