EBME Forums Forums Management Modernisation (Formerly, Controls Assurance) Outsourcing

Has anyone out there been part of outsourcing found it has not worked and brought it back in house. I have already seen the Whipscross report.

Outsourcing? Of biomed services?

There has always been a certain amount of kit "on contract" wherever I have been (generally stuff that we couldn't take care of ourselves, for whatever reasons).

But I guess you're talking about having a Company come in and take over the whole Biomed Department there, Billy. Why not? You could be in charge!

In the NHS setting, the Manager works for the Trust, and has the Budget. He also has the Task (namely tech support and maintenance of the kit), so - hopefully - he applies his Budget with due diligence to achieve his aims.

Some tasks can only be carried out by bringing people in. One-off jobs, installations and the like. And some specialist kit is best left to contractors, under the watchful eye (again, we hope) of the Manager.

It's nice to have the continuity and local knowledge that the traditional, directly employed biomeds can provide. But there can be downsides to that arrangement as well.

As I've probably said before, as long as every bit of kit is covered, it shouldn't matter too much how (and/or by who) it gets maintained. Just as long as it all gets properly managed (again, I stress).

The "mistake" that folk (or should that be:- idiots?) make is to embrace the notion of "outsourcing" from the viewpoint of "saving money".

The kit (all the kit) has to be maintained somehow. If the in-house crew can't do it all, for whatever reason(s), then there's no harm in bringing in others to do it. Just as long as it's properly managed, with the realisation firmly entrenched that tech support costs money, whichever way you look at it.

I don't know anything about Whipps Cross ... but if it failed, it will have failed due to poor management.

To answer your question, Billy

Salford Royal (Hope) went from in-house to Drager to TBS and currently back in-house.

I worked there under TBS, was there as part of the transfer back to in-house and left about a year later.

Any questions, PM me, and I'll see if I can answer

That must have been an interesting experience Dave. No doubt you could write a book about all that!

In summary, what were the results? Was the kit maintained well over the years? Were the users happy (did they care)? Were the techs happy? ... etc.

Did the Trust "get a result"? Or was that only the Money Men?

How long were those contracts for? I presume they were for a fixed term only. And how many of the in-house guys are survivors from earlier regimes I wonder?

As the NHS gropes its way into the future, I see this as becoming the norm for biomed services:- a repeating cycle of two or three years of this or that, with "in-house" being seen as just another option (and indeed, bidder).

Lastly (and as I must have said a zillion times before), all these innovations may be all well and good, but there are only so many techs available "out there" (and even fewer good ones), so those guys are likely to keep turning up regardless of whomever is supposed to be "in charge".

Meanwhile, I can't help wondering ... what's next for the Hope Hospital?

Put them all out to contract and be done with it!

Sorry to have to tell you this Geoff, but I believe that you have an institutionalised view of EBME in the NHS. Quote - 'In the NHS setting, the Manager works for the Trust, and has the Budget'.

Not necessarily true. This may be the case in the settings that you have seen, but it is not true in mine. I don't have any budget at all and am still responsible for maintaining the 'kit'. In case you are wondering, all the money that we spend, (wages/spares/vehicles etc) has to be earned by maintaining the kit and charging for the service provided.

The system has it's advantages and disadvantages. Keeps us 'on our toes' I suppose. Keeps the wolf from the door as well because the HB know they get a good deal from us.

I do understand that the 'budget' model appears to be the norm, but it doesn't apply everywhere.

Yes Mike, I am aware of the "Zero-Budget Department". It is a method that I am interested in myself. And I wish it got more exposure here on the forum.

But although there may well be others, I only know of two within the NHS. And Carlisle is not one of them, unfortunately.

So yes, we're looking at the "typical situation" here. Without appending a list of Exceptions and Omissions to every post, surely it's understood that (in most cases) we are talking in general terms.

And, in passing, I haven't yet heard of a Zero-Budget Department being outsourced ... although I must admit that it's an interesting thought!

Fair comment Geoff regarding the 'typical situation'. I suppose I did go a bit off topic regarding the original question. Sorry Huw.

My own opinion on outsourcing is that it is obviously finance driven. Yes, financial constraints are commonplace, but as Engineers/Techicians (speaking as someone working in the NHS), we have to resist the bean counters as much as practically possible. It is supposed to be a Health Service after all, not a money making exercise.

Agreed. But (as I've mentioned) sometimes the incumbent crew can't provide all that's expected of them, for one reason or another (such as unfilled posts, staff shortages, poor resources, lack of training ... etc., etc.).

(or even low morale, lack of ambition, poor leadership ... and all the rest)

Geoff, If you went with a third party and they could not meet all the requirements as you have mentioned above at least you should be able to get some of your money back.