Following numerous issues with its previous supplier, a major trust now enjoys trouble-free maintenance, testing and validation of its endoscope washer-disinfectors, enhanced by an impressive cost saving on compliant chemistry, since their move to iM Med.
Donna Williams, disinfection services manager, at Royal Liverpool University Hospital explains: “With our previous service contract we were experiencing unavailability of parts, machine downtime and staff concerns, not knowing what they’d be coming into each day.
“There was no consistency of engineers and the engineers never had any spare parts. One part missed a flight, so we had to wait another day before it could be fitted.
“The supplier didn’t take on board our concerns or complaints and we were not getting the service we were paying for. We felt we couldn’t carry on as we were.
“I had a good relationship with Lynn Brooks, the trust’s decontamination manager,” says Donna. “I always included Lynn in reports. She appreciated that we were under pressure. Lynn took the issues on board – the frustrations we were feeling, the shortfalls in service.
“Lynn set about having meetings with the appropriate parties and arranged a meeting with Nick Satchell, iM Med’s commercial operations director, towards the end of 2017. We discussed the issues we were having. It seemed these were not unusual.
“The ethos of iM Med resonated with us. Nick said they could give us a bespoke service and they do what they say they will.”
Now, not only have the aged machines had a full iM Med ‘health check’ so they are all once again running smoothly, there have also been dramatic cost saving benefits as well as additional enhancements too. As Donna explains: “We’ve made savings on service and maintenance, and on chemicals and on consumables as well.
“We’ve also got user training for endoscopy support workers, who work in the decontamination area. That’s being delivered by iM Med’s compliance division manager, Zoe Fayers-Rust.
Mike Holt, iM Med senior engineer – North West
“When we agreed for iM Med to take on the contract, Mike Holt, their senior engineer – North West, was here for about two weeks doing a ‘health check’ on the machines. Any issues that arose were settled straight away. Once Mike was happy that all the machines were up to standard, he took a step back. Mike still pops in regularly to check that things are going well and that we haven’t any issues. Andrew Thomas, iM Med’s technical and service manager, is here whenever required and they’re in at weekends if necessary. Any member of staff can contact them – by email or call. They get back straight away and are here with the required part.
“Both Mike and Andrew are very approachable. The customer service from iM Med is very good.
“We had validation on iM Med’s chemicals through a microbiological process with Tony Kerry, our AE(D). We changed the chemicals, the peracetic acid and the detergent. Andrew Thomas arranged the test on one of the machines.
iM Med provide the compliant chemistry, manufactured to the equivalent type tested recipe required for the endoscope washer-disinfector (EWD).
“Once the validation of the chemistry showed that iM Med’s chemicals do what they’re supposed to do we changed over almost straight away. The consumables they supply include shelves for the EWDs – over time the machines shelves get sharp edges, which can damage the scopes and harm staff. iM Med also supply single-use valves and a bedside cleaner for scopes which on-call doctors use.
“If there’s anything we need, we can contact iM Med and they will try to source it for us.”
Proud of the improved performance and the savings that have been achieved, Donna explains: “We’ve saved a considerable amount on the service and maintenance contract and on the chemicals.
“Machine downtime is very rare since iM Med took over the contract,” says Donna. “These machines are over nine-years old and have done in excess of 36,000 cycles, far in excess of what would be expected. They’re working above and beyond what’s normal, thanks to iM Med. They’re keeping them going until the new Royal Liverpool University Hospital opens. iM Med have committed to continue to provide the service and maintain the EWDs through to the move.
A water sample is taken by the iM Med engineer
“We’ve not had to cancel any lists, but under the previous maintenance service we were very close to it at times. During that time, it was thanks to the staff that we were able keep operating. The staff are very proactive, very responsive. They understand the importance of keeping the service operating for the benefit of the patients.
“We have regular review meetings with iM Med to discuss the KPIs. They highlight any issues and if we have any, we say so. It’s always a very proactive meeting. It’s because of the relationship we have built up so quickly with iM Med’s team – Gordon Ledingham, their managing director, Gillian Hill, clinical director, Nick Satchell, commercial operations director, and Julie Nelson, contracts and office manager.”
Despite the delay of the new Royal Liverpool University Hospital opening, following the collapse of Carillion, the busy department continues to work every day, from 7am through to 9pm, including weekends and Bank Holidays, reprocessing ’scopes for the endoscopy unit as well as for six main theatres and ICU.
“We’re JAG accredited.,” adds Donna. “JAG was very impressed with the unit despite its age.
“Lynn thought I’d disappeared because I didn’t need to contact her anymore. It made her life easier as well. I can’t recommend iM Med highly enough. They give you peace of mind.”
Describing her role, Lynn Brooks, now retired, says: “As decontamination manager, I didn’t manage any department at all, I was there as an advisor. Our previous supplier had serviced their endoscope washer-disinfector machines very well for many years. They were taken over by another, larger company and we began to have numerous issues – maintenance, validations, and so on. There was an overall drop in numerous areas.
“We met with them on a number of occasions to try to resolve the issues. Eventually, we realised we’d exhausted everything we could do.
“I was aware that Nick Satchell had started iM Med and we didn’t have a lot to lose. One of the things that’s always been important to me is that it was never about the money, it was the service side. However, the trust saved quite a lot of money when we moved over to using iM Med chemistries.”
Summing up the move to iM Med, Lynn adds: “It’s one of the best things I ever did.”
Working in Donna’s team, Diane Cleaver, technical support officer, explains: “With decontamination, you just can’t provide the service when you’ve got constant issues. We appreciate the benefits of working with iM Med. The staff are happy to talk to the engineers and know that they will get any issues sorted. Staff will email and call them.
“The continuation of engineers is important too. They know the machines well. Mike and Andy are very good, very communicative, very responsive.
“The machines are well over their ‘use by date’, but they’re still able to provide an excellent service, thanks to iM Med.”
Endoscope reprocessing technicians Lewis Kennedy and Nicola Dixon
In the reprocessing department, technicians Nicola Dixon and Lewis Kennedy speak first-hand about their experience. “We started just after iM Med took over the service and maintenance,” says Lewis. “So, luckily we’ve not experienced the problems I know the staff before had to endure.
“If anything arises, we always email iM Med. They’re here very quickly and issues are always sorted within a day. The engineers will talk to us and tell us what they’ve done. It’s a very good service.”
Giving a patient-facing perspective, Stacey Burke, acting unit manager, says: “To know that Donna and her team are well supported is peace of mind for me, too. It helps us in the endoscopy unit in many ways.
“We feel confident and comfortable – knowing that iM Med are giving such good service and keeping the machines going. It means we’re delivering a high standard of decontamination of the scopes for the patients.
“I wouldn’t have my procedure anywhere else. It’s a fantastic service.”
Onsite, undertaking a machine validation, Mike Holt, iM Med’s senior service engineer – North West, explains: “When we came in the machines had done a lot of cycles. They were nearing the end of their lifespan. We gave the machines a ‘health check’ to see what the issues were and corrected any recurring problems.
“I’ve worked on EWDs for nine-and-a-half years. Being the dedicated engineer, it’s in my interest to ensure any little thing is taken care of.
“This department has agency staff in at weekends. So, we pop in on a Friday and a Monday to make sure everything is ok for the lists.”
Developing an excellent working relationship has been an important element of the service, as Nick Satchell, iM Med’s commercial operations director explains: “From the outset in 2017, we’ve been proud to support Royal Liverpool University Hospital and to bring them up to the service level they deserve. Working in partnership with them has been key to the success of the project.
“Like Donna and the team at Royal Liverpool University Hospital, other clients say their phones are not ringing with issues anymore. It’s now an easy life as far as machine service and reliability is concerned.”
Regarding the change of chemistry, Nick explains: “iM Med are ISO 13485:2016 accredited for the design and manufacture of disinfectants. This is a rigorous quality standard, awarded by British Standards Institution (BSI) following an in-depth analysis of our quality management system and UK-based manufacturing facility.
“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 enables NHS trusts to make a choice based on safety and quality to transition to iM Med for the provision of disinfectants and detergents. It also provides 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 manufacturer-only purchasing.
Lynn’s successor as trust decontamination manger, Robbie Cormie, says: “I was pleased to find that iM Med were here, as I’d taken them on board at my previous hospital. The problems the team had experienced here related to those I’d had.
iM Med’s engineer validating one of the nine-year old EWDs
“In fact, it was Lynn who told me about iM Med,” explains Robbie. “Lynn said ‘I thought I’d gone deaf. I couldn’t hear the problems anymore’. That’s the difference their service makes.”
“It’s nice to have a company that’s proactive, rather than reactive. It’s also reassuring to know that one of iM Med’s directors, Gillian Hill, is a qualified infection control nurse.
“They’re open and accessible. Their work is spot on too. As the trust’s AP, I review all the validation reports. The ones from iM Med come in on time. The format is very good, always accurate first time. iM Med do what they say on the tin.”
Looking to the future, Robbie adds: “We hope that we can continue the relationship with them in the new Royal Liverpool University Hospital.”
On 1st October 2019, Royal Liverpool and Broadgreen University Hospitals NHS Trust and Aintree University Hospital NHS Foundation Trust formally merged to create Liverpool University Hospitals NHS Foundation Trust.
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