Given my limited knowledge and experience with MVS, MSV and PFI, I tend to associate MVS with PFI builds and MES with traditional maintenance methodologies that can be used by EBME & Medical Physics if management chooses to do that. I think that irrespective of the definitions of the services being provided the points being made above were about contracts between service providers and customers. I think what's being discussed above, particularly in the statements made by tbs_user, is the move from a MSV that is no longer providing that type of service to that Trust to one that is based around is MVS or MES. The NHS Trust mentioned has a large PFI build on the way so perhaps the MVS or MES is just mirroring the trend asociated with PFI builds elsewhere.
Depsite these issues being viewed as ones for each trust to manage locally it's apparent to me that there are definitely "preferred" options despite the "impartial" nature of tendering processes, etc. When a single MSV is adopted by a number of trusts involved in seperate tenders for the provision of medical equipment services, nationally, then these tend to be subsequently replaced by a single company providing MVS or MES a few years later, for contracts of widely varying cost, awarded at different times in different trusts, it's not difficult to envisage that there may be some "bias" irrespective of the deliberations of the trusts entering into the contracts, the attractiveness of the services on offer or even cost.
In a truly competitive environment the bottom-line is that the services provided, whatever they be, are costed depending upon the level of activity that's required. For MSV and MES they still probably need to be managed, to some extent, by an in-house team (purchasing departments do not have all the requisite skills necessary to do this) and it's likely that some staff are also going to be needed to give an immediate response to situations that are outside the remit of contracts - such as clinical support and training to operators. Otherwise costs could spiral - these are the situations that can't be tied-down to predictable costs at specification - to avoid extra-contractual obligations like, emergency response charges, 400% markup on spares used for repairs of equipment that's not tied in the specification plus exorbitant labour charges to arrive at the minimum 25% profit margins expected by one particular MSV provider, for example.
There has always been the option for MES and MVS types of activity to come under the umbrella of an in-house Medical Physics or EBME department - using service contracts. MVS and MES probably give flexibility for the provision of services that meet wide-ranging requirements but, due to the unpredicatable nature or costliness of some of the highly specialised services required in the NHS environment, this is still likely to leave a requirement for individuals to manage contracts, perform equipment evaluations prior to purchase, carry out acceptance testing, provide clinical support, maintain asset databases and records, advise on accessories, consumables, deal with indident reporting, evaluation & dissemination of bulletins, etc.
This leaves the routine work that can be specified and costed more predictably to those employed by the service providers, i.e. PPM, servicing and some types of breakdown where fixed price repairs can be agreed on. I think some people forgot about this when they agreed on the MVS contract, at the site that tbs_user mentioned, which allegedly turned out to be more of a burden financially and contractually, for service provider and customer, than anyone except individuals in the original Medical Physics Department, imagined.
I'm sure the equipment manager at Salford Hope will be more than happy to share his specification and thoughts with all of you.
Which one - the in-house manager who wrote the specification or the MES manager who has to meet it?
Assuming they're not one and the same (that's a safe assumption I think) then I'm certain they will have differing views. Remember it's only Day 3.......