Medical Gas plant, such as medical vacuum pumps and medical air compressors, sometimes don't get the professional attention they need. So like most mechanical things, they break down. Just like our cars, if we don't have those serviced regularly, something expensive breaks or goes wrong, which actually costs us more than the regular service, and that fault might have been picked up before it became critical. As individuals, we tend to be lazy about preventative maintenance because it hurts our pocket, and we have a general mistrust about motor engineers - built up over the years. However, in the professional world of healthcare, medicinal gases are the lifeblood of patient care.
Estates Managers can call upon their medical gas pipeline systems provider - the specialist in this field, and have an engineer on-site within two hours. This may be OK as far as solving the immediate problem is concerned, or the fault may be more than just a quick fix. In this case plant hire comes into its own.
Many Estates and Facilities Managers aren't aware of the fact that medical gas plant can be hired for delivery within 48 hours. That solution has four major benefits: 1. The installation and extraction is included in the cost of hire. 2. The plant is maintained by the provider as long as it is in situ. 3. There is no panic about constantly having cylinder banks (medical air) replenished by porters and portable vacuum appliances (vacuum) by ward porters, whilst the plant is being repaired. 4. Theatre lists are not interrupted for longer than is absolutely necessary.
In one acute central London hospital, when three Anaesthetic Gas Scavenging System (AGSS) pumps all failed to produce the requisite level of suction in six theatres, the lists were backed up by three hours. These systems need to be "balanced" - that is to say, they must provide sufficient suction to extract anaesthetic gas from the floor of the theatre (so the surgeons and nurses don't pass out), whilst not sucking too much so that the patient wakes up! If temporary hire plant had not been available the theatre manager may have had to delay the whole day's list for six theatres. The cost of this would have run into tens of thousands of pounds.
Plant hire can include back-fed kits for Nitrous Oxide, Oxygen, medical air, surgical air and Entonox. These back-feed kits supply wards and theatres when there is a planned ward upgrade that requires a main pipeline break-in. This keeps the ward or theatre fed with the gases they need from locally positioned cylinders.
Longer term hire can also be beneficial for a hospital, when the capital budget is insufficient to provide a complete plant replacement. One compressor for a quad or triplex system can be provided at short notice and paid for out of the revenue budget until capital is released for purchase. Many hospital trusts are seriously considering taking the medical gas plant off their balance sheets, as a depreciating asset written off over 4 years and used for 15 years becomes a liability! The NHS doesn't need assets, but is one of the wealthiest "corporations" in terms of land and building assets in the UK. It tried to get around this fact by looking at the buildings and building management in terms of Public Private Partnerships (PPP) and Privately Funded Initiatives (PFI), but has realised that the rentals have spiralled out of their control. If rental agreements in these areas were put in perspective with smaller more manageable items such as medical gas plant, then this situation probably wouldn't have occurred. Plant hire works both on a short-term level and in the long-term and should be looked at seriously by Estates Managers and more importantly by Finance Managers with responsibility for estates.
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