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Staying power

Wednesday September 16th, 2009

By Peter Harrison, Director of Sales and Solutions, Siemens Healthcare

Public Private Partnerships in the health care sector are vital collaborations given the current financial pressures on the NHS.

As health care targets grow more challenging and controlling costs gets tougher, a Managed Equipment Service (MES) can be an increasingly attractive option. An MES is a long-term Public Private Partnership (PPP), typically at least 15 years, between a specialist provider and an NHS Trust. It is a joined-up strategic approach that looks after all aspects of equipment within a hospital – procurement, installation, maintenance, staff training and ultimately equipment refresh – to ensure that technology operational concerns are taken care of, leaving the hospital free to focus on patient care.

MES works to a fixed annual fee and stable investment plan, guaranteeing the replacement of equipment such as MRI, CT or ultrasound scanners. Clearly, as technology evolves hospitals need to ensure that they are afforded the benefits of such technical developments during the life of the MES concession. While there are different approaches available to address this issue, typically a policy of technical equivalence is deployed. For example, if we replace a seven-year-old CT system that was ‘high-end’ at the time of purchase, it will be replaced with what is considered a high-end system in the current market. Significant savings and efficiencies can be gained when this is compared to a Trust adopting a traditional procurement approach.

An MES can ensure that clinicians have up-to-date equipment now, and certainty for equipment replacement in the future. These planned replacement cycles can negate the overhead of clinicians having to spend valuable time building business cases each time a piece of diagnostic equipment needs to be replaced. Having state-of-the-art medical equipment can also decrease the time needed to acquire diagnostic images and lead to increased accuracy of diagnostic results, greater efficiency and reduced waiting times.

Not to be confused with leasing, MES is a more complex relationship that draws in wider operational aspects such as user training, expert safety management, equipment upgrades and replacement, and performance reporting. The MES approach also lends itself to VAT relief – though that will always be subject to the customer ascertaining the VAT status with their local Revenue and Customs office.

MES was born out of PFI major build consortium arrangements, yet today Trusts are developing MES partnerships directly with commercial partners. Long-term multimillion-pound MES agreements are now in place at hospitals in Airedale, Barnet, Blackburn, Dudley, Havering, North Staffordshire, Wishaw and Worcester, as well as Barts and The Royal London.

An extra benefit of using an MES relates to risk management. The MES provider assumes the financial and performance risk associated with equipment downtime, obsolescence, maintenance, installation, commissioning and replacement. Availability of equipment is also guaranteed, giving hospital clinicians and executives peace of mind – if a system does not meet the pre-agreed performance levels the MES partner will incur financial penalties.

The Dudley Group of Hospitals NHS Foundation Trust is currently in the ninth year of an MES partnership with Siemens Healthcare. The contract scope includes the supply, maintenance and ongoing replacement of all imaging equipment until 2041. This partnership recently supported the completion of two fluoroscopy rooms housing new imaging systems. Siemens supplied and installed the equipment, trained hospital staff, and provided technical and project management support with the construction of the new buildings. This enabled the Trust to gain rapid access to the latest technology without compromising patient care. This strategic approach to medical equipment also ensures that modern procedures can be offered to patients and that equipment uptime is maximised.

Alf Edwards, Chairman of The Dudley Group of Hospitals NHS Foundation Trust, said: “Having a partner keeping us abreast of technological developments from which we can benefit is fundamental to better patient care. Our staff are diagnosing and treating patients much more quickly than before and our waiting list performance is well within the Government’s 18-week target.”

The MES at Dudley also extends to the IT infrastructure, including the Picture Archiving and Communications System (PACS) which ensures diagnostic images can be efficiently distributed and reported.

“Previously it could take two weeks for a radiologist to report on an X-ray. But now that we digitally distribute images, nearly all X-rays can be reported on within 24 hours. And a clinician can now consult on the phone with a radiologist while they both look at the same image online, which is a major advance,” states Dr Peter Oliver, Medical Head of Radiology Services at The Dudley Group of Hospitals NHS Foundation Trust.

As well as supporting Dudley’s network infrastructure, the provider has also worked with the Trust to develop and implement an electronic patient record system. The system gives clinicians instant access to patient records, via wireless technology, from clinical patient bed areas.

Overall, MES is one strategic approach that works well for both the NHS and specialist providers. Having a fixed investment plan means that all equipment is updated and regularly maintained, providing certainty and value for money in an uncertain health care environment.

About Managed Equipment Services…

Through long-term, fixed-fee MES agreements, the latest medical devices are made available to clinicians and staff to speed up patient throughput and open the door to a wider range of non-invasive procedures.

MES is proven to provide the following elements:

• Certainty – Guaranteed equipment availability; if it doesn’t perform as promised, the MES provider incurs financial penalties.

• Risk transfer – Equipment ownership, management and availability risks rest with the MES provider.

• Value for money – A pre-planned and rolling equipment replacement programme delivers the latest equipment for the best possible clinical service.

• Flexibility – Equipment specifications can be varied over the contract period to ensure future challenges are met.

• Support – A single point of contact is available to resolve any equipment issue, should one arise.

Further information…

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