Peterborough City Care Centre goes live

Peterborough’s pioneering new City Care Centre went live on May 18 bringing a range of new services to local patients.

Expectations are high because Asteral’s Managed Equipment Service has already won a prestigious industry award. The service will supply some of, and maintain all of the centre’s medical and diagnostic equipment.

The City Care Centre, part of the Greater Peterborough Health Investment Plan, is run by NHS Peterborough and includes a minor illness and injury unit (incorporating the walk-in centre and GP out of hours), 34 specialist rehabilitation beds, a pharmacy, outpatient diagnostic and treatment centre, general rehabilitation services and a children’s care centre.

Asteral has also supplied and managed the installation of 2 X-Ray rooms and 2 Ultrasound scanners as well as the movement and re-installation of a bone densitometer.

NHS Peterborough City Care Centre project manager Ele Milne said ” It’s been truly exciting to see the new services come together on time and on budget. Asteral’s vendor-independent MES means we were able to choose the most appropriate equipment regardless of manufacturer. This ensures patients receive the best possible service.”

500% growth for Asteral’s Peterborough team

Asteral’s Peterborough-based team has grown fivefold so far this year as the installation of equipment across Peterborough’s new acute hospital, integrated care centre and mental health unit ramps up and more services go live.

They join Operations Manager, Robert Avery, who has been with Asteral for 3½ years. Robert has led Peterborough through the medical equipment selection process for the City Care Centre and set up procedures for Asteral’s 32-year Managed Equipment Service partnership for Peterborough’s new build “super-hospital”.

The team brings a diverse range of skills and expertise. General Manager, Louise Sullivan has extensive senior NHS and private sector management experience and is a trained diagnostic radiographer. Project Manager, Naresh Maharaj has managed various projects in the UK private healthcare sector following a stint at the South African Department of Health.

Team administrator, Donna Wilson, has 12 years experience as a legal secretary before moving to the Environment Agency. Medical Engineer, Brian Long brings experience working at Smiths Medical where he led work with the Home Office, NHS and emergency services on national defence in the wake of 9/11. More recently he has held posts in Canada and as a Specialist Engineer at Watford General Hospital.

General Manager, Louise Sullivan said “we have a huge amount to achieve with responsibilities to procure, maintain, replace and coordinate training for all of the major diagnostic and theatre equipment for the Peterborough and Stamford Hospitals NHS Trusts. Since taking up our posts, we have all been encouraged by the enthusiasm of the staff at Peterborough as they recognise the value of the services Asteral delivers”.

 

Digital Transformation of Leicester and Rutland’s breast screening service marks Asteral’s two year anniversary

As Asteral’s managed equipment service at University hospitals Leicester reaches its second anniversary, the scale and flexibility of the project is becoming clear with 31 variation requests accepted within contract last year.

These variations include the complete refurbishment of Leicester and Rutland breast screening services, going completely digital by 2010. With four digital screening rooms and three digital screening trailers, the quality of patient care will be transformed as the local NHS moves away from film and chemical processing. Two of the rooms have already been installed and the rest go live over the course of the next 18 months. All of the facilities have been furnished with equipment chosen from the full range of manufacturers to respond to clinicians’ priorities.

Dr Hilary Daintith, Clinical Director of Breast Screening, said “the flexibility Asteral has shown to incorporate this transformation which was outside the scope of our original contract is amazing. As well as the certainty of long-term planning through the MES we also get to change our priorities as clinical requirements develop. Over 1,500 women every week will benefit through improved image quality, better diagnosis and a reduction in it examinations. In addition, the digital transformation will save us £150,000 on film every year.”

Accompanying photo:

  • Glynis North (left), a UHL patient who has been encouraging women to have regular check ups with Superintendent Radiographer Julie Smith (right). Photo Courtesy Leicester Mercury

Leicester’s gamma camera upgrade delivers results

Latest results show that University Hospitals Leicester’s high expectations when Asteral upgraded their gamma camera last year have been exceeded.

The performance metrics collected by Asteral as part of its Managed Equipment Services contract with Leicester reveal that the new gamma camera has increased throughput and delivered high staff satisfaction.

Claire Greaves, UHL’s Head of Nuclear Medicine, explained that “because the camera is so versatile, scheduling has become much easier and this has helped us meet our two week waiting times across all of our hospital sites. The camera brings invaluable new functionality allowing us to link NM and CT images while both NM staff and radiologists can view results remotely.”

In addition to the new equipment, UHL is also benefiting from more stable planning and support “The knowledge that the cameras will be replaced every 10 years without having to bid for capital equipment money is great. And in the more immediate term, the speed of response that comes from having on-site first-line engineers from Asteral dramatically increases equipment uptime and reliability.”

Leicester’s robotic transformation

Asteral, the leading vendor independent Managed Equipment Services (MES) provider has installed the third and final robotic pharmacy at the City’s General Hospital.

The new high-tech pharmacy robots, owned and managed by Asteral, have now been installed at pharmacies at the Royal Infirmary, Glenfield and Leicester General Hospital. They are helping to free up staff time to spend more time on wards, instead of running around stockrooms looking for medicines. The robots have also significantly reduced picking errors, as they identify the medicines by their unique barcode. Pharmacy staff then complete a final manual check against the prescription to ensure the right medicines, dose and expiration date goes to the patient.

Measuring a colossal eight metres each, all three robots can work 24/7 finding and dispense up to 720 medicines per hour, as well as store 25,000 packs of medicines.

Commenting on the installation, pharmacy manager at Leicester General, Clare Meakin said “We are extremely pleased with the robotic pharmacy as well as the process that led to its installation. It will allow us to reduce the overall medicines stock holding in the department, make the hospital pharmacy service more responsive and improves the accuracy of medicines that we dispense. We have already noticed that we can handle peak periods of demand far more effectively.”

As well as the benefits of the new equipment, Suzanne Khalid, Chief Pharmacist for University Hospitals of Leicester, was also keen to explain how the MES made planning and implementation much more straightforward: “The business case for the pharmacy was much easier to make and also significantly quicker because it went through an MES. Overall, it allowed us to provide a safer and more efficient service to our patients.”

The Whittington Hospital NHS Trust

The Whittington Health NHS Trust, located in North London close to Highgate Village and Islington, serves a diverse socio-economic and mixed ethnicity population of around 300,000.

Adoption of modern clinical procedures at the Trust was restricted due to older technology and many pieces of equipment were getting close to their recommended replacement age. The hospital needed to update its imaging facilities but lacked the capital needed to buy new equipment.

“We initially dipped our toe into the leasing pond but found that upon renegotiation, we couldn’t afford to update the equipment due to other financial pressures. Without modern equipment, we were unable to offer patients low radiation dose techniques or alternatives to invasive procedures,” said Dr. David Grant, Clinical Director of Diagnostics and Therapies and Consultant Radiologist at The Whittington Health NHS Trust.

Initiating change

Remedial work designed to combat the situation started in 2000, with a PFI project to construct a new clinical block and main entrance. With infrastructure improvements underway, the Trust then focused its attention on equipping the new facilities. To provide a high standard of care and compete in an increasingly commercial NHS environment, advanced modern diagnostic equipment was required.

Whittington’s management team were looking for a solution which:

  • Provided access to a broad spectrum of technical expertise and advice
  • Would integrate with the existing PFI contract and manage the building interface
  • Provided technology refresh over the contract lifetime
  • Provided full financing for all equipment
  • Reduced both the Trust’s fixed costs and the long term financial risk

In October 2005 The Trust awarded a fifteen-year contract to Asteral. This agreement ensured that the days of outdated technology would be a thing of the past. The hospital would benefit from and sustain the benefits of being one of Britain’s most technologically advanced imaging departments.

Clinical and financial benefits

Whittington chose Asteral Select because it ensures that all elements of equipment provision and management are outsourced to a specialist third party. It also guarantees that state-of-the-art equipment will be maintained throughout the lifetime of the contract. This enables the hospital management team to focus solely on patient care and passes responsibility for the strategic management of equipment lifecycles to Asteral.

Asteral worked with the Trust from day one to evaluate the Radiography needs of the hospital, and develop a sustainable long-term equipment replacement programme. Plans for ongoing user training and a fully-managed maintenance service were also jointly developing. For a fixed monthly payment, Asteral provides the Trust with a planned long-term investment strategy delivering the latest technology, coupled with the highest standards of service, maintenance and training.

“A secure investment plan, an integral part of a long-term contract, represented a realistic opportunity in the present financial environment to ensure that state-of-the-art equipment is continually updated and refreshed,” said Dr. Grant. “This approach ensures that access to modern and well-maintained equipment is kept constant and that nothing passes its agreed replacement age. This is a huge advantage in maintaining the standard of clinical care.”

Investing in modern equipment

The first part of the scheme saw Asteral purchase a number of mobile Ultrasound and X-ray machines. These were installed ahead of the planned service commencement to assist the Trust with the replacement of the most urgently needed and older equipment. Asteral then refurbished an old general emergency department X-ray room, replacing the aged equipment with a state of the art, fully digital, twin plate X-ray system and digital dental panoramic X-ray machine. This was installed in advance and provided valuable benefits in assisting the training of Radiographic staff in the use of the new digital technology.

Asteral took responsibility for all design and building interface matters. We reviewed all room drawings provided by the PFI contractor to ensure that the room design was suitable for the installation of the new equipment. Asteral carried out all room fit out works associated with the fixed equipment.

The MRI Scanner, weighing six tonnes, required heavy duty lifting and positioning via a third floor window. This was the final piece of equipment and was craned into place in September 2006.

Unveiling the new department

The department went live in November 2006 and now boasts: six Philips Digital Radiography rooms; a 64 slice Siemens CT Scanner; a Philips Achieva 1.5T MRI Scanner; a GE Infinia Gamma Camera; six Philips Ultrasound units; three Mobile C-arm Image Intensifiers; and a Xograph digital dental unit.

“The previous MRI scanner was in its eleventh year, so it is great to have a new device. It will enable us to offer patients a greater range and quality of examinations such as MRCPs and vascular imaging obviating the need for invasive diagnostic studies,” stated Dr. Grant

He continued, “We are all delighted with the new department. Working in such a modern and spacious environment with state-of-the-art equipment enables us to offer the best possible service to our patients. We are now concentrating on developing new services and further improving both access times and the communication of results.

“Initial feedback from patients is also positive, they like the new and clean facility. Furthermore, the dedicated waiting areas inside the Imaging Department have improved patient dignity – no more waiting in corridors in gowns.”

The introduction of new equipment has also encouraged the adoption of innovative new processes. For example, the imaging department has introduced a unique patient waiting bleep system. Upon booking into the department each patient is given a bleeper to call them back when their examination slot is available. This reduces the number of people waiting in the department and helps to eliminate patient anxiety by giving them freedom to visit the shops and cafés inside the hospital building without the risk of missing their appointment.

Ongoing excellence

With all equipment now operational and providing patients with the quality of services they deserve, Asteral has shifted its focus to providing service excellence for the long-term. On the ground, our specialist team ensure ongoing maintenance and training programmes are closely managed, minimising equipment downtime and promoting the use of new digital technologies to maximum effect.

“The structured approach to ongoing maintenance and fault handling is already improving the quality of the services we deliver. Room downtimes are markedly reduced” says Dr. David Grant, clinical director. “Asteral takes the equipment headache away making the operational part of the job much easier. Because of the contractual implications, Asteral ensures that OEM engineer fault responses are much quicker.”

With this contract in place, The Whittington Hospital is able to concentrate on introducing further reforms to improving patient care, safe in the knowledge that the equipment is in the hands of an experienced and reliable partner.

University Hospitals of Leicester NHS Trust

University Hospitals of Leicester NHS Trust (UHL) was formed in April 2000 after three of the city’s hospitals – Glenfield, Leicester General and Leicester Royal Infirmary – came together to provide a more modern and efficient healthcare service.

Improving asset management

Work began on a £761 million PFI investment (The Pathway Project) to modernise UHL buildings and facilities over a 30-year period. The Trust’s three imaging departments urgently needed investment and the Imaging Services Directorate specified that any solution must deliver best value, improved management of assets and, ideally, innovation. The solution also needed to support strategic objectives, have high-level executive buy-in and be flexible enough to meet evolving requirements.

Innovative

Asteral responded by offering an innovative Asteral Select contract that would provide genuine risk transfer and be funded entirely from existing medium-term budgets. The solution did not require additional funding from the government, nor did it rely on resources provided by the PFI investment. Asteral and the Trust worked in partnership to develop and refine the most effective long term solution.

Asteral demonstrated an in-depth understanding of all medical equipment issues and their effect on the Trust’s services. Within the first nine months, Asteral installed bespoke, state-of-the-art, Radiology equipment and facilities at UHL. Asteral provides a full-time on-site engineer and Radiographer to ensure the smooth running of the service.

Fixed costs

UHL pays fixed costs and receives a comprehensive service that includes staff training and equipment management in line with regulatory requirements.

Over the last two years uptime has improved and staff are free to concentrate on patient care without having to worry about procurement, payment, warranties, maintenance or training. At the Trust’s request, Asteral supplies performance data according to equipment type, hospital site and supplier. UHL can see in an instant how equipment is performing and being used, and view an auditable trail of all supplier and maintenance activities, which has meant a significant improvement on service.

Accelerating the pace of change

Asteral spent considerable time understanding not only the strategic challenges facing UHL, but also the Trust operational needs. As a result, Asteral has been able to help accelerate the pace of change through supporting strategic objectives and gaining high level executive support, without which the scheme could not have progressed.

Other benefits to UHL of its partnership with Asteral include:

  • A single point of contact for all equipment related problems
  • Strategic and resilience planning, managed by Asteral’s qualified technical and scientific team
  • A flexible contract allowing for the addition or removal of equipment types as clinical requirements change
  • Performance measurement through a set of agreed Key Performance Indicators (KPIs)
  • Best-value procurement from a variety of manufacturers, allowing the Trust to specify each item according to clinical preference
  • A VAT recoverable service

Asteral Select and clinical consumables

In addition to the traditional equipment planning and procurement, design, build, installation, and ongoing maintenance Asteral’s Select service at UHL has evolved to include a clinical consumables management service (“CMS”), the provision of non-clinical and technical staff, as well as the provision of integrated IT systems. Following the transfer of on-site consumables staff, Asteral manages the Cardiology consumables and procedure packs for nine catheter laboratories across UHL and the East Midlands Congenital Heart Centre which together perform over 450 procedures per annum.

Asteral is unique in the marketplace due to its proven capability and capacity to deliver a clinical consumables management service including contrast media. Asteral has invested in and secured an MHRA Wholesale Dealer’s Licence for the handling of contrast media, and developed our own CMS IT infrastructure to provide integrated procurement, inventory management and procedure level costings for Cardiology and Interventional Radiology departments. Asteral is one of the largest independent buyers of clinical consumables in the UK, and in addition to savings related to managed service tax efficiencies, we have achieved economies of scale that lead to real procurement savings for our customers. Asteral has a catalogue of 3,000 clinical consumables sourced from 65 suppliers in line with its ethos of vendor-independence.

“Both Asteral and UHL’s imaging services directorate have been prepared to allocate time, energy, imagination and resources to developing and sustaining a strategic partnership of which both organisations can be proud,” says Helen Seth, Deputy Director of Operations.

Kingston Hospital NHS Foundation Trust

Kingston Hospital NHS Foundation Trust’s Radiology department offers high quality CT services. Increasing demand meant that its existing suite needed an upgrade to cater for the growing number of referrals.

As is the case with many other Trusts, funding the essential work, managing the project and ensuring service continuity presented a huge challenge: a challenge which Asteral overcame, on time and to budget, with an Asteral Select solution. The Trust benefited from lower whole-life costs than traditional capital purchase or lease options, enabling them to deliver a modern, efficient department with improved patient and staff experience.

Increasing demand for scanning services

Kingston Hospital has a large Radiology department. In a typical day, the department would have seen more than 40 patients for various types of CT scan and levels were set to increase. Over the past decade, national demand for scans has increased by 10% year-on-year.

The previous technology, an 8-slice CT Scanner, provided a good service but the high level of use caused occasional downtime, which led to patient rescheduling. The consistently high volume of patients also meant that many scans were delayed, increasing the pressure on staff to maintain acceptable waiting times.

New approach to procurement

The Radiology team had a compelling business case, but the funds required to upgrade the existing equipment and remodel the building represented a significant investment, which called for a new approach.

Following a detailed evaluation, the Radiology team decided that the Asteral Select would provide the flexibility to build a solution to meet their future needs. In addition, Asteral was proven to offer the lowest whole-life costs of all compliant tenders.

Asteral Select

Asteral’s solution that was closely modelled around the needs of Kingston’s CT team. This spanned financing, project management of the design, build and installation, equipment commissioning and operations – all delivered on time and to budget in just nine months.

Asteral’s vendor-independent status allowed the team to find the best equipment available based on performance, reliability, flexibility and overall value. The two CT scanners selected featured state-of-the-art dose reduction technologies, greatly enhancing the value of the service to existing and potential referrers.

In place of a capital or lease purchase Asteral provided a fully-funded finance arrangement that enabled the Hospital to make monthly payments over the course of the seven-year contract. The monthly payments cover the technology and maintenance, together with the build, project management, training, response desk and other services.

The building work required not only made room for the two new scanners but also facilitate the projected increases in patient flows. Working in phases to allow the department to continue functioning, Asteral oversaw the creation of a new preparation room, patient changing areas and CT scanning rooms, as well as offices, WCs and new plant rooms.

Addition of Asteral Protect

Following the success of Asteral’s Select Service, in 2013 Kingston used the London Procurement Partnership framework to add a 3-year Asteral Protect contract to their existing service. The Protect service provides maintenance for Radiology equipment at mixed cover levels, ranging from PPM-only to fully comprehensive including special parts. The equipment for the Asteral Protect, including 6 ultrasounds and 11 x-rays, is based across two hospital sites.

Industry leading service

The agreement with Asteral means that if there are any issues with the systems a single telephone call leads to swift resolution. As with all Asteral Select contracts, Asteral stipulates that in any given month, an industry-leading level of uptime is maintained.

Jim Weir, Head of Radiology at Kingston Hospital, has been impressed with the service. He said: “From the outset, Asteral’s team has impressed me with their expertise and professionalism. Since both scanners became operational in late January, Asteral has provided detailed monthly reports of the performance and availability of each scanner complete with key performance indicators, something I have never experienced from any other supplier.

“I am really proud of our new department. We provide an excellent quality of care due to new imaging techniques enabled by state-of-the-art technology. We also provide outpatients with a much-improved experience, thanks to a more efficient imaging facility and remodelled patient flows.

The project has increased the capacity of Kingston’s Radiology department by more than 240%, allowing much greater flexibility in patient scheduling. This not only improves service levels to all patients and referrers but also, most importantly, enables the Hospital to increase urgent or in-patient access and supports the planned extension for a ‘walk-in’ direct access service.”