Equipment failure or unavailability due to repair or maintenance rarely has a serious impact on patient care. However, it does cause incidents and inefficiencies. The risk of adverse events was also increased because preventative maintenance for 16% of equipment we sighted was not done on time, and yet the un-serviced equipment remained available for use. Keeping to maintenance schedules is even more important as 36% of equipment we sighted across our 8 sample hospitals had exceeded its expected life.

Although we found little evidence of equipment shortages, assurance that hospitals are achieving value for money from their management of medical equipment. Health service providers, and hospitals, cannot answer key asset management questions, such as how much equipment is needed, the cost efficiency of maintaining or replacing existing equipment, or whether high value equipment is used to its full capacity. This is because hospitals and health service providers are not capturing or effectively using information on equipment and do not have a strategic asset management approach for medical equipment.

This lack of a strategic asset management approach is impacting efficiency:

•  leasing equipment is not routinely considered as an acquisition option
•  procurement is generally not aggregated to obtain lowest cost from a supplier
•  available funding determines equipment replacement priorities and decisions are not always based on robust information.

For the majority of hospitals and health service providers, no one has clear responsibility for managing medical equipment and its costs. Responsibility is dispersed across health service staff, biomedical engineers, hospital operations managers, heads of clinical service areas and central health department staff. This reduces accountability