Ambulances queue up daily outside overburdened and under-resourced hospitals. This is one of the most obvious and immediate signs that the NHS is facing one of its greatest challenges. There is little sign of a respite as hospitals struggle to cope with surging patient numbers.

Hard-pressed NHS trusts are declaring critical incidents with worrying regularity. And it would be even more alarming if it were reported more widely.

This crisis has become so commonplace that some trusts are quietly cancelling appointments and procedures without highlighting the situation as critical.

The UK has just 2.4 hospital beds per 1,000 people, reveals data from the British Medical Association.

That is less than half the EU OECD average: the UK ranks second-worst in a table of 23 nations. So the idea of one of your hospital wards closing due to a healthcare associated infection (HCAI) is utterly unthinkable. At a time when you can’t spare a single bed, losing a ward to infection – however briefly – cannot be allowed to happen. Not now, not ever…and certainly not on your watch.

Facilities management professionals are as much in the frontline as the doctors, nurses and other clinicians when it comes to infection prevention and control. They’re the ones in the crosshairs if infections occur because vital sluice room equipment has broken down due to insufficient planned preventative maintenance (PPM).

But with all the added pressures facing NHS trusts, it is becoming harder than ever to monitor the condition of sluice room machines – especially when there are so many individual units scattered across health trusts’ multiple sites.
 

Medical pulp macerators and bedpan washer disinfectors need regular servicing.

Reliable machines may have long lifespans but those durations are finite. So trusts’ FM teams must monitor machines’ condition closely and be able to forecast accurately when they will need to be replaced.

This is seldom easy – but even less so when the machines have all been installed at various times by a number of different suppliers. Each company will have its own maintenance schedules and its own means of delivering aftercare.

There is also the ever-pressing matter of keeping your sluice rooms supplied with consumables such as medical pulp, bedpan washer and scale inhibitor. And all the while remaining in budget and on course to hit the NHS Carbon Footprint targets.

Not easy is it? Not when there are so many other equally patient-critical assets that need to be managed as well. You’re facing an ever-increasing collection of challenges:

• Ageing infrastructure: Many of the buildings and facilities within the NHS are old and require ongoing maintenance and repairs. As a facilities manager, you'll need to ensure that these assets are safe, secure and meet the necessary standards, while also managing limited resources and budgets.
• Budget constraints: Like many other public sector organisations, you need to find cost-effective ways to maintain and improve facilities, while also keeping up with ever-increasing demands for services.
• Meeting compliance requirements: Handling the first two challenges is hard enough but the NHS operates under a plethora of compliance requirements, including health and safety, environmental and building regulations.
• Keeping up with technological advances: The healthcare industry is constantly evolving, and this includes the technology and equipment used in the delivery of healthcare services. You need to stay up-to-date with the latest developments in the sector and ensure that your facilities are equipped with the latest technology.
• Meeting the needs of patients and staff: The NHS is a people-focused organisation so all the facilities you manage must be fit for purpose, welcoming, comfortable and accessible to all users.

Reviewing And Auditing Sluice Room Equipment

Hospital trusts (and therefore their facilities managers) face an unenviable task. They must raise standards and improve patient outcomes…while at the same time delivering further cost efficiencies on already stretched budgets.

Getting better performance from sluice room equipment is an obvious way to prevent and control HCAIs. It reduces infection-related bed blocking, freeing up vital bedspaces and enabling more patients to be treated more quickly – improving patient outcomes and reducing waiting lists.

Improving machines’ performance also reduces operating costs and improves return on investment – enabling funds to be redirected to other pressing projects within the trust. But without the right machine auditing and review information, those improvements are less likely to happen. Intelligence and data are at the heart of the solution: knowledge is power.
 

Ideally, all equipment should be detailed in an asset review outlining the precise location, condition, maintenance history and requirements of each machine.

And then the whole report should be summarised for an easy at-a-glance view of all the trust’s sluice room assets and their performance.

Something this fundamental sounds simple enough – but in reality, few sluice room equipment manufacturers supply this information in anywhere near the level of detail required. And they don’t provide a whole-of-estate report that covers every machine used by a hospital, regardless of its manufacturer.

This is because sluice room equipment is such a specialised area of manufacturing. Of the few companies operating within this important area of healthcare, only one (DDC Dolphin) is capable of repairing and maintaining all suppliers’ equipment and providing the detailed level of auditing and reporting that FM managers require on a daily basis.

A typical DDC Dolphin monthly Asset Report will include line after line of detailed information about every single medical pulp macerator and bedpan washer disinfector in the hospital(s).

Extensive detail about the performance and condition of scores of machines can be summarised in just half a dozen pages. Information is conveyed in an easy at-a-glance format. A typical Asset Summary Review will include the:

• total number of sluice room assets
• number of DDC Dolphin machines within the facilities
• number of machines on service contracts
• numbers of machines by type
• number of machines under warranty.

A condition summary will highlight the number of machines that are:

• brand new to three years old
• four to six years old
• seven years or more
• 10+ years old.

It will also detail the number and value of any outstanding repairs, along with numbers of callouts, parts fit visits and services.

Below this summary appears an even more detailed asset review. This spreadsheet lists the following information for each individual machine:

• account
• make, model and serial number
• delivery date
• machine condition (on a scale of 1 to 10)
• last case date – when the machine was last seen
• contract end date
• outstanding repair quote
• callouts (over the last three years)
• total spend (over the last three years).

The bottom line totals the outstanding repair quotes plus the number of callouts and total spend over the last three years.

Data can be provided in the usual formats. Pdfs look good for reporting and presentations but spreadsheets enable fast filtering and data sorting. Facilities managers can see very quickly which manufacturers and machines have enjoyed the best reliability record and provided excellent value for money. This enables smarter and better-value purchasing – maximising machine uptime and providing superior protection against the risk of HCAIs.

Filtering and sorting the data also enables facilities managers to see more quickly which wards at their hospitals have experienced the most issues with their machines. This may indicate that the medical staff in those wards require further training to ensure that they are using the equipment correctly – improving machine uptime. In turn, this will also enable clinicians to work more safely and efficiently. Faster, better operation of sluice room machines allows staff to dedicate more time to other aspects of patient care.

The spreadsheets and pdfs also make it easier to produce detailed reports for Care Quality Commission (CQC) inspections. Compliance becomes simpler and less time-consuming, assisting in the drive to attain or maintain the highest CQC ratings.
 

Reporting Via An Online Portal

All this detailed reporting can be made available via an online portal. This enables smarter real-time reporting. Users see the full information on repairs, callouts and reports without the need to get in touch with an account manager. 

And when they do wish to speak with their account manager, they see the same precise information that DDC Dolphin team members are viewing on their system. Everyone is looking at the same picture at the same time.

This avoids confusion and speeds up the process. FM teams can quickly grasp the challenges facing them and agree solutions to resolve them. They can swiftly approve maintenance or the replacement of capital assets and then move on to their next task – secure in the knowledge that their trust’s depth of defence against HCAIs will remain strong and resilient.

DDC Dolphin’s online portal enables FM teams to log in and view data 24/7 from any location with a broadband connection or mobile signal.

This means fewer meetings, less travel, more time saved, greater productivity – and a smaller carbon footprint. It’s another step forward in the NHS’s journey to reduce direct carbon emissions by 80% by 2028-2032 and to achieve net zero by 2040 (direct emissions) and 2045 (indirect emissions, such as those from suppliers).

And aside from the obvious cost efficiencies, work/life and environmental benefits, the online solution comes back to the vital issue of infection prevention and control. Working from home or elsewhere offsite during a major Covid outbreak or the annual ‘flu season minimises the risks to patients and clinicians on the wards.

True Cost Of Sluice Room Machine Breakdowns

Medical pulp macerators and bedpan washer disinfectors should be serviced twice a year. Planned preventative maintenance extends machine life – leveraging greater value from each unit – and reduces the risk of unplanned downtime.

The typical life expectancy of a medical pulp macerator or bedpan washer disinfector is usually 10 years, though some private sector operators choose to run their machines beyond this point.

Fail to service a sluice room machine correctly and its lifespan may be cut to seven years. That in itself is wasteful but unserviced or poorly/irregularly serviced machines can break down as many as three times a year.

At best, this costs an average £2,100 per machine in callout charges, labour and spare parts – and that’s before you factor in the loss of productivity. Based on two shifts of four nurses per ward, the average cost of lost productivity is conservatively estimated to be £1,584 (based on three machine failures per year).

At worst, a machine failure can result in an infection getting loose in the hospital – harming patients and clinicians. Medical negligence compensation claims for HCAIs can run to £40,000. Even a minor claim for an HCAI-related illness can be as high as £3,000.

Claims for sepsis – the body’s extreme reaction to an infection – can cost millions of pounds. In January 2023, a young girl who had both arms and legs amputated after delayed diagnosis of meningococcal sepsis had a £39 million settlement approved in the High Court.
 

Dealing With Machine Downtime In The Most Efficient Way

Enhanced reporting is one thing – but what happens when a medical pulp macerator or bedpan washer disinfector breaks down? Spreadsheets or pdfs, as useful as they are, won’t wave a magic wand over the machine and fix it. But there is another very cost-effective solution…

DDC Dolphin operates a demonstration service. In certain circumstances, it may be possible for hospital trusts (and large operators of multiple care homes) to request a medical pulp macerator on free trial. This enables trusts and other operators to evaluate machine performance, functionality, ease-of-use and running costs in the real world.

Trusts can see how macerators such as the Pulpmatic Eco+ (the most environmentally friendly, economical and hygienic macerator on the market) and the larger Uno and Ultima outperform their existing machines. This free trial also applies to DDC Dolphin’s Panamatic bedpan washer disinfectors.

So what starts as a machine breakdown issue swiftly becomes an opportunity to improve infection prevention/control, save time and money and reduce carbon emissions.

It is also an opportunity to review other advanced waste disposal solutions such as Vacumatic, a 100% hygienic, efficient and odourless system. Hermetically sealed bags store waste safely and vacuum-compact it – reducing the cost of disposal.

Hidden Cost Of Machines Supposedly Working ‘Perfectly’ 

If a sluice room machine breaks down then the impact is all too obvious. But equally insidious are the hidden extra costs that are accruing in machines which appear to be working perfectly and yet may be underperforming.

Limescale build-up in a bedpan washer disinfector can significantly increase its operating costs because more energy is needed to heat the chamber. A mere 1 mm of limescale can increase operating costs by 11%. Limescale can also stop the heating filament from reaching the correct temperature needed to properly disinfect waste utensils.

Multiply that 11% rise in operating costs by the dozens of bedpan washers in the average hospital and the energy bill swiftly mounts up. For every nine bedpan washers you operate, you’re effectively paying for the energy of a 10th machine that isn’t there! And that is before you begin to consider the negative impact on your hospital carbon footprint – at a time when environmental targets are very much a priority.

Furthermore, bedpan washers need degreaser and scale inhibitor. Medical pulp macerators require disinfectant to stop bacteria from growing inside. And it has to be the right disinfectant. Cheap alternatives may look good on paper but they often need higher dosages – so more has to be purchased. That means more administration, more time…suddenly the so-called saving is not the value proposition it promised to be.

Use the wrong chemicals or the incorrect dosing and your machine may not last as long. Worse still, the risk of infection increases – making the possibility of an HCAI outbreak more likely.

Outsourcing the servicing, maintenance and supply of chemicals is the obvious solution. But as a facilities management professional, do you really want to be dealing with a plethora of multiple suppliers, all with their own contracts, timescales, quirks and foibles?

Safeguarding And Streamlining Servicing And Maintenance

As previously stated, DDC Dolphin is the only capable sluice room equipment manufacturer of servicing all makes and models of sluice machines, using its own directly employed engineers. They provide a rapid-response callout service throughout the UK, based on 24- to 72-hour service level agreements.

Engineers are based all over the country. This minimises the time spent travelling to hospitals – speeding up the response to call-outs. These engineers are trained to operate within strict infection prevention protocols and are equipped with high levels of personal protective equipment (PPE).

Hospitals that specialise in highly contagious tropical diseases depend on these specialists for sluice room equipment servicing, maintenance and installations.

Facilities managers can streamline the administration of this vital servicing work through a series of 360° care packages and agreements that help trusts to:

• avoid unplanned costs
• catch potential issues before they develop, preventing unexpected downtime and extending the lifespan of machines
• accurately forecast budgets, thanks to fixed-price packages over five years
• guarantee the timely supply of all the necessary chemicals (with discounts) based on yearly, quarterly or monthly deliveries.

This creates a virtuous circle which enables trusts to improve their sluice rooms while still remaining within budget. Money saved through extended machine life, greater reliability and lower energy usage enables trusts to replace older equipment with new machines…which in turn perform better and save yet more money.

And all to the benefit of patients, clinicians and the wider community through superior infection control and lower carbon emissions. 

For more information, contact DDC Dolphin.