EBME
site, engineering colleagues from the NHS have shown they have the knowledge and ability. However, across the country, the contribution that these departments have to offer, in ensuring safe patient care, has not been given the recognition that it deserves; they have been given poor facilities in the basement and allowed limited influence over procurement. “There has been an over reliance on OEMs and expensive service contracts in the NHS. Every EBME department should have the ability and capacity to maintain and manage all of a Trust’s equipment. The need for expert engineers in house has been proven. “As a result of this emergency, EBME engineers are now being put back in the spotlight. Their knowledge across a wide range of equipment was really key on site.”
Decommissioning the Nightingale hospitals: what next?
Once the pandemic subsides and field hospitals are no longer required, the question arises of what should happen to all the extra medical equipment procured. How should it be decommissioned? There is also the question of what should happen to ensure the UK is equipped and better prepared to deal with future outbreaks of this kind. “It would be a mistake to deploy all of the medical equipment into the NHS as ‘free issue’,” said David Rolfe. “I believe a pandemic preparedness equipment stock should be built which could be deployed quickly in the case of another pandemic. It is far from clear when this virus will be expunged or when a vaccine will be deployed on a wide basis. “The cost of providing this contingency would be very small compared to the cost incurred, so far, in reacting to the pandemic without preparation. Companies like Althea have the means to store the equipment and ensure it remains in serviced order and then
A production line was created to build the trollies, mount the patient monitors, perform tests, then configure these to the desired settings requested by the doctors.
rapidly deploy and commission it in the event of another major emergency. “The major lesson to be learnt for the future is that proper pandemic planning and putting real contingencies in place, in terms of medical equipment, would be at a fraction of the cost – perhaps hundreds of millions of pounds versus the hundreds of billions of pounds that this has cost the whole economy.” Dr. Sandham believes we can learn from history: “In the 1970s-1990s, the Government had ‘mothballed’ hospitals that were controlled by the military in the case of a war and the equipment was maintained. As the Cold War dissipated, these mothballed hospitals were closed down and they got rid of all the equipment. The military also had their own operational hospitals and medical staff, which offered additional capacity. The last military hospitals closed, or were turned over to the NHS Trust, in 1995. “Today, there are no more military hospitals and all of the UK’s mothballed facilities have been closed. If the pandemic had happened in 1990, we would have been able to open all of these facilities; there would have been beds and all of the equipment would have been maintained. This would have made things much easier for the Government. Once we are through this pandemic, I believe the Government should find somewhere to mothball all of the equipment that has been purchased.” He believes that using large exhibition spaces is a good model for getting field hospitals up and running, but the challenge has been “having the equipment ready to go”. Going forward, a strategy must be developed to ensure contingency in the future. “If the equipment was mothballed it could still be used in 10 years-time. There needs to be a replacement programme, with a budget for replacing equipment after a set
OCTOBER 2020
period. There also needs to be a strategy for storing this contingency equipment in the event of another pandemic, or even a war, rather than disposing of the equipment. Either the Government or the military should be responsible for finding this storage capacity”. “In terms of the clinical engineering community, it would also be useful to have a database for emergency equipment that is used by all NHS hospitals, in the event of a pandemic or disaster,” he continued. He added that hospital directors who are already responsible for overseeing emergency responses, such as terrorist attacks, should also be given responsibility for ensuring there is sufficient contingency stock of equipment during a pandemic. Caroline Finlay agrees with John Sandham that there is an opportunity for a pooled resource in the future. “We could learn a lot from the military and the way they respond to incidents, particularly in terms of their use of centralised libraries. It isn’t feasible for every hospital to store emergency equipment, but centralised equipment libraries could be established, and the medical devices kept in a state of readiness. “Rather than being stored solely for pandemic situations, this equipment should be kept for hospitals that need to deal with additional activity, as well as being utilised for training young engineers. This needs to be driven at a national level by a Government taskforce,” she asserted. Rob Strange favours a Ministry of Defence model in the future: “The MoD have field hospitals in storage awaiting rapid deployment during any crisis should the need arise. All associated medical equipment is maintained by their own in-house ‘medical and dental’ technicians.” He points out that Avensys already operates a similar model and the approach
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