Whittington Health
The Whittington Hospital NHS Trust, located in North London close to Highgate Village and Islington, serves a diverse socio-economic and mixed ethnic population of around 300,000.
Adoption of modern clinical procedures was restricted due to older technology and many pieces of equipment were getting close to their recommended replacement age. The hospital needed to update its imaging facilities but lacked the capital needed to buy new equipment.
“We initially dipped our toe into the leasing pond but found that upon renegotiation, we couldn’t afford to update the equipment due to other financial pressures. Without modern equipment, we were unable to offer patients low radiation dose techniques or alternatives to invasive procedures,” states Dr. David Grant, Clinical Director of Diagnostics and Therapies and Consultant Radiologist at The Whittington Hospital NHS Trust.
Initiating change
Remedial work designed to combat the situation started in 2000. A PFI project to construct a new clinical block and main entrance began.
With infrastructure improvements underway, the Trust then focused its attention on equipping the new facilities. To provide a high standard of care and compete in an increasingly commercial NHS environment, advanced modern diagnostic equipment was required.
The Whittington’s management were looking for a solution which:
- Provided access to a broad spectrum of technical expertise and advice
- Would integrate with the existing PFI contract and manage the building interface
- Provided technology refresh over the contract lifetime
- Provided full financing for all equipment
- Reduced both the Trust’s fixed costs and the long term financial risk
In October 2005 The Whittington Hospital awarded a 15-year Managed Equipment Service (MES) contract to vendor-independent specialists Asteral. This agreement ensured that the days of outdated technology would be a thing of the past. The hospital would benefit from and maintain the benefits of being one of Britain’s most technologically advanced imaging departments.
Clinical and financial benefits
The Whittington chose a MES solution because it ensures that all elements of equipment provision and management are outsourced to a specialist third party. It also guarantees that state-of-the-art equipment would be maintained throughout the lifetime of the contract. This enables the hospital management team to focus solely on patient care and passes responsibility for all the strategic management of equipment lifecycles to the MES partner.
As an expert in this field, Asteral worked with the Whittington Hospital from day one to evaluate the radiography needs of the hospital, and develop a sustainable long-term equipment replacement programme. Plans for ongoing user training and a fully managed maintenance service were also jointly developed.
“A secure investment plan, an integral part of a long-term MES contract, represented a realistic opportunity in the present financial environment to ensure that state-of-the-art equipment is continually updated and refreshed,” said Dr. Grant. “This approach ensures that access to modern and well-maintained equipment is kept constant and that nothing passes its agreed replacement age. This is a huge advantage in maintaining the standard of clinical care.”
Investing in modern equipment
The first part of the MES scheme saw Asteral purchase a number of mobile Ultrasound and X-ray machines. These were installed ahead of the planned service commencement to assist the Trust with the replacement of the most urgently needed and older equipment. Asteral then refurbished an old general emergency department X-ray room replacing the aged equipment with a state of the art, fully digital, twin plate X-ray system and digital dental panoramic X-ray machine. This was installed in advance and provided a valuable benefit in assisting the training of radiographic staff on the new digital technology.
Asteral took responsibility for all design and building interface matters. It reviewed all room drawings provided by the PFI contractor to ensure that the room design was suitable for the installation of the new equipment. Asteral carried out all room fit out works associated with the fixed equipment.
The MRI Scanner, weighing six tonnes required heavy duty lifting and positioning via a third floor window. This was the final piece of equipment and was craned into place in September 2006.
Unveiling the new department
The department went live in November 2006 and now boasts six Philips Digital Radiography rooms; a 64 slice Siemens CT Scanner; a Philips Achieva 1.5T MRI Scanner; a GE Infinia Gamma Camera; six Philips ultrasound units; three Mobile C-arm Image Intensifiers and a Xograph digital dental unit.
“The previous MRI scanner was in its eleventh year, so it is great to have a new device. It will enable us to offer patients a greater range and quality of examinations such as MRCP’s and vascular imaging obviating the need for invasive diagnostic studies,” stated Dr. Grant
He continues, “We are all delighted with the new department. Working in such a modern and spacious environment with state-of-the-art equipment enables us to offer the best possible service to our patients. We are now concentrating on developing new services and further improving both access times and the communication of results.
“Initial feedback from patients is also positive; they like the new and clean facility. Furthermore, the dedicated waiting areas inside the Imaging Department have improved patient dignity – no more waiting in corridors in gowns.”
The introduction of new equipment has also encouraged the adoption of innovative new processes, for example, the imaging department has also introduced a unique patient waiting bleep system. Upon booking into the department each patient is given a bleeper to call them back when their examination slot is available. This reduces the number of people waiting in the department and helps to eliminate patient anxiety by giving them freedom to visit the shops and cafés inside the hospital building without the risk of missing their appointment.
Ongoing excellence
With all the equipment now operational and providing patients with the quality of services they deserve, Asteral has shifted its focus to providing service excellence for the long-term. On the ground, its specialist team ensure ongoing maintenance and training programmes are closely managed, minimising equipment downtime and promoting the use of new digital technologies to maximum effect.
“Asteral takes the equipment headache away making the operational part of the job much easier. Because of the contractual implications, Asteral ensures that OEM engineer fault responses are much quicker.”
With a MES contract in place, the Whittington Hospital is able to concentrate on introducing further reforms to improving patient care, safe in the knowledge that the equipment is in the hands of an experienced and reliable partner.
