EBME
with the technology replacement and purchasing plans, if they are to achieve the organisation’s vision for the future. The Medicines and Healthcare Products
Regulatory Agency (MHRA DB 2015: Managing Medical Devices)5
, states:
Section 2.1 Management Responsibility l Healthcare organisations should appoint a director or board member with overall responsibility for medical device management.
l The management structure for medical devices should have clear lines of accountability up to board level.
l Healthcare organisations should set out a long-term approach and objectives for the management of their medical devices.
Section 2.6 Monitoring and Audit An audit report should be submitted to the board examining policies and procedures for the safe acquisition, use, maintenance and repair, decontamination and disposal of medical devices. This board report will give the executives confidence that their organisation meets the regulatory requirements for external monitoring and audit by the Care Quality Commission (CQC). The CQC will inspect against their ‘Essential standards’ of quality and safety, as well as policies and systems of management for medical devices. After many years of promoting strategic medical equipment replacement planning, I am still seeing a widespread lack of executive understanding on how to sustainably link replacement of their technology to the organisation’s five-year business plan.
I keep getting asked the same questions:
l How does the organisation create a longer- term sustainable strategy for medical equipment asset management?
l What technology needs should be bought to meet their strategic goals?
Poor equipment procurement and management impacts both on the clinical outcomes for patients and the organisational efficiencies. In many healthcare organisations, lower tier managers are expected to buy and manage medical equipment assets without any knowledge of the organisation’s plans for the future. Five-year strategic plans are being drawn up by the executives, who often don’t review their plans with the medical technology asset managers or buyers, and then wonder why they do not achieve their operational business targets on time, and they go over budget. Organisational leaders need to understand that the medical equipment assets are inextricably linked to their longer-term operational efficiencies and clinical outcomes. If the productivity and clinical outcomes are part of their five-year operational strategy, then investment in the ‘right’ medical equipment assets must be part of that plan. Connectivity of these assets into the IT infrastructure, such as the Electronic Patient Record (EPR), will also play a key function, as data becomes vital in terms of assisting clinical decision support. The Secretary of State for Health and Social Care, Matt Hancock MP, recently
gave a keynote address to the Healthtech Alliance UK and said to delegates: “If you work in the NHS, in any part of the service, far too often old, out-of-date 20th century technology gets in the way of your ability to do your job. So, when people say that better technology is a ‘nice to have’ that costs too much, I say wrong again. Better technology is vital to have and embracing it is the only way to make the NHS sustainable over the long term”.6
A strategic approach to change I can go onto the internet and read many NHS Trust ‘strategic plans’ which talk about using technology to improve outcomes for patients but, reading between the lines, it is clear that many of these ‘plans’ are superficial and unlikely to deliver their goals within the time frame set, because there are gaping holes around technology procurement and project management.
Many healthcare organisations are in the process of creating sustainable financial models, but these models require a five- year technology replacement strategy that underpins the five-year operational strategy. During the COVID pandemic of 2020, many healthcare practitioners have been using online consultations to avoid contact and the spread of the disease. This enables a more dispersed clinical model, but for this to be more effective long term, it will require investment in both the medical equipment and IT infrastructure. This not only requires an investment in hardware and software, but also in skilled people who understand the complexity of connecting medical equipment assets into the EPR, and managing those assets. As discussed previously, delivering an organisation’s strategic plans will also require a strategic asset management and replacement strategy that is aligned with that ‘future state’ sustainable business plan. In summary:
1. Organisational policies must be the driving force to change practice. These policies
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