I'm trying to establish how many Renal Units Waterplants are looked after by either PFI or Trust Renal Technicians.
This is because our current water system we took over from PFI 10 years ago and it is now obsolete and with it being under trust contol we are finding it hard to find a case to replace it! Speaking to some PFI friends, if it was still under there control they would of started to replace it.
Have anyone else out there experienced the same issues?
Whos water plant is under PFI control and who isn't?
We don't have any PFI builds down here, just a mixture of in-house and contracted private provider units. In-house equipment is all on a capital replacement register with an 'expected' replacement date. As these dates approach we are asked to assess each item on the risk of not replacing. If there are no clinical/financial benefits in replacing, and the equipment can still be maintained safely, it should be pushed back to the next financial year when another assessment is made.
We currently have one water plant being considered for early replacement due to being served a notice of obsolescence by the supplier. However it is still not considered high risk as we have 100% redundancy and we can still get parts to repair it.
The privately run units are on 10 year contracts so the equipment in these contracts will follow that replacement timeframe.
We have 5 sites with only one being maintained through PFI. Due to the age of the PFI plant a condition appraisal was requested and this resulted in the plant being pencilled in for replacement next year. Frequency of failures and supply issues are monitored at out Trust water management group so this replacement date can be reviewed if needed.
Our in-house plants are placed on the risk register and replacement considered dependant on risk, amount of capital available and comparison with other capital funded risks within the Trust. Unfortunately, as long as appropriate quality water is being supplied at the point of use I have found it difficult to convey the risk level to others outside of the renal field. Though saying that, once treatments begin to be impacted by plant issues things get escalated quite quickly.
We have a Purite RO75 system that is now obsolete and some of the major parts are no longer supported. i.e. PLC, Tanks, Controllers. Purite did send out a letter stating this.
We have had problems and it is on the Trust Risk Register.
Also we have done a Business Case to replace it with another system and we have recieved quotes!
But our Directorate Manager say because the system is producing good quality water and is looked after well there is no technical arguement for the case to replace it!!!! Our Lead Clinician now has to put their arguement forward.
I understand we are our worst enemy as do a good job looking after it and ensuring it produces high quality RO water, but I fear that we are sometimes just fire fighting the system so to speak!
I know a Unit is Glasgow I believe (correct me if I'm wrong) had the same system as us and have recently replaced it. It was still under PFI control replaced because it became obsolete.
I just feel totally frustrated as the hurdles/barriers I'm coming up against, and at the end of the day this is a Medical Device which produces a patient prescription!
Have anyone else had similar experiences and how did they overcome them?
We have a 18 year old plant at 20 on the risk register, but we are opening a new unit next year so we are keeping it going for now. (Hasn't ever given us real trouble - touch wood)
What are the consequences of total failure?
Potentially huge costs if patients need to be dialysed elsewhere, NHS or private, transport, staffing extra shifts, Sunday or night shifts, loss of reputation and bad publicity, stress for patients and staff.