EBME Forums Forums Management Medical Equipment Management On-Call

Hi,

I am interested in the level of cover various EBME departments have in place for out-of-hours on-call. The number of staff on the rota, types of equipment covered etc. Also are there any large hospitals (trusts) in the UK that don’t provide cover? I’ve heard of a trust that is considering dropping the on-call service altogether.

It will be interesting to see how many replies you get to this one, Bill.

Over the years I have come across a fair number of hospitals who have no on-call arrangements at all!

Hi Bill,

We have no on-call service.

Hi Max,

What arrangements does your hospital have in place if say a defib goes down in the middle of the night? Do the users swap/ borrow equipment from a library or store room? Also what happens if you have a major failure with the central monitoring on ITU, do the staff just work around it?

One suggestion that has been mooted is that BME depts. work shifts & provide weekend cover as part of their normal duty. This would remove the need for on-call, but wouuld probably cost more in terms of number of staff & unsocial working.

How was the "cover" over the long weekend just passed, I wonder?

I appreciate that you're approaching this from the NHS point of view, Bill ... but I may as well remind folk that other circumstances often apply elsewhere.

For instance, although NHS hospitals invariably have more kit than they know what to do with, that's certainly not the case everywhere. So just swapping over the kit (or simply grabbing another from the cupboard or store room) is not always possible.

During my Happy Days in a well-known Desert Kingdom, at least two of "my" hospitals had the biomeds working an over-lapping three-shift system, giving 24x7 cover. With "reduced cover" (usually one bloke) during the night, but sometimes more if we were behind with the work. It was great, as that night-time shift allowed us to clear a great deal of the work that invariably got interrupted during the day, as well as easier access to Theatres etc.

To my mind that level of service is what "real biomeding" should be about ... but I realise that in Blighty, such ideas are not universally welcomed.* A different mind-set, perhaps (as I have mentioned before).

But to be fair, those situations also differed from the NHS situation in that a great deal of hand-holding was "required".

Mind you, operating a shift system generally means "more blokes"; so if that's what the Management is thinking of going for, best make it clear from the onset that more resources will be involved.

* During various forays as an Agency Tech any suggestion that I come in "after hours" has always been greeted (with one exception) with all sorts of "reasons why not" - the usual one trotted out being "lone working", or "lack of supervision" ... blah, blah, blah. Rarely (almost never) did the needs of Doing the Job (aka Clearing the Work) prevail.

Not getting much of a response, oh well.

The move to a shift pattern will obviously cost more, NHS bosses are aware of this, that is why it has been put on the back boiler.
I know of at least one Anaesthetic Engineer who voluntarily works a late shift because he can't access the machines during the day.

Bill,

At Cambridge we do not run an on call system. We have an equipment library that is open for 12hrs a day Mon-Fri and 8hrs on a Saturday. We do have a comprehensive amount of spare equipment to cover equipment failures.

From my personal experience most of the 'faults' staff find over long weekends can be sorted out quickly by competently trained medical staff on the wards. With ventilators and such performing the pre-use checks properly does clear most of these up. Uptime of most modern medical equipment is very good.

We do also get departments asking us to work weekends/nights to cover there equipment, making it easier for them, but we point out that they are but one area we have to cover and while it may work for them it doesn't work for every department and user within the hospital.

That's where the idea of the "Zero-Budget Department" might be the answer. If the user department has (and actually controls) its own tech services (maintenance, whatever) budget, then - in theory at least - it should be able to specify the terms of the service it wants to receive. Just as long as it is willing to pay for it. That's what a "Quality Service" should be:- one that fully meets the customer's requirements.

Are we to assume that your Anaesthetic Engineer doesn't work a day-time shift as well though, Bill?

What's wrong with "flexi-time"? That is, adjusting working hours (or patterns) to suit the needs of the job?

Lots of folk work shifts (and not only in hospitals). Some even have to grapple with "three days of days", a day off, then "three days of nights" (or whatever); that sort of thing is the real killer.

And "unsocial hours"? Just another example of modern day "new speak", in my opinion. Work is work. Those who are in any form of secure employment should count their blessings.

We have two rotas Anaesthetic and Electronics. One week per month on call.ITU ventilators and monitoring networks are the usual call outs.