CASE STUDY: Imperial College Healthcare NHS Trust

Since moving to iM Med there are no worries over equipment and performance in the endoscope reprocessing units at Imperial College Healthcare NHS Trust

Imperial College Healthcare NHS Trust’s endoscope reprocessing units (ERUs) moved their maintenance, testing and validation contract to iM Med to address issues experienced previously. Moya Alexander, the trust’s decontamination lead, described the move as “a more collaborative and transparent relationship.” The improvements have enabled the department to extend its service to cover evening and weekend working, meet cost improvement plans and give technicians and management full confidence through the knowledge that any issues will be fixed quickly.

“We’ve managed to get an improved service for a similar market price,” explained Moya. “We now have dedicated engineers. Because of the partnership, machine up time and reliability has improved to such an extent that we are now able to work evenings and weekends.

“As we work so well and so collaboratively, we have moved forward and changed our chemicals, which has enabled us to meet our cost improvement programme for the department.”

“The current ERUs at Hammersmith and Charing Cross opened in 2012, with St Mary’s following in 2014. There are over 300 scopes across the trust’s sites and we reprocess 40,000 scopes a year. Activity is growing 5% a year. With the new-found confidence we have in machine reliability we are now working evenings and weekends, indirectly generating income for the trust.”

“At the beginning, Andrew Thomas, iM Med’s technical service manager, worked long days as required. The result was that the problems with machine downtime went away very quickly. There was a steady decline in problems, which gave us the reassurance that we’d made the right decision.”

Nick explained: “Previously our technicians didn’t always raise issues because they felt they would be difficult to resolve. Whereas now, the issues are being raised in ‘real time’ as everyone in the team has the confidence that problems will be quickly and easily resolved.”

iM Med’s field service manager, Andrew Thomas said: “We did a health check of the equipment as we took over the contract from the previous supplier. This enabled us to know the state of each machine. After the health check, we undertook initial work to improve operation and reliability immediately.

“Spares are no longer an issue. The engineers have a range of spares readily available and some spares are left on site to facilitate more first-time fixes.”

As well as the washer-disinfectors, iM Med also supports and services the dosing pumps for the sink manual cleaning, the vacuum packing units and the department’s clog washers.

Moving onto consumables, Nick said: “We couldn’t just change chemicals. It was important that it was equivalent to the type-tested validated chemical. iM Med’s chemical was proven through a machine validation and approved by the trust’s AE(D). We had a disinfection efficiency test of all the trust’s 14 endoscope washer-disinfectors. It gave us the reassurance that there would not be any issues.

Consumables supplied by iM Med include: chemical for the manual wash, chemical for the washer-disinfectors, heavy duty bags for vacuum packed scopes and self-sealing irradiated bags for the wet packing of endoscopes. iM Med has also sourced alternative scope trays, after those supplied by the machine manufacturer were found to cause scope damage and Health and safety issues with finger spiking.

Nick added: “We’ve just completed our annual customer survey with our clinical teams. There are now not as many repairs and breakdowns of scopes. Now that we have spread the work over some evenings and weekends, there is not as much pressure on scopes and reprocessing.”

“The improved service and reliability have had a huge effect on everybody. It’s been a real boost to everyone’s confidence. There are now no worries on the machine performance side. We have a full machine service contract, the terms of which are being met.

“It’s released a lot of management time. I’m now able to do far more analysis to see where issues are and to make improvements to the service as a whole.”

With an imminent transition audit and the department’s move from ISO 13485:2012 to ISO 13485:2016, with its more stringent criteria for obtaining the medical devices quality system, Nick says: “This audit is going to be very tough for us. We have moved to a new certification body so will have new auditors and it is a transition audit, plus it is also a full re-certification audit too. However, with equipment now in good working order, a huge amount of supporting data and our KPIs being met, I feel much more confident going into this audit.”

With many years of experience in endoscope decontamination, the iM Med team are able to assist in a number of ways, as commercial operations director, Nick Satchell, explained: “From the very start we try to understand where our customers ‘pain points’ are and focus around resolving those, as well as ensuring good communication and transparency in all we do.

“We also help our customers by bringing in third-party suppliers to the ERU, taking responsibility on behalf of the client to broker the resolution of any issues. If there are problems, each party lets the other know and we come together to resolve them. It helps to develop a ‘no blame’ culture. We do this for a number of clients.

“Like Nick and his team at Imperial, other clients say their phones are not ringing with issues any more. It’s now an easy life as far as machine service and reliability is concerned.”

During the development of endoscope washer-disinfectors, manufacturers establish the disinfectants and detergents that are compatible with the materials used through the process of type-testing. This ensures that material integrity is not compromised leading to degradation of internal components.”

iM Med produces the disinfectant and detergent required for a range of endoscope washer-disinfectors by designing and manufacturing equivalent type tested recipes in its UK manufacturing plant. This has enabled NHS trusts, including Imperial College Healthcare NHS Trust, to make a choice based on safety and quality to transition to iM Med for the provision of their endoscope disinfectants and detergents. It has also provided an opportunity for NHS trusts to open-up the procurement of service and consumables through more than just the manufacturer-only route. This gives hospitals the power to procure based on choice and quality for the life costs of their equipment, rather than being restricted post purchase to a ‘handcuffed’ position of equipment manufacturing-only purchasing.

Summarising the benefits of the move to iM Med, Nick Wood added: “I can now sleep at night. I can go home at the end of the day and not worry about equipment and performance. If there’s a breakdown, I know it will be fixed quickly. We’ve an improved quality of service and consumables.

“It’s not rocket science to achieve or indeed provide the service which we have. It’s a result of working and partnering – ourselves and iM Med. It’s delivering exactly what we need.”

For further information, call iM Med on 01223 440 475