Together with our volunteers, we’ve spent the last couple of days intensively diving into the world of repair of critical care medical equipment and ventilators. Our research-from-home raised some really concerning questions.
The starting point — ventilators
In the UK, critical care equipment is a serious issue. Many have observed we have one of the lowest rates of critical care beds per capita.
The ventilated beds situation is not much better. Research from last year revealed:
Ventilated beds per 100,000
Australia – 10.51
NZ – 5.93
UK – 5.64
This is probably why the UK government announced an effort to seek out new manufacturing capacity for ventilator equipment. The media paid this announcement a great deal of attention, and we’ve seen much debate and criticism of this initiative. At the same time, many are working on “open source” designs.
But are we ready to repair what we ventilators already have?
But we’re really worried that not enough attention is being paid to the maintenance of the equipment we already have. This is equipment that NHS staff is already trained on. Even during “normal” times, the equipment needs regular servicing. But we don’t know how well it will do under constant use, for weeks at a time.
We’d love to learn that there is a silent, big effort under way to deal with all of the issues we’ll raise below. We’re just watching from the outside.
In looking at documents from NHS Supply Chain, we rely on 11 companies for intensive care ventilators. Of these, six are also providers of repair services and maintenance contracts.
One of these companies is known to aggressively force well-meaning people sharing their repair manuals to stop. Two more are extremely large multinational companies known for their tight control over supply chains.
When existing arrangements break down
The case of the emergency 3D printing job in Brescia, Italy that saved ten lives when manufacturer supply chains failed gained the world’s attention. Especially because the manufacturer threatened to sue.
It appears in the medical tech space, manufacturers mostly control access to spare parts, there are few to no third-party vendors. What happens when manufacturers fully control supply chains and these are disrupted? Are we prepared for this both technically and in a legal sense? (Dark Matter Labs raised these questions during calmer times.)
Much of NHS equipment is covered by service contracts which probably restrict options in terms of repairs. Then at any given time, equipment goes without a service contract. What in-house or independent “surge capacity” exists for servicing this equipment?
In digging deeper, we learn from NHS Supply Chain that — this appears to be for all equipment