St Mary's Hospital, Isle of Wight NHS Trust

CASE STUDY: St Mary's Hospital, Isle of Wight NHS Trust

‘Outstanding’ department enjoys excellent, cost-saving service and type tested chemistry for EWDs 

Rated ‘Outstanding’ following an in-depth Quality Standards Assurance audit, the endoscope reprocessing department at St Mary’s Hospital, Isle of Wight NHS Trust, has made significant cost savings through working with iM Med.

The service and maintenance contract and type tested chemistry for the department’s endoscope washer-disinfectors (EWDs), together with a range of consumables supplied by iM Med have all delivered a distinct financial benefit, while staff safety has been enhanced by installing a peracetic acid vapor monitoring system.   
“Being an island and reliant on ferry services creates its own problems for service support. It’s a major factor, but it’s never been an issue for iM Med,” says Lesley-Anne Moody, matron specialist medicine at St Mary’s Hospital. “They go above and beyond. They’ve been over on the day of the call. That’s massive.

“One call was at eight in the morning. The other was at four in the afternoon. The most I’ve had to wait for an engineer is 24 hours, and that was due to delays on the ferry.

“They’re like an extended family,” adds Lesley-Anne. “It’s almost like having a resident engineer here. They are so quick to respond. The staff have a great relationship with the engineers.

“The approach is flexible, so we can be in front of a machine and talk to the engineer on the phone. We tell them what the machine report is showing or describe the issue. The engineer tells us how we can sort it, if it’s simple stuff, or they will come over, if it’s more complex, and bring the appropriate part with them if required. There’s no delay with parts.”
“iM Med seem to go the extra mile. Their service is very impressive, fantastic, you can’t fault it. They’re very conscientious."
Victoria Winter, senior support worker and an authorised user (AU(D)), explains: “When we were due to renew the original service and maintenance contract with the machine manufacturer, procurement wanted us to obtain alternative quotes.

“We contacted iM Med, who were able to give us a very good cost saving. We knew their engineers and the quality of their work. We were also offered a number of reference sites.

“We moved to iM Med two years ago, in May 2019. They’re delivering a significant saving on the contract, covering service, quarterlies and validations. Their engineers are lovely. They did a ‘health check’ on all the machines to ensure they were running well at optimum efficiency - the four endoscope washer-disinfectors and the four drying and storage cabinets. We’ve had no delays to procedures due the performance of the machines.”

Lesley-Anne says: “We’re doing over 9,000 procedures a year and that will only increase. The department usually operates operate Monday to Friday, with weekend emergencies going to Portsmouth or Southampton. We couldn’t do that during Covid, so we ran a seven day service to cover weekend emergencies.

“iM Med’s engineers still came over at the height of the pandemic. For one late call out we emailed the NHS to request accommodation and the engineer had food at the hospital.”

In the reprocessing department, Gavin Simpson, technical support worker, says; “Working with iM Med has been absolutely fine. They give first class support with the machines. You get to know them when it’s the same engineers every time. They’re very good.”

Regular maintenance increases efficiency and reduces downtime. iM Med offers a range of service and maintenance packages to meet all budgets. This has been shown to deliver guaranteed cost savings, with reliable, compliant quality. Validation ensures processes are in compliance with relevant standards and are related directly to parameters defined during the design and type testing of the EWD. iM Med reports 100% client retention of its service and maintenance contracts.

Alternative supply of type tested chemistry

Outlining the change of chemistries, Victoria explains: “We didn’t realise that alternative type tested chemistries were available until we spoke to iM Med. We did the calculations and there were very favourable savings on the chemistry too. We spoke to Bob Jobbins, our AE(D), about it.

“We had to re-validate each machine. It’s a six-week process for each as you have to wait for the mycobacteria test results to come back. We’re currently in the process of re-validating the third and final machine. Each commissioning and re-validation has gone very well.”

Victoria adds: “There’ve been no issues with the delivery of the iM Med chemistry, but there were with the supply of the manufacturer’s chemistry.”

Lesley-Anne explains: “After we told the manufacturer that we would have to cancel there was no care. Due to the lack of availability of chemicals, we got to the point where we were looking at which patient to prioritise. I spent a week chasing the supply. Other hospitals told us the same story.

“Luckily, we had converted one machine and had the iM Med chemistry available, so we were able to continue to work to full capacity and no patients were affected. It was great that we were able to do that, even though we had lower patient numbers during the pandemic. iM Med’s chemistry supply is reliable. Their delivery has been brilliant.

“With the previous chemistry there was an occasional leak and an alarm if an inexperienced person loaded it, due to how the bottles were connected. iM Med’s is an upright bottle. You just take of the lid and pop in the connector and it’s ready and safe. It’s idiot-proof. We’ve had no issues with leaks.”

Victoria says: “It’s a very straightforward process now, especially when you compare it with how we used to have to prepare chemicals a few years ago. 

“We use a process challenge device - a fake scope. On the two machines that have been converted it’s gone fine. We are just completing the changeover of chemicals for the final machine. 

“We trialled iM Med’s chemistry for the manual wash two years ago but have only gone over to it recently,” adds Victoria. 

“There’s a cost saving and it’s compatible with what we are using in the machines, plus we have the reliability of supply.”

The manual wash uses iM Med’s Clean stage 2, while in the theatres the team use Clean stage 1 to immediately manage the endoscope post procedure.

iM Med produces the disinfectant and detergent required for a range of EWDs by designing and manufacturing equivalent type tested recipes in a UK manufacturing plant. Peracept, iM Med’s disinfectant for EWDs, is microbiologically tested and compliant with all relevant standards. Its compatible detergent is DLCept 3.

To provide hospitals with financial reassurance in the event of any issues, iM Med backs the quality of its type tested chemistries with a financial guarantee that covers any eventualities.

This enables NHS trusts to make a choice based on safety and quality to transition to iM Med for the provision chemistry. It also provides an opportunity for trusts to open-up the procurement of service and consumables, allowing hospitals to procure based on quality for the life costs of their equipment, without being restricted to manufacturer-only purchasing.

JAG best practice requirement

With staff safety enhanced by the installation of a peracetic acid vapor monitoring system, Lesley-Anne says: “A monitor is now a JAG best practice requirement. The need for one was a recommendation of the IHEEM audit undertaken by Bob Jobbins, our AE(D). We had one in place before the JAG audit in October 2020.”

Victoria explains: “We had looked around for one earlier but there was not much around at the time and there was very little response from those who were. We asked Helena Tilley, our iM Med account manager, who came up with the goods.”

iM Med is the sole UK distributor for the ChemDAQ peracetic acid monitoring system which helps departments ensure air quality is at a safe level. 

The ‘plug and play’ system easily adapts to machine placements, delivering continuous monitoring and recording, with time-weighted average exposure readings and is downloadable, giving tracking for JAG monthly reports.

“The ChemDAQ is working fine,” says Victoria. “It ensures we’re protecting the health, safety and wellbeing on the team. When we do a chemical change, the monitor will fluctuate, but it’s never enough to alarm.”

Lesley-Anne adds: “Bob Jobbins is satisfied that we now have a peracetic acid monitor. It gives us reassurance and was a big thing to have ‘ticked off’ our list for the JAG accreditation.”

Commenting on the various changes, Bob Jobbins, the trust’s AE(D), says: “The machines are running well. The reports are timely and accurate. They come through electronically which enables me to do my audit throughout the year.

“Manufacture supplied chemicals can be expensive. I’m pleased that the trust has chosen an alternative type tested solution. When considering such a change it is important that the product is properly assessed and that the machines go through a full recommissioning, ensuring everything is working correctly for patient safety. The supplier company should also take responsibility for any damage.

“I recommended the installation of the peracetic acid monitor,” adds Bob. “At one time peracetic acid was considered to be less dangerous than other chemicals. Now, however, it is known that there is a danger to those who may be exposed over a period. So, it is definitely important to monitor levels and ensure staff safety.”

Cost-saving consumables

Consumables are another area where iM Med has enabled the department to make savings. “I hunt around for alternatives but Helena always comes up with the goods at a great price. They’re really good quality and cost saving,” says Victoria. “The gauntlets are fantastic. They help prevent contact dermatitis. We used to use long-sleeved gloves. Everyone’s happy with them.”

Other consumables supplied include clear and red bags; pouches; bedside kits for the procedure rooms, X ray and ITU; connectors for the automated flushing device for the manual wash, and connectors for the EWD’s auxiliary channel female connector, plus a variety of O rings for the drying cabinets and EWDs.

In summary, Victoria explains: “The cost savings have been a major thing as we’ve increased service, adding another theatre. Cost aside, iM Med are very friendly, approachable, even on things not related to the work they do. They’re someone you can ask for advice.”

Lesley-Anne says: “iM Med seem to go the extra mile. Their service is very impressive, fantastic, you can’t fault it. They’re very conscientious.

“I put my trust in Vicky,” adds Lesley-Anne. “I was put in post 18 months ago with the objective of improving quality control and other issue. Lots of actions were required, including a structural change in leadership.”

The department is therefore justly proud to have been named ‘Outstanding’ in the recent quality standards assurance audit. “They said we are well led, well-staffed, clean, tidy, safe and that our standards met trust compliance levels and mandatory levels,” says Lesley-Anne. “CQC were also very happy with everything. We’re now looking forward to this year’s annual JAG accreditation.” 

For further information, call iM Med on 01223 440 475
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