From your posting above John:
The average Hospital has 700 - 1000 different models of medical equipment. Even with an infinite budget we would not be able to train on all devices, so we must make decisions based on which equipment carries the hifghest risk to enable us to make decisions on how to spend our training funds wisely. I agree that the NHS needs to invest in training, but we also need to advise on how that money is best spent.
You seem to miss the points I'm getting at John; the irreducible costs involved in purchasing a service manual, buying the spare parts to carry out the repair, and carrying out the repair using a qualified technician following the manufacturers recommended test procedures. This associated with the requirement that the majority of medical equipment requires servicing or at least inspection and functional verification on a regular basis.
Where these costs are insignificant compared to the risks associated with failing to service a range of devices adequately then in-house servicing is cost-effective. Otherwise overall cheaper alternative means have to be found: third-party maintenance, manufacturer, i.e. transferring the risk, or not at all. I would hope that the not at all is not an option considered unless the equipment is disposable or presents very minimal risk to all concerned if it fails.
Perhaps the acquisition of manuals, training, and following manufacturers recommendations seems expensive to some because they compare the costs of servicing to manufacturers recommendations to not servicing equipment at all. Is this the "risk-element in the equation"?
Laying-on of hands, rather than following schematics, etc, etc and fashioning spares from thin-air is not in most technicians capabilities. The other extreme (in terms of cost) of extensive manufacturers training is another issue but at least manuals allow for qualified engineering technicians performing service or repairing equipment without manufacturers training.
That's why each manual usually specifies what should be done, the recommended spares and the test equipment required. It seems, to me, that the minimum we should be doing if we are servicing equipment is to follow recommendations in a service manual or gather enough information from the manufacturer to make a decision as to whether servicing in-house is feasible at all.
If departments cannot afford a manual for each piece of equipment, or the majority of it, the correct spares and the test equipment to service/repair the equipment then perhaps servicing of those devices concerned should not be attempted in-house.
That is why I suggest that the decision to service, in-house or not, based on the information available is made as early as possible (possibly before purchase). A way to do this is to gather information from the manufacturer at, or prior, to purchase. Whichever way one chooses to get the equipment serviced or repaired it will clearly cost money.
The decision of which approach to take when assessing risk should be contatined within the limits of the "compromise" associated with the maximum acceptable risk considered and the "ideal" situation that reduces the risk to an absolute minimum.
Do you have a servicing policy or in-house recommendations for each piece of equipment that you don't have a service manual or manufacturers servicing recommendations John? If not who decides on what's adequate, if they're not manufacturer trained, you don't have a manual or servicing procedures and there's no in-house test schedule? How can you assess or perform calibration of clinical diagnostic equipment without the basic information? Have you evaluated the risks associated for each device in this case?
