Community Equipment Services play a vital role in keeping people independent and safe in their own homes. So how does the system work in practice, and how do Medequip depots ensure that the equipment prescribed reaches the right people, at the right time and in the right condition? We take a look inside at the people and processes at Medequip’s York depot to see how the CES cycle operates.
Medequip’s contract here is with North Yorkshire County Council, covering an area in excess of 3,300 square miles. Medequip also operates a satellite depot in Scarborough to provide the levels of coverage required across England’s largest county.
The main depot recently relocated from Knaresborough to York, and North Yorkshire Operations and Customer Service Manager Darren Clark explains how the move has helped. “We now have far more space and capacity,” he stated. “We have been able to design our processes based around workflow, which has increased our efficiency significantly. We’re always conscious that this service is really owned by the prescribers, and we’re committed to playing our part in providing the best and most cost-effective provision for the people of North Yorkshire.”
Addressing the logistics
So how does the day start? Logistics Manager Bruce Holroyd gives us an insight. “We’ll catch up on emails to see if anything needs to be added urgently to the day’s list,” he explained. “This aspect of the service is all about logistics. Dependent upon the scheduling, we’ll have backloaded some vehicles the evening before so our driver technicians can set off from their home addresses to optimise their routes. Part of our cleaning team comes in early, so when a late request comes in, we can usually get the piece of equipment onto a vehicle in the correct condition for delivery.”
An important part of the morning’s work is to engage with the entire team. Communications at all levels are essential, discussing everything from general work reviews, warehousing and cleaning stations, with meetings and event slotted in as required. Bruce’s task is to check and verify that everything is running smoothly, identifying and solving any issues as they arise.
Alongside the prearranged business of the day, the team must also factor in same day emergency orders, usually for beds to facilitate hospital discharges. Medequip’s same day service plays an important part in freeing up bed spaces in hospitals by making sure individuals have the right equipment to return home in safety and comfort. These requests can come in at any time of the day up to 3 o’clock in the afternoon, which demands flexibility from everyone. “We also operate an out of hours emergency call out service – our overriding priority is quality of life,” said Bruce.
Training sessions
This morning, there’s also a training session going on in the training room. Medequip is building its paediatric catalogue, and a supplier of specialist paediatric seating has scheduled a session to look at issues around cleaning, reassembly, delivery and problem solving. These are expensive items, and children grow quickly, so refurbishment and reuse is a vital part of ensuring that each person gets the best piece of equipment to match their needs and that the service achieves value for money. Working closely with equipment manufacturers means Medequip can continue to provide an informed and professional service.
Cleaning and testing
It's very busy at the Goods Returned station, where the cleaning team is hard at work. Cleaning is a vital part of the cycle, and it’s a complex task. Equipment is first assessed and reviewed from a condition point of view. Once deemed suitable for reuse, it is jet washed or steam cleaned as appropriate, with a special scrub room for mattresses. Lifting items are LOLER tested and inspected as well as PAT tested, and batteries checked to make sure they are fit for purpose and safe for use. All electrical equipment is PAT tested annually.
This is a specialist job carried out by a committed team. “You can’t assume that if it’s clean on the outside, it’s clean on the inside,” said Chris Connor. “We’re also responsible for equipment checks such as making sure pumps for pressure care equipment pass through their cycles to verify their effectiveness. We assess, clean, check, test and bag up ready for reuse.”
Each piece of equipment carries a lifetime track and trace code number, and is scanned in and out of the depot. Once it’s cleaned, tested and back on the shelves it’s on the system and ready be ordered for re-use.
In the warehouse
In the meantime, there is new equipment being delivered which needs to be coded, sometimes assembled and then put onto the shelves ready to be picked for use. The busiest times in the warehouse are between 8 and 10 in the morning, preparing equipment and loading vans, then again around 3 o’clock.
This is the remit of Warehouse Team Leader Matty Wood. “The most challenging aspect of the job is getting everything done in the time we have available,” he explained. “There are always deliveries we don’t know about until later, some of which may be two-man jobs so I suddenly lose a member of my team for the rest of the day – North Yorkshire is a very big county!”
Matty is passionate about quality at every level. “I always say, if I wouldn’t accept it at my house, then it’s not going out,” he said. “We all share the same belief in going above and beyond to make sure we can to fulfil our commitments. We’re a multi-skilled team and we work together to achieve this.”
Liaising with prescribers
Meanwhile, Equipment Co-ordinator Anna Hunt looks after all the recycled ‘specials’ including seating, stand aids, bathing aids, hoists and slings. Anna’s role involves scheduling, organising, dealing with repairs, warranty issues and advice for prescribers.
This is a specialist area, and Anna works closely with prescribers to ensure they are aware of the availability of different pieces of equipment. Each prescriber has access to a catalogue detailing the products available, including a 360o video on each. Prescribers are also always welcomed into the depot to view items to assess their suitability for individuals.
“My work is all about communication with prescribers, and getting specials back to a condition where they can safely be used for another child,” said Anna. “Paediatric seating typically has a five year lifespan. With care, we can extend this to eight years, not only saving money but also making the right product available for each child, when they need it. It’s important that we have a real rapport with occupational therapists, prescribers and families, based on trust and understanding.”
Even when this specialist equipment reaches the end of its life in the UK, it’s not the end of the road, thanks to Medequip’s links with charities like organisations like PhysioNet, who then make use of these expensive items elsewhere in the world. As an example, in 2022, many recycled specials were exported to Ukraine.
Out on the road
One of the most vital aspects of the job is getting the prescribed equipment out to the people who need it, demonstrating how to use it safely and collecting items no longer required. Medequip’s York depot employs a team of 19 experienced driver technicians, charged with visiting people’s homes and integrating the equipment into a domestic setting.
Driver Technician Andy Hall explains some of the challenges and complexities of this aspect of the service. “I really enjoy getting out and meeting people, and this role gives me a great sense of being of practical use,” he explained.
For Andy and his colleagues, there are many logistical challenges involved in the role. The DL and YO postcodes covered by this contract are two of the biggest in the country. Each day will typically have around 25 deliveries, but these can be spread across a wide geographical area. Parking can present problems, particularly when delivering larger pieces of equipment, as well as access to individual homes such as small cottages with narrow doors or blocks of flats. Sometimes, these issues have been flagged up in advance, but often come as a surprise!
He finds the emotional issues affect him greatly too. “Bereavement collections need to be handled with real sensitivity,” he explained. “People have suffered a personal loss, and often want the equipment removing from their homes as soon as possible. This may be a place I’ve visited on more than one occasion with different pieces of equipment, and I may have encountered people at their most vulnerable times. I always tell myself that no matter how difficult my day may have been, for the people you’re delivering to or collecting from, it’s always been worse.”
Continuously working for improvements in service quality
Today in the depot, alongside the day to day work, the team is busy planning for an important event which plays a vital role in improving communications between all those who deliver community equipment services across North Yorkshire.
The North Yorkshire County Council contract is a C-QUIN ( Commissioning for Quality and Innovation) framework, designed around achieving constant improvements in service quality and patterns of care – all vital considerations for Medequip.
To support this, Medequip organises four key Open Days or Roadshows each year. These events bring together everyone involved in delivering the contract, including prescribers and clinicians, providing a unique opportunity for them to share their issues and suggestions as well as best practice. The events are rounded up with equipment training with manufacturers and suppliers, product presentations and Q&A sessions.
“Our Open Days give us an important opportunity to interact with all the different specialists delivering this vital service,” explained Darren Clark. “We’re always aware that Medequip is one cog – albeit a critical one! – in the delivery of community equipment services. Events like this enable us to bring together our experiences and knowledge and pool our resources to ensure we continue to operate in line with the needs of the people who use our services and the established C-QUIN values.”