Opinions please -

Lean thinking - can anyone see a problem with us ebme types working alongside the Estates electricians, or even incorporating the duties of both trades into one entity?

Cheers
Mark

LEAN issues apart ... have your Electricians wised up a bit since I last chatted with them, then?

Historically, many UK EBME departments were staffed by clued-up electricians from Estates when they were first set up. It was a natural progression, after all. But (I think we can all agree that) medical equipment has, shall we say, moved on a bit since those days.

In short, many biomeds could do the work of Estates electricians, I should imagine. But not the reverse. On the other hand, I happen to know a number of ex-Estates people who have retrained as biomeds (and now work in the biomed department). That's fair enough, but I don't think that's what you're getting at is it? Do I detect another "bright idea" (at saving money) by your management?

Sorry Mark, but it's the big "thumbs down", I would say. And, don't you have more than enough work on already?

I can see one slight problem here.....

One group does ELECTRONICS.....

the other does not !

Ok, it's a simplisitic veiw and could a, as Geoff says, clued up sparky make it in biomed, yes, probably., but I would much rather take someone from TV/video or other electronics arena and teach them the medical side of things than go down this other path.

Is there cross over, perhaps, but, I think it better not to cross the line, there are enough areas of grey between biomed and maintenance are there not?

Yes Geoff, I have more than enough to do at the moment.

The funding for the NHS is dropping off and, dare I say, a new government is on its way in.

So, before the crap hits the fan, we are being encouraged to think outside the box in an attempt to secure our future - hit the ground running now, so that we are in a stronger position for the near future.

Cheers
Mark

Just to play out my usual role (that of Devil's Advocate) ... some Estates "sparkies" do get involved with electronics to a certain extent (control gear, and stuff like that).

But, two further points, if I may:-

1) Perhaps it would help if Mark furnished us with an example of what such convergence would actually mean (they must have something in mind down at Taunton, after all).

2) In a word (or two) ... Patient Safety!

Sorry, Mark ... best get your people to try thinking inside the box first!

The company in which I work has both a biomed and and facilities (or estate) group. The senior manager of the facilities group has the office next to mine. I no more understand the detail of his work than he does of mine. We discuss, we cross reference but we both know where our particular understandings and knowledge stop. These are not the same things.

Again I would say, yes, some electricians could tranfer skills to the biomed environment just as some biomeds could transfer the other way (if they were interested in doing so) but these are not the same skill sets.

More to the point, I think, beware the dilution of the "professional" status of your work.

Dave, I'm sure we all take your point ... but I would venture to suggest that you're being a bit modest there, Mate.

Personally speaking, I've always been able to keep up with what Senior Facilities Management (Estates, or whichever terminology is preferred) were saying, and I'm no Einstein (as I would be the first to admit). Especially that is, as in one case I could actually cite, where the guy was an ex-chef!

Sorry Geoff, no examples, just brain-storming with an eye on the future.

Cheers
Mark

What I was going to add was what I have advocated before. And that is a combined Technical Services Department, containing all aspects of tech support for the hospital:-

Biomed
Building services
IT
M&E

... and anything else "technical" we can think of. Maybe that's the sort of thing you should be looking at.

By the way, I also favour putting "Support Services" under one umbrella as well (but not, I should make clear, the TSD one).

That is:-

Catering
Housekeeping
Laundry ... et al

Hi All

To reinforce what being said here - do not under sell yourself - you like many if not all of us spent years in college (university) studying electronics to a high level. We did not study cable joining and light bulb changing in night school to become a sparky.

Our proffesion (and that is what it is) takes a long time - years of experience to become good at, As does becoming a good sparky or chef. Of course we can all do cross training and learn other trades - but and heres the but Biomed is a multi disaplined profession (ie - electronics, physiology, biology, chemistry, mechanics, IT to name a few) To learn all of the ablove takes years of learning.

So, please don't sell yourself short or let your management under sell you and mix you in with other Non clinical areas.

Thank you - that my rant for the day - new rant tomorrow.

Phil.

We are all under Support Services here i.e. Estates and Facilities. However there are several sections under this heading which includes us as we come under Estates.
So although we look after gas and electronics from regulators to sophisticated monitors, no electrician, fitter etc here, would contemplate attemping to fix anything of ours - not even in the middle of the night.
They may be good at what they do, but medical devices are entirely different. There have been several documents over the years, highlighting the responsibility of the Supervisor of Technical Servicing (HEI98 and MDA DB9801 for example.) This person is supposed to authorise people to work on equipment, possible with company contractors who report to him when on site, but impossible with tradesmen, unless he has direct control over them.

@Phil

Not only multi-disciplined, with years of training, but having the "right" mind-set (attitude, aptitude etc.) as well!

As I explained to a boss a couple of years ago ... "yes, I can drive a van ... I can also paint walls, and put up shelves (and I actually don't mind doing any of those things) ... but is that what you want to pay me to do"? That is, is the Service Engineer paid to service kit, or to spend four, five, six hours on the motorway each day?

Sorry for the digression. But it was just in amplification of what has already been said. Most biomeds I've come across (and I've met a few) are useful blokes, helpful*, and willing to "make things better" in general. In a word, proactive. But that same attitude can easily be taken advantage of by "the management" (and, as may be imagined, I speak here from sorry experience)!

* Dare I also add "humble"?

Cheers guys.

If your Trust isn't already cost cutting, it will be!

Job saving exercises ahead, me thinks.

Cheers
Mark

As everyone must be aware, the UK's government hospitals have, since the NHS was created, been lurching from one "financial crisis" to another. It is a given in the UK, just like the miserable weather, and the expectation that our national teams "always lose"!

In a way it's a good thing, as it keeps those who may otherwise be tempted to adopt a sloth-like posture to remain on their toes, as it were!

However, if we look at things objectively, the NHS has improved in most meaningful (and measurable) ways, more or less year on year since its inception.

It is right and proper that it is constantly being called to account. It is, after all, a Public Service, paid for by the tax-payer. Notice, too, that it remains the largest employer in Europe (and, worldwide, only the Chinese Army, and Indian Railways, "employ" more people). Around one in every 23 workers in the UK earn their crust in the NHS.

People (and the Daily Mail) moan and groan about it. But perhaps they would see things a little differently if they had been unlucky enough to be injured in a car accident in, say, Lagos or Khartoum ... or fallen seriously ill in (again, purely for purposes of illustration), say, Mali or Mogadishu. Compared with the needy in places like that, I don't think that those in the vicinity of junction 25 of the M5 have too much to worry about.

And, as regards "the workers" ... well, to put it bluntly, Mark, you are scare-mongering, Mate. As I have said a zillion times before, as long as the kit is there (and, in the UK at least, it always will be), there also has to be someone around who is able to fix it. Just continue to make yourself useful, and no doubt all will be well!

if you want cost cutting ours does the best. It asks that you give as much notice of retirement and then when your day comes you leave. After a while someone then says 'whys the work piling up!!' Could it be that you have not replaced the retiree and you have taken another of our workforce 3 days a week.

Art of management will always be a mystery.

Or could it be that they are working up to taking on another raft of agency techs, making them graft for a while, and then (just as they seem to be ... er, relaxing a bit) giving them the elbow?

Seriously, though Billy ... maybe the "plan" is to do more with less!

PS: we are all looking forward to seeing the vacancy advertised in due course!

Mark,
We used to be under estates and "helped out" with a few electronic related problems, control boards for lifts, backup lighting controllers etc. but these were few and far between. We wouldn't consider asking sparkies to assist us, they would probably be straight up to their super. for a pay rise.
We took on some Assistant Technical Officers to work on low tech stuff, they were employed at a lower grade than qualified electricians! A move that I vehemently argued against, after all they are required to do a techician's job at a lower grade.
If you are looking to merge with someone I'd home in on the IT dept. after all there is a greater convergeance between us and IT. There are mainy times that we hve been at the mercy of IT to "allow" us to sort out equipment problems.

Or, better still, have IT "merge" with biomed ...and let them be at the mercy of us!

Not really looking at merging with anyone.

We're being given the opportunity to rethink the protocols that we work by.

"We do it this way because we've always done it this way" is not a good premis to stand by.

Lean thinking is the way forward http://www.idea.gov.uk/idk/aio/5269340

Cheers
Mark

Perhaps one way to waste a little less would be not to hire consultants to spew out the latest BS!

There you are Mark, I've just saved you* £ 20,000, right there!

Nanny says:- "Stop all this old nonsense at once! We have new nonsense now!"

* Or do I mean the tax-payer?

Here's a link to an earlier thread.

Mark
Most Biomed departments in the NHS always have far more to do, than there is time available. It is no good just saying an infusion pump takes an hour, so thats 37 in a week. You also have to consider all the interuptions (cos we are always helpful).
If your department has been running properly, it should always be looking for better ways to do things without affecting the quality of the service.
As Bill has said, are the electricians going to be paid more for doing the same job? Where are they going to get their skills from? Besides which, don't they have their own jobs to do.
Nothing to do with Lean my friend. Stick to horses for courses.

Our division, Facilities, HAS to make a considerable amount of cash efficiencies within the next couple of years. To this end, all departments within Facilities must contribute towards this goal.

Does this mean that I start to clean the workshop myself - who knows.

If I do this, it has the potential to lose a whole-time- equivalent(WTE) cleaner's post. That's a saving, but not a very palitable one.

ALL options are being explored.

Horses for courses, but the going's getting tough.

Cheers
Mark

I don't think that cutting back on cleaners is a good idea, Mark. We are talking about a hospital, after all. And I doubt that the lady concerned is on what we might call "big bucks" anyway. Perhaps you need to glance around for another "big hitter"! Does any other post come to mind?

What more can I suggest ... except perhaps sacrificing the Manager's post? Could you still ... er, manage?

Surely all decisions could still be made, but in the time-honoured biomed fashion ... that is, a show of hands following discussion amongst the lads in the tea room ... and anything a bit more contentious or demanding could always be adjudicated right here, on the forum!

How much is that I'll saved you now? I hope you're keeping a tally, Mate!

We all been directed to make savings, but while the numbers of infusion pumps, monitors etc are ever increasing, the only possible way would be not service them. Suggest that to management, provided of course they sign to take the responsibility if something goes wrong - they'll jump a mile!

As we know, you can only cut so much, before you get down to the bone. All that is obvious, surely. Just look around at the wider scenario throughout the UK (eg, the decimation of industry, ditto the TA, Armed Forces being asked to make selfless sacrifices every day - for what? ... and all the rest); there comes a point where too much has been pared away, and the whole thing becomes non-viable.

The NHS is a bottomless hole in which to chuck money. But, if the Public continue to aspire to a "free at the point of care" health service, then that's what it takes. That is, it is not actually free at all. Just that the cost is, shall we say, a burden shared (in theory at least) by all.

The kit will always be there. And, as has already been mentioned a couple of times, it seems set to increase in number, rather than the reverse. So if "they" want it properly supported, then the resources have to be in place, one way or another, to do that. It's up to "them" (the over-paid Big Shots) to decide if they want the kit properly maintained, or not. It's their call. As I keep saying, "Rocket Science it ain't"!

But see the current thread about "Risk-based PM". In my opinion, it is one of the few sensible, practical, ways of taking matters forward, as it were.

Mark,
We can't realistically employ lean methods in our work. One of the main factors is "just in time". Think how long it takes to get spare parts from certain suppliers. Professional companies like RS and Farnell offer next day delivery but try and ask the big three medical companies for that and you'll be laughed at.
Another thing is the NHS beurocracy they'll stop you doing anything sensible. We had to make a 5% saving each year but are expanding our service. So the finance dept. took £350K of us and gave us back £250 to eapand the service, go figure?

If the NHS want to make savings they should look at the management and administration set-up first, but they would need to hire consultants to do this, better to trim the support services easier option.

I believe that we would all be better served if the NHS was afforded a few years of stability (that is, a respite from the heavy-handed interference by government, and the constant change that this triggers), and given time to consolidate, and properly manage, what it already has.

I also believe that the continued emphasis on cost is an out-dated paradigm, and we should be looking for new, better, and more meaningful ways of measuring the value of the Health Service. Cost per head would always need a mention, but how about more emphasis on the benefits ... and then a comparison with other countries? "Positive spin", if you like.

Live births per 1,000 (or however these things are best measured). Child mortality. Length of average in-patient stay (ie, the shorter the better). A metric for infection containment (or elimination). Number of nurses per head of catchment population. Number of A&E cases per head. Successful outcomes per number of surgical procedures. And stuff like that.

OK, let's get radical. How about number of people per annum turned away from tobacco and alcohol addiction? That way, maybe we could fund a doubling of the number of biomeds! That's it ... pipe-dream over!

And ... back in our own realm ... percentage of PM completed, accumulated equipment downtime (or, to continue in a positive frame of mind ... total uptime*), average response time, average time to repair, and stuff like that. Then get all that published on-line, for (yet another) "league table"! How does that sound?

Although it's always nice to have "happy campers", I'm afraid that the continuation of the cosy set-up of the biomed department (that undoubtedly exists in some places) must be placed a little further down the list of priorities.

* This would be difficult to measure (unless you just assumed that everything not "down", was "up", as it were), and its measurement would itself be ... er, a waste of time! When you thing about it, it's not simply the reciprocal of downtime! It would also (hopefully) be a very high figure when tabled as a percentage. 99.9% or something like that, if every piece of kit was included.

Lastly, remember Petronius?

"We trained hard, but it seemed that every time we were beginning to form up into teams, we would be reorganized. I was to learn later in life that we tend to meet any new situation by reorganizing, and a wonderful method it can be for creating the illusion of progress while only producing confusion, inefficiency and demoralization".

Petronius Arbiter - 66 AD

One of the great quotes from all of history..............

well, that and "I have a cunning plan" !

Yes. I first came across "Petronius" when I was in the army (not, I should make clear, the Roman Army)! That was another organisation where we would never quite have finished completing the earlier "change of plan" before yet another was foisted upon us!

And, of course (and sadly), this continues in the present day, what with the constant "juggling" going on in Westminster.

We had Brigades ... then some bright spark came up with "Field Forces" ... then (a few years later) it was back to Brigades. Same blokes, same barracks, same kit. New paint job!

My old mob (the REME) was traditionally organised in "Workshops" (and why not, for that's exactly what we were ... field workshops, usually ... all of which had a proud history). Now I see they're Battalions. What [censored]! The infantry has Battalions. Why can't "they" leave well alone? That's the trouble (well, one of the many) with this country, there's too many clueless meddlers about ... which wouldn't be so bad, just as long as they were kept well away from having any sort of official influence (interference)!

and yet change is a good thing, in general.
None of us can really tell the final effect of any decisions that we take, only deal with the outcomes. We try something, we screw up, we try something else. This is true of business/public service/politics as it is of anything else. This is how the world progresses, by bumps and jerks (thankyou, no puns required on the jerks reference!) When you get to be as "old and cynical" as Geoff and I obviously are (or am I stepping on your toes here Geoff?) then we (make that I) tend towards a concervative view, yet, it is only by trying that we can progress.
To bring this back to where it started (and to contradict myself in some ways) perhaps the way forward (greater efficiency, cost saving, etc, etc) is indeed to look at more intigration of support services.
Frankly, I don't know, none of us do.

and by the way Geoff, not being ex-forces, what is REME?

.... and I should make a general apology for the standard of my spelling (this applies from now on to all posts), never was my strong point ! Does this post/forum system have a spell check?

No but your browser does

Firefox has one built in.
If you are using IE - you can download a plugin for it.

(Also, the Google toolbar has one built in.)

thanks Huw but I think that might of slightly off the post subject !!!!!!!

Oh no, now I'm in trouble..........................

That ship has long sailed Dave - Petronius?
(Excellent quote though.)

Yes, Dave ... best speak for yourself there, Mate. Rather than conservative, I like to think of myself more of a "radical"!

My own position (and deliberately resisting any temptation here to turn this into a "party political broadcast") is to make the world a better place! And that can mean innovation, but it can also mean adopting proven "best practice" once it has been achieved and demonstrated to be of worth. That is, as I seemingly never tire of saying:- take what is good, and reject the rest!

"Bumping and jerking" a juggernaut the size of the NHS is no mean feat, let me tell you!

PS: not ex-Forces? How come you're claiming to be a biomed then? You'll be telling us you don't have a beard next! [stand back, wait for sparks to fly ... etc., etc.]

Yes, but "best practice" is not a static thing. What was best practice 30 years back (or more) is now seem, quite rightly, as a disaster. Just look at the highrise housing in the UK in the '60s"

"Best practice" must be confronted and chalenged continiously, just as our children do to us and we did to our parents. Such is life.

Anyway, I shall leave you guys to your fun, I'm off.

Agreed (about seeking perfection, that is). Best practice is whatever it happens to be (that is, in the here and now). The problem that some folk seem to have is in identifying what it actually is.

I dare say that we see it all the time - people putting their own self-interest way ahead of any thought about what we might call "the common good"!

Not so sure about the "disasters" of yesteryear, though. No doubt they did the best they could under the circumstances then pertaining. And, frankly, some of what was achieved back in those days was astounding, even when (or should that be, "especially when") judged from our present view point.

But by the way ... there was nothing much wrong with those buildings per se ... the real problem was (and in some case, still remains) some of the dross who inhabited them.

DaveC, REME stands for Royal Electrical & Mechanical Engineers - the Army's fixers. Basically, we'll have a go at anything!

Viret et aertenum.

Isn't that the Light Dragoons motto Geoff? They might not appreciate it being aimed at the REME!! (Although I do hope the corps does flourish).

A Latin Scholar, eh?

Or an ex-trooper, perhaps?

Actually it used to be the motto of the 13th/18th Royal Hussars (Queen Mary’s Own), but was adopted later (upon amalgamation with the 15th/19th The King’s Royal Hussars) by The Light Dragoons, as you mention.

OK, then ... how about Arte et Marte ... or even In Arduis Fidelis?

All of which, of course, has very little to do with Mark's original post!