EBME Forums
Posted By: bcarlisle Outsourcing - 05/01/12 12:42 PM
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.
Posted By: Geoff Hannis Re: Outsourcing - 07/01/12 11:04 AM

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. smile

I don't know anything about Whipps Cross ... but if it failed, it will have failed due to poor management.
Posted By: Dave H Re: Outsourcing - 07/01/12 11:19 AM
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
Posted By: Geoff Hannis Re: Outsourcing - 07/01/12 11:26 AM

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". smile

Meanwhile, I can't help wondering ... what's next for the Hope Hospital? think
Posted By: Neil Porter Re: Outsourcing - 07/01/12 12:08 PM
Put them all out to contract and be done with it!
Posted By: Mike Burns Re: Outsourcing - 07/01/12 7:39 PM
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.
Posted By: Geoff Hannis Re: Outsourcing - 07/01/12 8:38 PM

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! think
Posted By: Mike Burns Re: Outsourcing - 07/01/12 9:09 PM
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.
Posted By: Geoff Hannis Re: Outsourcing - 07/01/12 9:17 PM

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) frown
Posted By: Neil Porter Re: Outsourcing - 09/01/12 4:24 AM
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.
Posted By: KM Re: Outsourcing - 09/01/12 12:56 PM
Interesting thought.
Who do you get to manage that the 3rd party isnt just ripping you off or just siting there collecting their fee?
Posted By: bcarlisle Re: Outsourcing - 09/01/12 1:01 PM
We are talking about outsourcing the department not the equipment here. The staff that already maintain the equipment move their allegiance to the darkside. It still costs the same in heating/lighting etc, they will no doubt take ownership of the test equipment and intellectual rights acquired under the NHS ownership. Seems like there is only one winner and it is not the public purse.

As for the rip off comment above and control of it, well guess what, that has not been put in place by competent persons. Well we are talking the NHS here logic does not come into it.

Posted By: Geoff Hannis Re: Outsourcing - 09/01/12 1:04 PM

And the winner is ... ? think

If managers in the NHS can't be arsed to manage ... then they deserve all that's coming to them, surely (like:- the boot, if I had my way)? If they lack the skills required to manage a decent biomed service, then they shouldn't moan too much if such skills have to be brought in from outside. Sounds logical enough to me. Especially as the tax-payer expects the job to be done properly ... somehow.
Posted By: Joe Emmerson Re: Outsourcing - 25/03/12 8:30 PM
To be absolutely honest, if its outsourced and they do a good job, save money and provide a better quality through scale of economies etc then all should be good for your department.

You have nothing to loose to be honest as TUPE would apply. If it doesnt work well (cost/quality) there is always the option to bring it in-house again with equivelent funding which is something you may struggle to do now.

There are some good managed service providers out there now with some experience in the sector
Posted By: Phil Coulthard Re: Outsourcing - 03/04/12 12:37 PM
Hi Geoff

Just thought you might want to know about this current Tender, through the NHS Supply chain. Is there anyone that is NOT affected by this? What are your thoughts about it? Privatisation through the front door?

The Tender is divided up into lots. This is a framework agreement lasting 2 to 4 years.

1 £ 6400000

Maintenance and repair of Beds and Pressure Area Care equipment, against the following equipment areas:

2, 3, 4 section profiling beds and associated equipment
Birthing beds and associated equipment
Critical care beds and associated equipment
Bariatric beds and associated equipment
Cots and associated equipment
Treatment couches and associated equipment
(Beds that can go through a bed washer) and associated equipment
Dynamic mattresses and associated equipment
Pressure managing chairs and associated equipment


2 £ 2000000

Maintenance packages for Patient Handling equipment, against the following equipment areas:
Patient hoists and associated equipment
Specialist hoists and associated equipment
Portable bath lifts and associated equipment
High low baths and associated equipment
Calibration of hoists and hoist scales and associated equipment
Stretchers and associated equipment

3 £ 12000000

Maintenance packages for Patient Transport equipment, against the following equipment areas:

Powered trolleys, including mortuary trolleys and associated equipment
Manual trolleys, including mortuary trolleys and associated equipment
Patient transfer chair and associated equipment
Powered wheelchairs and associated equipment
Non powered wheelchairs and associated equipment

4 £ 23400000

Maintenance packages for Patient Assessment and Monitoring equipment, against the following equipment areas:

Foetal monitoring and associated equipment
Theatre & anaesthetic monitoring and associated equipment
Vital signs and Ward based/bedside monitoring and associated equipment
Cardiac output monitoring and associated equipment
Telemetry monitoring and associated equipment
ECG analysis recording equipment and associated equipment
Cardiac stress testers and associated equipment
Holters and analysers and associated equipment
AMB monitors, including Sphygmometers and associated equipment
Audiometry and associated equipment
Pulse oximetry equipment and associated equipment
CPAP devices and associated equipment
Spirometers and associated equipment
Temporary pacing units and associated equipment
Oxygen regulators and associated equipment

5 £ 1480000

Maintenance packages for Urology equipment, against the following equipment areas:

Mobile lithotripters and associated equipment
Fixed lithotripter, (electro conductive) and associated equipment
Fixed lithotripter, (extra corporeal shock wave) and associated equipment
Bladder scanners and associated equipment

6 £ 2400000

Maintenance packages for Neonatal equipment, against the following equipment areas:

Open neonatal incubator/warmer and associated equipment
Closed neonatal incubator/warmer and associated equipment
Phototherapy units and associated equipment

7 £ 84000000

Maintenance packages for Endoscopy equipment, against the following equipment areas:

Rigid endoscopes and associated equipment
Flexible endoscopes and associated equipment
Electromed equipment and associated equipment

8 £ 10880000

Maintenance packages for Ophthalmology equipment, against the following equipment areas:

Aberrometry equipment and associated equipment
Auto refractors equipment and associated equipment
Biometry and Ultrasound equipment and associated equipment
Computerised sight charts and associated equipment
Ophthalmic Diagnostic cameras, inc retinal cameras and associated equipment
Perimeter equipment and field analyser equipment and associated equipment
Lens Meters and associated equipment
Multifunctional Equipment and associated equipment
Pachymetry equipment and associated equipment
Retinal Angiograph Equipment and associated equipment
Retinal tomography and OCT machines and associated modules and equipment
Slit lamps and associated equipment
Specular Microscopy equipment and associated equipment
Topography & Keratometry equipment and associated equipment
Phacoemulsification and Vitrectomy equipment and associated equipment
Perimeter equipment and associated equipment
Phoropter equipment and associated equipment
Pupilometer equipment, inc/ PD Meters and associated equipment
Gloucometry equipment and associated equipment
Retinal imaging equipment and associated equipment
Corneal cross linking equipment and associated equipment

9 £ 3400000

Maintenance packages for Laser equipment, against the following equipment areas:

Dermatological lasers and associated equipment
Surgical lasers, (Urology and General and ENT) and associated equipment
Ophthalmic lasers and associated equipment

10 £ 17600000

Maintenance packages for Renal equipment, against the following equipment areas:

Haemodialysis and associated equipment
Heamofiltration and associated equipment
Peritoneal dialysis and associated equipment

11 £ 11600000

Maintenance packages for Orthopedic equipment, against the following equipment areas:

Orthopaedic power tools and associated equipment
Arthroscopy equipment and associated equipment
Trauma equipment and associated equipment

12 £ 38400000

Maintenance packages for General theatre equipment, against the following equipment areas:

General operating tables and associated equipment
Specialist operating tables, including transfer systems and associated equipment
Mortuary tables and associated equipment
Mortuary tables, including down draft and associated equipment
Invasive ventilators and associated equipment
Non invasive ventilators and associated equipment
Mobile theatre lights and associated equipment
Anaesthesia equipment including vaporizers and associated equipment
Fixed operating lights and associated equipment
Pendants and associated equipment
Theatre control panels and associated equipment
AED inc/ with manual override and associated equipment
Manual defibs and associated equipment
Electro surgical generators and associated equipment
Smoke evacuators and associated equipment
Suction Units and associated equipment
Intra Aortic Balloon Pumps and associated equipment
Rotablation equipment and associated equipment
Heart and lung perfusion equipment and associated equipment
Cardiac lung function and associated equipment
Oxygen regulators and associated equipment
Cardiac electrophysiology and associated equipment
Cardiac transducers and associated equipment
Volumetric infusion pumps and associated equipment
Syringe infusion pumps and associated equipment
Patient warming equipment, including blanket warmers and associated equipment

13 £ 25600000

Maintenance packages for Small Laboratory equipment, against the following equipment areas:

Amplification equipment and and associated equipment
Analytical equipment and associated equipment
Blending equipment and associated equipment
Drying equipment and associated equipment
Heating equipment and associated equipment
Histology/Histopathology equipment and associated equipment
Liquid Handling equipment and associated equipment
Measurement equipment and associated equipment
Mixing equipment and associated equipment
Pumping equipment and associated equipment
Sample Preparation and associated equipment
Separation equipment and associated equipment
Shaking equipment and associated equipment
Storage and safety equipment and associated equipment
Pipettes and associated equipment

14 £ 15600000

Maintenance packages for General Pathology equipment, against the following equipment areas:

Blood gas analysers and associated equipment
Gas chromatography-mass spectroscopy and associated equipment
Mass spectroscopy and associated equipment
Point of care urinalysis analyser and associated equipment
Point of care drugs of abuse analyser and associated equipment
Point of care HBA1C analyser and associated equipment
Point of care blood glucose analyser and associated equipment
Point of care coagulation analyser and associated equipment
Point of care cardiac marker equipment and associated equipment

15 £ 18000000

Maintenance packages for Microbiology and Serology equipment, against the following equipment areas:

Automated blood culture systems and associated equipment
Random access immunoassay system and associated equipment
Automated identification and susceptibility analyser and associated equipment
Automated ID of TB system and associated equipment
Open immunoassay elisa processer and associated equipment
Urinanalysis system and associated equipment
Malditoff system and associated equipment
Plate streakers and associated equipment
NAATS molecular testing analyser and associated equipment

16 £ 3200000

Maintenance packages for Hematology equipment, against the following equipment areas:

Full blood count analyser and associated equipment
Slide maker/slide stainer and associated equipment
Digital morphology and associated equipment
Automation and associated equipment
Coagulation and associated equipment

17 £ 15000000

Maintenance packages for Biochemistry equipment, against the following equipment areas:

HPLC analyser and associated equipment
Immunoassay analyser and associated equipment
Electrophoresis Analyser and associated equipment

18 £ 10400000

Maintenance packages for Cytology equipment, against the following equipment areas:

Liquid Based Cytology analysers and associated equipment
HPV screening analysers and associated equipment

19 £ 8000000

Maintenance packages for Microscope equipment, against the following equipment areas:

Upright Microscopes and associated equipment
Inverted Microscopes and associated equipment
Camera and Imaging Systems (both analogue and digital) suitable or Microscopy and associated equipment
Digital pathology microscopes and associated equipment
Laboratory microscopes and associated equipment
Virtual Slide scanners and associated equipment
Digital Slide scanners and associated equipment
Operating microscopes and associated equipment
Outpatient microscopes, including dental and associated equipment
Ophthalmic microscopes and associated equipment

20 £ 7954000

Maintenance packages for Refrigeration equipment, against the following equipment areas:

Blood Tracking and associated equipment
Ward Fridges and Freezers and associated equipment
Pharmacy Fridges and Freezers and associated equipment
Laboratory Fridges and Freezers and associated equipment
Temperature Monitoring and Mapping and associated equipment
Economy Refrigerators and Freezers and associated equipment
Fridge Freezer Combination Units and associated equipment
Sample Carriers and associated equipment
Temperature Loggers and associated equipment
Blood Bank Refrigerators and associated equipment
Plasma Storage Freezers and associated equipment
Ice Machines and associated equipment
Cryogenic and associated equipment
Ultra Low Temp Freezers and associated equipment
Body chambers and associated equipment
Mortuary freezers and associated equipment

21 £ 528,000,000

Maintenance packages for Imaging equipment, against the following equipment areas:

CT and associated equipment
MRI and associated equipment
Nuclear inc Gamma and PET and associated equipment
Mammography and associated equipment
Ultrasound and associated equipment
Fluoroscopy and Angiography and associated equipment
General and Mobile X-ray and associated equipment
CR Readers and associated equipment
Mobile Image Intensifiers and associated equipment
Contrast Injectors and associated equipment
Bone Densitometry and associated equipment
Probes and associated equipment

22 £ 128,000,000

Maintenance packages for Radiotherapy equipment, against the following equipment areas:

Treatment Systems and associated equipment
IT Systems Recording and Verification and associated equipment
Treatment Planning Systems and associated equipment
Simulation software and associated equipment
Quality Assurance Systems and associated equipment

23 £ 30720000

Maintenance packages for Washing and Sterilisation equipment, against the following equipment areas:

Washer disinfectors and associated equipment
Automated endoscope re-processers and associated equipment
Water treatment, (Softener and Reverse Osmosis) and associated equipment
Drying cabinet and associated equipment
Laboratory Water and associated equipment
Porous load steam sterilisers, including autoclaves and associated equipment
Hydrogen peroxide sterilisers and associated equipment
Ultrasonic cleaner and associated equipment
Trolley washer and associated equipment
HTM testing.

24 £ 1920000

Maintenance packages for Sluice equipment against the following equipment areas:

Pulp macerators and associated equipment
Bed pan washers and associated equipment
Incontinence macerators and associated equipment
HTM testing.

25 £ 2560000

Maintenance packages for Calibration and Repair of equipment, against the following equipment areas:

General purpose electrical test equipment and associated equipment
General purpose mechanical equipment and associated equipment
EME testing equipment and associated equipment
Pressure flow equipment and associated equipment
Weighing equipment and associated equipment
Temperature monitoring equipment and associated equipment
Radiation equipment, inc. microwave and gamma and associated equipment
High accuracy calibration and associated equipment
Luminance equipment and associated equipment
Optical equipment and associated equipment
Pathological equipment and associated equipment
Humidity and moisture equipment and associated equipment

26 £ 109148

Maintenance packages for Dental Washing equipment, against the following equipment areas:

Ultrasonic cleaners and associated equipment
Washer disinfectors and associated equipment
Sterilizers and associated equipment
Water treatment systems and associated equipment

27 £ 328000 to £ 3936000

Maintenance packages for Dental equipment, against the following equipment areas: Dental chairs and associated equipment Dental compressors and associated equipment Dental imaging and x-ray and associated equipment
Posted By: Geoff Hannis Re: Outsourcing - 03/04/12 6:45 PM

To be honest Phil, I don't even understand what it is we're looking at.

"Maintenance packages" ... what does that mean? I suppose we could guess, but guessing doesn't really cut the mustard with stuff like this, does it?

Does it mean PM, on-site, resident engineers ... or what?

Who provides the resources (workshop(s) etc.) ... how? To what level? And where?

What sort of level of service are we talking about? Techs on site? PM to manufacturers' recommendations etc., etc. (the list is endless).

And what are those prices? Or, put another way:- how can anyone tender if prices are already given?

All very strange, in my opinion.

But what I do know is that anyone would be taking a gigantic risk on bidding on anything like that without first visiting the site(s) (and it could even depend upon where they actually are), taking an inventory of the kit and assessing its condition.

Privatisation? Not really. Someone putting out feelers ... or simply a "fishing" exercise, perhaps. think
Posted By: CHJ Re: Outsourcing - 04/04/12 7:48 AM
Hi Phil, Geoff,

My interpretation of it is that it is Framework Agreement. As far as I can guess this is open to all companies that wish to be able to provide services to the NHS - I don't think that it means services are going to be outsourced but means that should an individual trust wish to outsource a particular part of the service that they will then have a list of companies that have passed a global vetting and have been approved to work in the NHS.

At the moment it is still just in the PQQ stage - no formal tender has actually been released. Companies can go for as many or as few lots as they want.

The values against each lot are just an indication of the expected value of that lot - the prices have not really come from anywhere but just provide any bidding companies a chance to estimate the scale of the works.

I'm sure once the PQQ stage has been completed and when the ITT comes out that there will be further information available but we'll have to wait and see about that.

Regards,
Posted By: biomedbill Re: Outsourcing - 04/04/12 9:40 AM
Like Geoff I'm equally confused. Is someone within the NHS (or the private company, NHS Supply Chain) putting ALL NHS equipment servicing out to tender? If so I'd better get my Stormtrooper outfit out of the wardrobe and swear allegiance to the Dark Side again. Just had to check the date on Phil's post, unfortunately it's not April 1st. Anyone got more background on this?
Posted By: CHJ Re: Outsourcing - 04/04/12 10:25 AM
Below is the extract from the PQQ information page:

The purpose of this framework is to procure service providers who can offer maintenance contracts for the range of equipment included in the various lots included within the tender. NHS Supply Chain reserves the right to exclude any organisation that does not meet these criteria.
It is anticipated that the framework services will be accessed: by framework users who: (i) wish to purchase a defined service package to cover equipment currently included in their installed base and (ii) wish to purchase point of sale maintenance in relation to newly purchased in-scope equipment.
It is anticipated that the maintenance contracts will be in the form of packages for different cover levels against the relevant equipment.
The framework will be for a maximum of four years but it is recognised that individual service packages, purchased in relation to specific equipment, during that period may be for a term exceeding four years.
It is intended that the framework provide a basis for comparison of service level packages provided by different service providers across the range of equipment covered by scope of the tender. The intention is that customers ordering under the framework will be able to procure their maintenance contracts on a more accurate and benchmarked basis and in a way which takes a more sophisticated approach to risk analysis of such matters as criticality of equipment failure than is currently available.

NHS Supply Chain intends to use a series of commercial levers throughout the course of the framework agreement, including but not limited to: operating a management fee on all orders through the framework; prompt settlement discounts; aggregated turnover discounts; on time renewal discounts and bulk purchases. Further details regarding the operation of these will be included in the tender documentation. NHS Supply Chain reserves the right to implement these and other commercial levers throughout the course of the framework agreement.

Tenders and all supporting documentation for the contract must be priced in sterling and written in English. Any agreement entered into will be considered a contract made in England according to English law and will be subject to the exclusive jurisdiction of the English Courts. NHS Supply Chain is not liable for any costs incurred by those expressing an interest in tendering for this contract opportunity. NHS Supply Chain reserves the right to terminate the procurement process (or part of it), to change the basis of and the procedures for the procurement process at any time, or to procure the subject matter of the contract by alternative means if it appears that it can be more advantageously procured by alternative means. The most economically advantageous or any tender will not automatically be accepted.

All communications must be made through NHS Supply Chainís eTendering portal at http://procurement.supplychain.nhs.uk/ using the Message Centre facility linked to this particular contract notice.

Please note that the number of maximum suppliers as set out in II.1.4 is provided as an estimate only. The Invitation to Tender will detail how suppliers can be awarded to the framework agreement. NHS Supply Chain reserves, therefore, the right to appoint more or less suppliers to the Framework Agreement in the event that more or less than 400 reach the minimum score for appointment which will be set out in the ITT.

NHS Supply Chain intends to enter into arrangements under which it will be entitled to purchase services and/or supplies which it will make available for purchase by 1) any NHS Trust; 2) any other NHS entity; 3) any government department, agency or other statutory body and/or 4) any private sector entity active in the UK healthcare sector. Only NHS Supply Chain can order from the Framework Agreement and enter into contracts under it.

Regards,
Posted By: RoJo Re: Outsourcing - 04/04/12 10:26 AM
Has anybody done outsourcing the other way round? (In sourcing???)
i.e. an NHS hospital department selling their services to a private hospital/organisation.
Thank
Robert
Posted By: CHJ Re: Outsourcing - 04/04/12 10:45 AM
Hi Robert,

I'm aware of a few that do this. The main team that I can think of are MEMO at University Hospital Bristol - they also provide the EBME deartment for Weston General.

There are also a few EBME teams that we have spoken to about working together for mutual commercial benefit. That is to say that we can share resources and both make money.

Wasn't there an earlier topic about some EBME departments that operate on zero budgets and that everything that they do is billed to the relevant department requiring their services? Surely that could be a model that some other trusts could adopt?

Regards,
Posted By: Phil Coulthard Re: Outsourcing - 04/04/12 10:47 AM
Hi Chris, Geoff and anyone else interested, The point made by Chris above is correct. The specific terms of the Tender are unknown at this time as it is only at the PQQ stage. I raised the issue because of the shear size of the tender being looked at. This is no secret and anyone can still apply by expressing interest from the OJEU web site

http://ted.europa.eu/udl?uri=TED:NOTICE:81742-2012:TEXT:EN:HTML&src=0

I am no lover of big business taking over hospital services ie privatisation through the back door. But I am no lover of state control either. I am a member of a coop and I believe this is a third way. We compete for business, take ownership and responsibility and accountability for what we do. We are democratic in the way we do business. I am looking for potential partners from the EBME community who would like to take some of this work from the bigger fish out there. I think it was Neil Kinnock who coined the phrase "dont get mad, get even"
Posted By: Geoff Hannis Re: Outsourcing - 04/04/12 7:29 PM

I'm pleased that you mentioned the word "fish" there, Phil ... because I'm still of the opinion that that is what it is:- simply a fishing exercise.

My recommendation would be to waste no further time on it. It's easy to get excited about "bidding", and easier still to spend (waste) many man-hours in putting together a decent proposal. But you can only do that if you are given (or more usually, buy) a decent RFP* in the first place.

If you had mentioned in the first instance that the extract you gave was from "Europe" ... I would have said "bin it" straight away. How can you be sure that the locations are not in Italy, or some such place? Or even (more likely) that contractors from "most favoured nation(s)" don't already have their names in the frame?

Forget it, Mate ... you'll just be "making up the numbers" (of bidders), if that. frown

* Request For Proposal (or "Document to Bid Against").

PS: I doubt that the phrase mentioned was coined by the particular gentleman you suggest ... nothing he ever said (or, presumably, still says) was likely to be original. As he is now a time-served free-loader on the EU gravy train (along with at least one other member of his family, of course), it wouldn't surprise me if the poorly drafted, vague and unhelpful document you cite came from his office.
Posted By: Geoff Hannis Re: Outsourcing - 04/04/12 7:51 PM

Yes, Chris ... a poor attempt at a Pre-Qualification Document.

The theory being that when (or if) a real RFP comes along, only bidders who have pre-qualified will be invited to bid.

I say "theory" because, as those of us who inhabit the Real World are only too aware, "money talks", so no doubt a "Pre-Qualification" could be hurriedly pushed through (or indeed, waived) should Mr.Big & Co. decide that they want to bid on the day.

As I say (and without in any way wishing to rain on Phil's parade of enthusiasm) ... a complete waste of time, effort and nervous energy for any of the posters to this forum whom I am aware of.

Forget it. frown

Further reading:-

1) One
2) Two
Posted By: Geoff Hannis Re: Outsourcing - 04/04/12 8:07 PM

Originally Posted By: RoJo
Has anybody done outsourcing the other way round? (In sourcing???)
i.e. an NHS hospital department selling their services to a private hospital/organisation.

Yes, Robert. I know of one or two. But not with great success, in my opinion. Frankly, they should have spent all their energies on what the tax-payer was paying them for*. That is, getting their own house (department) in order first. At least that way they would have had something to "showcase".

"Enthusiastic amateurs" is what I called them at the time. smile

* Not to mention "unfair competition" (like using tax-payer funded tools and test equipment to carry out "private" work). I should also mention "insurance" (as in:- lack of).
Posted By: Geoff Hannis Re: Outsourcing - 04/04/12 9:04 PM

Originally Posted By: Phil Coulthard
I am a member of a coop and I believe this is a third way. We compete for business, take ownership and responsibility and accountability for what we do. We are democratic in the way we do business. I am looking for potential partners from the EBME community who would like to take some of this work from the bigger fish out there.

As you know, Phil, I have always been a proponent of co-operatives, and collaborative projects, myself. But (most likely due to my own failings as much as anything else) have never really been able to pull them off.

Perhaps I have been unlucky, but my search (over many years now) for "true buddies" with sufficient skill-sets (etc.) who are willing to share in all respects has only ever turned up slim pickings, to say the least. Most blokes I have ever come across are happy enough to "join in" once things get going, but those who are willing to take on a share of the risks (or, for that matter, the planning burden) as well are, shall we say, few and far between. frown

I'm pinning up this post now just to emphasise what you are saying. Who knows, perhaps someone will see it, and spark! smile
Posted By: Mike Burns Re: Outsourcing - 05/04/12 9:09 AM
Rojo - In response to your question, does any other NHS department do insourcing? - yes we do. We do work for local Private Surgeries, Carehomes and even Leisure Centres.
Posted By: Phil Coulthard Re: Outsourcing - 05/04/12 7:51 PM
Well, I'll soldier on Geoff, someone will one day look for an alternative and who knows in the archives they may find this note. I am having a go at the PQQ, not too demanding, we have the financial standing now and track record.

We can have a go at most general rad units and ultrasound but I had hoped to cover general biomedical boxes, ECG, defibs ect. I used to work on this stuff years ago at Jimmy's but a bit out of touch. So if anyone wishes to pitch in and is qualified to so, please get in touch.

If anyone is wondering where the idea of the coop came from, it was the old Peripatetic music teachers in Newcastle, who were all made redundant during the Thatcher years. They formed a marketing coop, shared work, wrote song sheets and started building simple instruments which they sold. Simple stuff really. Its still going today.
Posted By: Geoff Hannis Re: Outsourcing - 05/04/12 8:41 PM

Good luck with that, Phil. I'm sure we all wish you well. smile

That's a nice story about blaming Margaret Thatcher. But I think you'll find that workers co-operatives in England go back at least as far as the 1830's.

Yes, simple stuff. Wholesome, even ... but somehow at odds with the climate of greed and individual selfishness that we see all around us today. frown
Posted By: Phil Coulthard Re: Outsourcing - 06/04/12 7:03 AM
Perhaps someone can help me out with some basic maths. From this PQQ,

21 £ 528,000,000 Maintenance packages for Imaging equipment,
4 £ 23400000 Patient Assessment and Monitoring equipment

for item 21 based on around 500 trusts thats approx £1M per trust which is about right for the Radiology maintenance budget. If I apply the same reasoning to item 4 , that approx £47K for Patient monitoring. Is that the sort of figure spent today by current outsourced work to manufacturers? I honestly dont know. We did all of the repairs back in the 80's so the OEMs only installed the kit. Things may have changed. This is a 2 to 4 year framework so it could show the current governments thinking for the near future.
Posted By: Geoff Hannis Re: Outsourcing - 06/04/12 7:10 AM

500 Trusts? Are there that many (and with x-ray kit)?

Who knows where these figures come from! Monkeys in Brussels?

I (for one) still don't really understand this stuff ... where does the figure of £ 48 K comes from? And - if it's a "given" - what (if anything) can you do about it? think

And, more importantly, what work are you actually supposed to do for that amount?
Posted By: Phil Coulthard Re: Outsourcing - 06/04/12 7:11 AM
Im sure you are right Geoff about coops back in the 1830's but I wasn't around then. I was in the Thatcher era and witnessed the hopelessness of people at that time who became unemployed.

I guess Im just a Moonwalking Bear

http://www.schumachercollege.org.uk/blog...jonathan-dawson
Posted By: Geoff Hannis Re: Outsourcing - 06/04/12 7:12 AM

Well, no doubt you're witnessing it all over again now, then. frown

And who is to blame this time ... ?
Posted By: Phil Coulthard Re: Outsourcing - 06/04/12 7:37 AM
Well thanks for the first correction I meant hospitals. There are currently 144 Trusts

http://www.monitor-nhsft.gov.uk/about-nhs-foundation-trusts/nhs-foundation-trust-directory

So the figure for item 21 is greater than £1M per trust.

So can you give a notional figure of basic items in item 4, comparative to x-ray of the spend in a typical trust?
Posted By: Geoff Hannis Re: Outsourcing - 06/04/12 7:46 AM

I'll leave that to others, Phil. smile

As I've tried to point out, I am resigned to live in the Real World myself.
Posted By: Phil Coulthard Re: Outsourcing - 06/04/12 7:57 AM
Not in the blame game. I believe its evolution we need not revolution. I dont want to waste this forums time with issues that are irrelevant so I wont get on my soap box.

There is some relevance though in how we choose to work. There are certain realities that are heading all our way. We cannot rely on exponential growth to feed the current model in a world that is of finite resources. The government knows this but in 5 years what can they do? They barely scratch the surface of the problem.

So yes I think coops are very relevant today as the state shrinks and people look for alternatives.

I am also in favour of open source manufacturing whereby products are made by end users and sw is developed by a community. It might mean the alternative to an iPad is the size of a encyclopedia but the community would have the fun of building it and knowing how it works. This is all part of the same story. Local growth, community, ownership.
Posted By: Geoff Hannis Re: Outsourcing - 07/04/12 7:42 AM

You're not wasting the forum's time, Phil ... but with a nod to Billy's original post at the beginning of this thread, it might be worth starting a new topic if we're going to discuss workers' co-operatives. smile

Yes, co-ops are relevant, but I think you'll find that takers are few and far between. You mention that the state is shrinking, but I don't see that. Successive governments have layered more and more control* over the people, to the extent that a sizeable chunk of the population (it could even be the majority) are dependent. I see them every day, and everywhere I go:- the common herd, immobilized by sloth. Not many entrepreneurs there, Mate. And that's just what the One World Government agenda wants, of course.

It's all very well talking about evolution. But some (most) of us simply can't wait that long! frown

Anyway, Sam and Dave have already got all this covered:- didn't they call it the "Big Society" or some such thing?

* Actually it's worse than that ... they seem intent on criminalising everybody as well. No doubt we're already well beyond the point where they have a "file" on everyone.
Posted By: Geoff Hannis Re: Outsourcing - 07/04/12 1:38 PM

Originally Posted By: Phil Coulthard
I am also in favour of open source manufacturing whereby products are made by end users and sw is developed by a community. It might mean the alternative to an iPad is the size of a encyclopedia but the community would have the fun of building it and knowing how it works.

Actually Phil, thanks in no small measure to the internet, there is a fair amount of that sort of thing already going on.

The "Retro Computer" scene, for example, is very strong ... with some of the recent "home grown" stuff better in many ways than the original(s). Check out this thread when you have time.

Us Brits are good at that sort of thing, are we not? The Classic Car (Motor-cycles, Tractors et al* ... Caravans, even) scene also comes immediately to mind. It's great that enthusiasts club together (literally) to keep all that good old stuff going ... now well beyond the design life (if indeed the designer at the time considered that at all - probably not is my guess).

And, of course, Open Source software has always been well supported. smile

* Check out one of my favourites:- www.spiritburner.com!
Posted By: Graham Roberts Re: Outsourcing - 19/04/12 2:06 PM
We used to outsource some specialist services such as scope repairs etc and do everything else within the hours available in house. Outsourcing is not reasonable for all tasks e.g. the little old lady who used to call in with her nebuliser for service. We used to sit them down and chat to them while we serviced the nebuliser - they thought it was wonderful and also I hasten to add, showed that we cared.
Posted By: Lee S Re: Outsourcing - 19/04/12 3:32 PM
We used to do the old ladies nebulisers as well, but you could not do it these days with the excessive levels of tar and nicotine that invariably coated the unit.

Lee
Posted By: Dave H Re: Outsourcing - 19/04/12 4:43 PM
I think Lee if your unit is covered in tar and nicotine then you should seriously consider asking your smokers to go outside
Posted By: Mithrandir Re: Outsourcing - 22/06/12 1:46 PM
I still believe that we, as biomeds, need to be on site to give that first line response, you know the jobs, changing the lamps in the lightsource to stop the whole endoscopy list being cancelled. Not big money jobs but need a "man what can".

All that PM work that could easily be outsourced pays our wages to be on site to do the silly jobs.

These silly jobs that we have seen in the PFI schemes means it costs £120 to change a light bulb.

Outsourcing just means another layer of "profit" to be paid out to someone somewhere.

( time to put soapbox away and crawl back to my broom cupboard and do those nebs....)
Posted By: Geoff Hannis Re: Outsourcing - 22/06/12 2:13 PM

You're absolutely right. smile

It's those "little" jobs which have always been the real reason that biomeds need to be in-house, and on-site. To provide an immediate response, if you like.

We must also remain humble in order to carry out such work. Humble, but proud to be providing an efficient service ... whether that is appreciated by others or not.

Some things (many, in fact) cannot be measured in monetary terms alone (despite what the suits may have us believe).

In passing, I'm wondering what any of the service contractors would quote (if at all) for a 24x7 presence on site (a service that I myself, and others known to me, have provided in the past). And when I say "presence" ... I'm talking about shift work, carrying on with out-of-hours PM, whilst remaining generally available for whatever crops up, and all the rest. think
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