Could engineers help improve the NHS?

Senior reporter

A new report calls for hospitals to have their own chief engineer. But would their skills be limited by a management role?

Engineers and doctors haven’t always had an easy relationship. In our recent article on the art of medical innovation, Imperial’s Chris Toumazou – who is both regius professor of engineering and chief scientist of the Institute of Biomedical engineering – said this: ‘When I started at Imperial I was in awe of the medical community; I felt there was a culture and mindset [that] they were the prima donnas and we [the engineers] were technicians who provided them with instruments they needed.’

Nowadays more and more engineers are used to working in partnership with clinicians to develop devices and adapt existing technologies for use in medicine. Indeed being a medical practitioner now involves using a huge array of complex equipment – from 3D printed implants to advanced scanners to diagnosis software – and this reliance on technology is only likely to grow.

The growth in biomedical engineering has prompted the Institution of Mechanical Engineers (IMechE) to produce a report looking at how the sector can be developed for the benefit of the UK economy and the NHS. One of the report’s key recommendations is that every NHS acute trust (the bodies that manage hospitals) should have a chief biomedical engineer.

The idea is that a chief engineer in hospitals would help make sure equipment was functioning and used properly, was the right bit of kit for the job and had optimum availability.

The report found that, in 2013, 13,642 incidents related to faulty medical equipment (from pacemakers to MRI scanners) were reported to the Medicines and Healthcare products Regulatory Agency (MHRA), leading to 309 deaths and 4,955 people sustaining serious injury.

Miscalibration is also a significant problem, even at the basic level of things like weighing scales that have led to incorrect doses of medicine being distributed. And half of the high-value equipment in the NHS is due to be replaced in the next three years, creating a huge challenge to select and purchase the right technologies to meet the demands of the health service while ensuring value for money.

But why does this mean hospitals need their own engineers? Wouldn’t we be better off investing in more and better trained technicians and make sure procurement managers have a sufficient knowledge of technology as well as medicine?

Dr Patrick Finlay, lead author of the report and chairman of the IMechE’s Biomedical Engineering Association, thinks a biomedical engineer would be the best person to act as a ‘strategic leader in a hospital’s technology procurement and deployment programme’.

Speaking to The Engineer via email, he said the chief engineer would be responsible for the following:

  • Ensuring all the hospital’s imaging and procedure planning systems were compatible with each other;
  • Ensuring that systems were in place to handle routine maintenance and repair of devices, as well as critical failures;
  • Ensuring that appropriate stocks of equipment were held so that operations were never cancelled due to equipment non-availability;
  • Liasing with suppliers and researchers to evaluate new equipment;
  • Cost effective life-cycle management: should equipment be bought, leased or rented? Should maintenance be in house or subcontracted? When does equipment become obsolete and need replacing?

Having more trained engineers in managerial roles would be no bad thing. But would it be making the most of their skills to limit them to procurement and planning? One of the other roles of a chief biomedical engineer proposed by the IMechE would be to contribute to research, development and translation. Perhaps in this context what we’d really benefit from is more “engineers-in-residence”.

By immersing themselves in a hospital setting and examining the daily routine of diagnosis and treatment, such engineers may be able identify more ways to improve medical devices, which could then be fed back to industry. They may also spot problems that no one has thought to address before and develop their own solutions.

They may even be able to apply their problem-solving skills to the administration of the hospital. A fresh pair of eyes and a different way of thinking can sometimes elicit simple solutions that no one immersed in the existing culture of an organisation would have considered.