MEDICAL DEVICES
Government requested that Healthcare Improvement Scotland establish an independent oversight group for the use of transvaginal mesh implants in Scotland. The TVMO group is multidisciplinary, with an independent chair, Emeritus Professor Lorna McKee. It meets throughout the year, and includes staff from NHS Scotland, IRIC, MHRA, the Royal College of Obstetricians, NHS Inform, and patient and public representatives. The group’s remit is to review data on the use of transvaginal mesh implants in NHS Scotland, to review adverse event reporting by NHS Boards with data provided by IRIC and MHRA, to consider how significant new evidence can be incorporated into agreed NHS Scotland pathways of care, and to ensure that any patient information is up-to-date, reliable, and appropriate. In addition to these four main functions, the group will also develop a self-evaluation tool for NHS boards for completion, and analyse the results.
Estates-related incidents Phil Ashcroft, Principal engineer at NHS Improvement, discussed the reporting of estates-related incidents affecting the safety of patients and the continuity of services in England, explaining that this was part of the statutory responsibilities on NHS healthcare providers established by the Care Quality Commission (Registration) Regulations 2009: Regulation 18. Such organisations are required to report these incidents through the ‘efm Defects & Failures’ web portal hosted by NHS Digital. The NHSI speaker explained that the monitoring of Defects and Failures and issuing of Estates and Facilities Alerts has comes under the
remit of NHS Improvement since the NHS Estates function was transferred to it from the Department of Health in February 2017. Phil Ashcroft described the process of managing incidents and corrective actions taken in response, which may lead to the development of an Estates and Facilities Alert. He added that the publication process was a four- way collaboration with the other UK Health Departments.
Endoscope decontamination incidents Professor Heike Martiny of
TechnischeHygiene, Berlin, presented on a number of incidents related to decontamination of endoscopes and dental instruments. She illustrated
how the design of a closed-channel duodenoscope could prevent effective cleaning. This was due firstly to a fixed distal cap which hampers adequate reprocessing, and, secondly, to the integrity of an O-ring which has not (yet) been validated as suitable. She also highlighted published papers indicating that 42 out of 57 biopsy forceps were supplied non-sterile, and 61% of endo-washers (also known as channel flushing machines) were found to be contaminated. Dental instruments such as dental handpieces, endodontic files, and multifunction syringes, were also found to be contaminated. This underlines the requirement for validating each reprocessing process.
From left: Innes Connor, Tom Steele, and Eddie McLaughlan, assistant director at HFS.
October 2018 Health Estate Journal 57
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