EBME Forums Forums Free discussion Free discussion Staffing Levels for EBME deptments.

Do I sense that a consensus is emerging? That's good, and it demonstrates (in my mind at least), what this forum is all about.

No one has come out totally against the idea of PM in principle, and we now seem to be edging towards agreement that flexibility in setting PM intervals is a universal requirement, regardless of the general rationale being adopted. Risk-based PM in all but name, then, whether each of us calls it that or not!

More contributions, please!

@Roger

Traditional :: calendar based, with intervals as recommended (note the word used) by the manufacturer in each case. There's nothing fundamentally wrong with this method. It is after all the "safe" approach (that is, it cannot be criticised by outsiders), and it's all very well as long as you have sufficient resources!

Thanks for noticing my 1), 2), 3) by the way. It's a credo of sorts. Any so-called biomed who doesn't sign up to those basic tenets should be shown the door, in my opinion!

@Webbie

Yes, unless you have a lot of stuff on service contract, I think we can all agree that it sounds like you're well understaffed there, Mate.

@Phil

Your point is well taken. Personally, my interest is in the "universal model" (academic, if you like). I am not an NHS-staffer myself, but the NHS (being, as it were, the "elephant in the room") can hardly be ignored! I subscribe to the view (which is one I have always taken) that good maintenance engineering principles can (and should) be applied and managed whatever and wherever the equipment lays. Each of us has to do the best we can with whatever resoirces are to hand. And I'm taking about tents and huts ... all the way through to the finest hospitals in the world!

Would I do six-monthly PM when all the manufacturer calls for is annually? It would depend upon the condition of the kit after one or two PM cycles (and the passage of time of its being in use). I think we can assume that the manufacturer makes his recommendations based upon an presumption of "typical" use (whatever that may be taken to mean). The manufacturer isn't there, standing alongside, when you make your PM visits, is he? However, you are there, with the kit in front of you ... so it's your call!

Equipment is equipment, repairs are repairs, maintenance is maintenance, electrical safety is electrical safety etc., etc. ... and patients, nursing staff et al ... and biomed techs, are all people, whatever the circumstances locally.

All this waffle on 3 months, 6, months do ppm's, don't do ppm's, not one mention of the legal aspect should a piece of kit fail due to a lack of maintenance and cause grief to the patient (that is the reason we have biomedical technicians and not TV repairmen)

You're mistaken there Neil, I'm afraid. The legal aspect has been touched on, both here and in the earlier threads linked to.

But, seeing that you're with us ... what's your own take on all this:- simply following manufacturer' recommendations, ECRI guidelines, national standards (ie, the norms in Saudi Arabia), or what?

Are you happy with the idea of flexibility in setting (and adjusting) PM intervals? You still do PM, I hope!

And your second point is a bit nebulous, Mate. We're talking about staffing levels (and now we've drifted off into approaches to PM). The quality of the common or garden biomed tech is taken as a given for the purposes of this discussion!

Back to the original question, remove all the equipment that is under contract and the do as Geoff has already indicated find out how many man hours you require to do a proper PM of all the remaining equipment. 100 pulse oximeters will require a lot less time than 100 patient monitors, do not forget to compensate for lost (in the back of the cupboard) equipment, equipment in use, the pm is also required to update the inventory.

Geoff, we are now in the process of accepting MSD standards for all MODA hospital, but as of yet they have failed to standardize the asset management, HIS, RIS or any other software. They had a contract with NEXUS but started doing bits and pieces in different hospitals rather than setting up one hospital as a standard for the rest. Also CBAHI will be taking over the responsibility of all medical institutes for standards and build quality. Slowly the country is being dragged into the present century.

AH or AD?

It all sounds like a bit of a dog's dinner to me, Mate (but, there again, what else is new)! Remember MAMISS?

Too many vested interests, I should imagine. But I digress ...

Meanwhile, please note that I have started a new thread about Risk-based PM (and any or all related matters, no doubt)!

I hope that your original post has been adequately answered here, Webbie. Obviously, the more techs you have available, the better the tech support of your equipment will be.

The "problem" (as always) is in getting Senior Management to agree (and then conjure up the necessary funding) ... and then, the realisation that good techs "don't grow on trees".

Off the top of my head, I would suggest that the NHS in England and Wales would benefit greatly from an instant doubling of the number of biomed techs in its employ*. And then positioning them where the need is greatest (like at your place, by the sound of things). But again ... funding? And ... where are those techs to be found?

Regarding staffing level "norms", as I have already hinted at, I believe it would be both illuminating and instructive to establish the relationship across the NHS of total numbers employed by the Trusts versus the number of biomeds! With such figures to hand (and it could be in the order of 1%), coupled with the number of maintainable items of equipment ("assets") in each case, perhaps then an "ideal" level of staffing could be arrived at.

As to grades ... well, the usual mix should apply, I expect. But (from my own way of looking at things), I would put more emphasis on what is to be maintained (that is, the equipment) and then recruit and assign staff accordingly. For instance, in larger hospitals (such as yours), I would favour having techs with special skills (anaesthesia equipment, x-ray etc., etc.). And lastly (while I'm at it), I would want to take over the complete show, including the labs and all the x-ray equipment as well (that is, as we were always used to doing in other parts of the world). Why not?

* But, strangely enough, I don't think it got a mention at any of the recent political party conferences.

Just to move on side ways, what about the PCT and GP equipment out there.

Similar principles apply. Kit is kit, wherever it lays.

I believe that we would all be best served if NHS biomeds stopped trying to "make it fit" (that is, struggling to contain more and more work, without being given the necessary resources), and simply put their hands up and said "we can't do all this stuff" (especially at the quality levels, response times, and all the rest, seemingly expected - demanded - these days)!

Whack the ball firmly back into Management's court. After all, it's those Big Shots who are raking in the wonga ... supposedly for their leadership, problem solving skills, or whatever. Simply put, if "they" want the service, it's up to them to stump up the funding it takes to carry it through.

The theory is great but there are few qualified techs out there at band six level, we have advertised with poor response. A lack of investment in our profession over the years has resulted in the current recruitment problems.