Journal of Perioperative Practice PROCUREMENT GUIDE March 2012

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Journal of Perioperative Practice

PROCUREMENT GUIDE March 2012 Volume 01 Issue 01 www.afpp.org.uk

01423 881300 www.afpp.org.uk


Journal of Perioperative Practice PROCUREMENT GUIDE March 2012 Volume 01 Issue 01 www.afpp.org.uk

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Journal of Perioperative Practice PROCUREMENT GUIDE March 2012 Volume 01 Issue 01 www.afpp.org.uk

March 2012 ––– The supplement will form a central pull out, every two months, in the Journal of Perioperative Practice and will also be distributed electronically to procurement professionals.

––– Enjoy this first edition and we look forward to hearing from you with your views.

Contents

Welcome to your March procurement guide

Dawn L Stott, CEO, AfPP

Commercial procurement collaborative explained Khalid Shihadah BEng Procurement Specialist – Clinical NHS CPC

09 The safety of medical devices

The supplement will form a central pull out, every two months, in the Journal of Perioperative Practice and will also be distributed electronically to procurement professionals.

There will be regular features including: • Company news • Innovation and awards • Procurement

Effective procurement:

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A warm welcome to all our medical device partners and I hope you enjoy our first edition of the AfPP Procurement Guide. We believe the launch of this new supplement will complement our well established and well respected portfolio of publications; it will also assist in raising our profile within the procurement market place.

We are aiming to provide you with between eight and sixteen pages of unbiased editorial comment around current topics and other issues within the medical device industry. The supplement will also include paid for editorial and advertising.

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Ian Cutler

10 Medical device regulations: MHRA • •

Forthcoming events Interviews/ Q&A/Points of view etc from key contacts/ organisations that work within the perioperative procurement field.

The HQ team, trustees and I hope you enjoy this new addition to our range of publications and would encourage you to engage with

us by providing editorial or feature articles to include in forthcoming issues of the guide. Enjoy this first edition and we look forward to hearing from you with your views.

11 Medical device driving licence

Darren Brand, Medical Devices Educator, Conquest Hospital, Hastings

With my best wishes Dawn L Stott CEO, AfPP

12 Product news/Innovation

Journal of Perioperative Practice Procurement Guide In print within the AfPP Journal of Perioperative Practice covering National AfPP members, but also with a dedicated print and e-distribution to supplies and purchasing managers.

May 2012 Airway Management/ Anaesthesia; EORNA Congress review – A European perspective Procurement

Key Sectors: NHS Supply Chain, Independent Hospitals, Higher Education. Medical Device Companies.

July 2012 Infection Control + Procurement

Published 6 times a year we will focus on procurement issues in every edition as well as specialist subjects which for the following year include:-

September 2012 Consumables + Innovation + Procurement November 2012 Safety + AFPP Congress + Procurement

January 2013 Recovery + Procurement

Contact Information: Advertising, Sponsorship and Partner Packages. Open Box Publishing Tel 0121 608 2300 Email Frances.murphy@ openboxpublishing.co.uk Editorial AfPP Chris Wiles Tel 01423 882950 Email chris.wiles@afpp.org.uk

PR and press material. All press releases welcome and we will feature as many as we can in each issue, all press releases need to be submitted to: Email Frances.murphy@ openboxpublishing.co.uk Tel 0121 608 2300


Journal of Perioperative Practice PROCUREMENT GUIDE March 2012 Volume 01 Issue 01 www.afpp.org.uk

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Journal of Perioperative Practice PROCUREMENT GUIDE March 2012 Volume 01 Issue 01 www.afpp.org.uk

––– Within the theatre environment they will generally have a small inventory of stock and they will set the level of the safe quantity required. As their stocks become reduced there will be processes in place to identify requirements and replenish stock. For example, bar coded stickers may be used on all items and once that item of stock is running low the sticker will be sent back to supplies on a specific form to trigger them to place an order.

––– Within the theatre environment we fall into the indirect procurement category. The economic climate is currently driving suppliers to increase their stock unit prices or change their minimum order values, delivery charges are also sneaking up as suppliers strive to make their required profit margins...

Procurement

Effective procurement Almost all purchasing decisions include factors such as delivery and handling, margins and prices. In organisations there are often defined processes intended to streamline the purchasing procedure; they are there to promote a fair and open environment to help minimise fraud and collusion but promote fair and open competition. The website Wikipedia splits the procurement activities into two distinct categories: • •

Direct, production related procurement Indirect, non-production related procurement.

Direct procurement occurs in manufacturing settings only. It relates to all items that make up a finished product i.e. raw material, components or parts, and affects the production process. Indirect procurement activities relate to ‘operational resources’ i.e. those resources required to enable organisations to operate. It covers a wide spectrum of goods and services, from low value items such as office supplies, machine lubricants to complex and costly products and services such as heavy equipment and locum services. Within the theatre environment, even though it sometimes feels like a manufacturing process, we fall into the indirect procurement category. The economic climate is currently driving suppliers to increase their stock unit prices or change their minimum order values, delivery charges are also sneaking up as suppliers strive to make their required profit margins. Whether you work in the public or private sector this has an impact on budgets and the profitability of your unit.

Recently, many hospitals have begun to focus on ways they can become more efficient in the way they manage their stock. For hospital groups or within trusts with more than one hospital, this may mean access to computer systems to analyse which hospitals carry the same stock items with a view to sharing boxes rather than buying a whole box when only one item may be used every six months. Using this type of buddy system with other hospitals to share stock helps eliminate the problems around waste of money, storage space etc. Suppliers are also changing their ways of working and are adopting the approach of designated order days rather than delivery on demand i.e. one day per week will be your designated delivery day with a 48 hour lead in time. This approach means that the clinical areas have to be more disciplined about how they requisition stock and are required to have their ‘pick sheets’ completed in time for the next delivery day. Therefore, if a specialised piece of equipment is required for a procedure, this has to be identified well in advance to ensure the procedure can take place as planned. Most hospital supplies departments have processes in place to manage these requirements and are assisted

greatly by bespoke IT systems that support them. For example: •

Information about forthcoming procedures are inputted onto computer system – includes patient, procedure, surgeon. • This information is interrogated to ensure the correct requirements are identified and either ordered from an outside agent or from the internal supplies department. • The amount of patients on a list will be identified and the type of procedure to be carried out and the core items of stock required will be identified i.e. drapes, swabs, syringes, etc. • If the allocation of stock identifies that stock is low an order will be triggered to replace.

Many procurement departments are using the sale or return element offered by many medical device companies, particularly for the more unusual items of stock that are not held as part of the general inventory. Within the theatre environment they will generally have a small

inventory of stock and they will set the level of the safe quantity required. As their stocks become reduced there will be processes in place to identify requirements and replenish stock. For example, bar coded stickers may be used on all items and once that item of stock is running low the sticker will be sent back to supplies on a specific form to trigger them to place an order. The procurement process does not end at the commissioning or contract award stage, but spans the entire life cycle of the product or service from inception and design through to contract management and disposal of any redundant assets. Effective procurement should support all areas of healthcare to ensure they meet their aims and objectives in the delivery of high quality healthcare for all. Thus ensuring the current and future needs of local people are met and are based on value for money. References: Wikipedia; The Scottish Government Website Dawn L Stott CEO, AfPP


Journal of Perioperative Practice PROCUREMENT GUIDE March 2012 Volume 01 Issue 01 www.afpp.org.uk

––– NHS CPC recognises that orthopaedic procurement constitutes a significant spend for trusts which requires a much greater clinical involvement than other areas. We offer a service that aims to bridge the legal and financial requirements of modern day procurement with the genuine concerns and practices of orthopaedic consultants and their clinical support staff. We therefore use our experience in NHS procurement and orthopaedics to liaise between these groups.

Commercial procurement collaborative explained Procurement in the NHS is becoming increasingly pressured and valued within NHS trusts, not just in the current climate but from a best practice point of view for a fair and transparent method of sourcing the best products and services for trusts via a rigorous procurement process that ensures compliance.

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Procurement We are proud to say that NHS CPC (commercial procurement collaborative) is wholly NHS owned and funded, hosted by Leeds and York Partnerships NHS Foundation Trust. NHS CPC is committed to not only helping achieve savings and ensuring compliance for trusts, but acting as a communication bridge between commissioners and providers, and between NHS and suppliers of goods and services. We offer access to specialist public sector procurement and commercial expertise, with procurement teams covering health and social care, corporate services, IT, clinical and estates and continues to implement new frameworks and contracts. NHS CPC procurement professionals utilise the buying power of our member trusts to put in place a range of competitive medical and non-medical contracts. We supplement this by sharing standardisation opportunities where suitable, and recommend areas where innovation can also improve local services and patient care. Our work with NHS commissioners supports the contracting process with healthcare providers. In addition, our experts can provide one-off procurement projects to meet bespoke, specific trust requirements. I joined NHS CPC in August 2011 as part of a team of clinical procurement specialists who organise contracts for a range of frameworks such as endoscopy, pacemakers, vascular grafts, power tools, intra ocular lenses and my speciality, orthopaedics. The procurement process in the public sector is a rigorous and transparent procedure which is governed by strict timelines and legislation. This is an objective and impartial process which is aimed at encouraging a competitive market and achieving a best value for the NHS. I have over 10 years experience in the healthcare sector and hold a degree in medical engineering. I specialise in orthopaedic design and prior to joining NHS CPC I worked in the private

sector for various world leading orthopaedic organisations, initially in R&D and then in sales and marketing where I conducted extensive product and clinical training as part of my role. Effective and efficient procurement is essential for distributing the funding to areas where it is needed the most, cutting out waste and investing in state of the art, market


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Journal of Perioperative Practice PROCUREMENT GUIDE March 2012 Volume 01 Issue 01 www.afpp.org.uk

leading products services for the future of the NHS. NHS CPC recognises that orthopaedic procurement constitutes a significant spend for trusts which requires a much greater clinical involvement than other areas. We offer a service that aims to bridge the legal and financial requirements of modern day procurement with the genuine concerns and practices of orthopaedic consultants and their clinical support staff. We therefore use our experience in NHS procurement and orthopaedics to liaise between these groups. By meeting with clinicians, financial and procurement professional to gain an understanding of their requirements and targets; we are able to draw up a bespoke specification for each individual trust which is open to offer from

Procurement various orthopaedic suppliers on our framework. By doing so, we can keep the responses relevant and ensure the best outcome for the trust, satisfying both financial and clinical requirements. Effectively we utilise our sound relationships with suppliers to facilitate a procurement process on behalf of the trust in order to make a shortlist of suppliers who could satisfy the trust’s needs. This shortlist is then invited to present to the clinicians, procurement and finance directorate, following which, a decision to award the contract can be made. This decision is predominantly a clinical decision, as all the suppliers shortlisted can offer a sound business case for the term of the contract. Couple this with a best value approach ultimately ensures a better outcome for patients. We have over a hundred clinical and corporate contracts

The procurement process in the public sector is a rigorous procedure which is governed by strict legislation. This is an objective which is aimed at encouraging a competitive market and achieving a best value for the NHS.

tendered and ready to implement which trusts can benefit from. We charge trusts a modest annual fee for membership and in return for this investment they receive benefits in the form of compliance and in cash, releasing savings through the implementation of any of these contracts. As an alternative to membership, access to specific contracts and projects can be purchased on an individual basis.

We strongly believe that the NHS can operate in line with its legal obligations, satisfy its financial targets whilst maintaining the use of world class, market leading products by adopting this much more inclusive and informed approach to procurement. Khalid Shihadah BEng Procurement Specialist - Clinical NHS CPC


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––– Following the major revision of the Directives (2007/47/ EC) (European Commission 2007) the MHRA incorporated the revisions in The Medical Devices (Amendment) Regulations 2008 (SI 2008:2936) that became effective in March 2010.

––– The manufacturer, having satisfied its appointed notified body that its technical data and manufacturing processes are in compliance with the Medical Device Regulations, has to sign a legal statement that the medical device complies with all the relevant requirements of the Medical Device Regulations.

––– Independent test houses that are selected according to their particular expertise. Their role is to examine and comment on manufacturers’ technical data and manufacturing processes, and in some instances to test the finished product. It is the responsibility of the manufacturer to select a notified body appropriate for its product and manufacturing operations. The Competent Authority has an overseeing responsibility for ensuring that medical devices do not compromise the safety of patients and users, but they do not ‘approve’ the regulatory compliance of a medical device.

Devices

The safety of medical devices What is a medical device?

This is defined in the UK Medical Device Regulations. It states that a medical device is ‘any instrument, apparatus, appliance, material or other article, or an accessory, to be used for human beings for the purpose of: – diagnosis, prevention, monitoring, treatment or alleviation of disease, or compensation for an injury or handicap, – investigation, replacement or modification of the anatomy or of a physiological process, - control of conception’ ... ‘and which does not achieve its principal intended action in or on the human body by pharmacological, immunological or metabolic means, but which may be assisted in its function by such means’. This qualifying statement was added to the definition to distinguish a medical device from a medicinal product or drug. This definition covers a very wide range of medical devices from simple products such as bandages, thermometers, tongue depressors, and so on, to more sophisticated products, for example, aortic stents, heart valves, X-ray equipment and CT scanners.

EC Directives

Medical devices are subject to the requirements of three principal EC Directives. These are: • • •

The EC Active Implantable Medical Devices Directive The EC Medical Devices Directive The EC In Vitro Diagnostic Medical Devices Directive.

There were four supplementary EC Directives that complemented the original Medical Devices Directive. These were: •

2000/70/EC and 2001/104/ EC: medical devices that incorporate stable derivatives of human blood

• •

and plasma 2003/12/EC: reclassification of breast implants 2003/32/EC: medical devices utilizing tissues of animal origin 2005/50/EC: reclassification of hip, knee and shoulder joint replacements.

A major revision was undertaken in 2006/2007 to incorporate the Active Medical Devices Directive, the Medical Devices Directive and its supplements, and to update the texts in line with experiences gained in their implementation. This was published in the Official Journal on the 5 September 2007 with the reference 2007/47/EC. The revision also included the Biocidal Products Directive. These Directives have to be transposed into national legislation for them to be applied in each of the member states of the European Union.

are referred to as notified bodies. These are independent test houses that are selected according to their particular expertise. Their role is to examine and comment on manufacturers’ technical data and manufacturing processes, and in some instances to test the finished product. It is the responsibility of the manufacturer to select a notified body appropriate for its product and manufacturing operations. The Competent Authority has an overseeing responsibility for ensuring that medical devices do not compromise the safety of patients and users, but they do not ‘approve’ the regulatory compliance of a medical device. The manufacturer, having satisfied its appointed notified body that its technical data and manufacturing processes are in compliance with the Medical Device Regulations, has to sign a legal statement that the medical device complies with all the relevant requirements of the Medical Device Regulations. A Competent Authority also has the responsibility for: •

Competent Authority

Each member state then has to appoint a Competent Authority that has the responsibility to oversee compliance with their national Medical Device Regulations. Each Competent Authority then has to appoint third party organisations that

Reviewing and commenting on a clinical investigation plan which has to be submitted by a manufacturer for the clinical evaluation of a novel medical device. Notifying the EC and other member states of the notified bodies that they have appointed.

• •

Monitoring and reporting on adverse incident reports. Sharing adverse incident reports with the Competent Authorities of the other member states. The withdrawal, restriction or prohibition of suspect medical devices.

The Competent Authority in the UK is the Medicines and Healthcare products Regulatory Agency (MHRA) (www.mhra.gov.uk). In the UK these principal and supplementary Medical Device Directives were implemented as Statutory Instruments under the UK’s Consumer Protection Act as follows: •

The Medical Devices Regulations 2002 (SI 2002:618) The Medical Devices (Amendment) Regulations 2003 (SI 2003:1697) The Medical Devices (Amendment) Regulations 2007 (SI 2007:400).

Following the major revision of the Directives (2007/47/ EC) the MHRA incorporated the revisions in The Medical Devices (Amendment) Regulations 2008 (SI 2008:2936) that became effective in March 2010. Extracts from an article by Ian Cutler, The safety of medical devices: the tools of your working day, in Foundations in Practice (an AfPP publication).


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Devices How the MHRA regulate devices The Regulations implement the EC Medical Devices Directives into UK law. They place obligations on manufacturers to ensure that their devices are safe and fit for their intended purpose before they are CE marked and placed on the market in any EC member state. There are currently four sets of Medical Device Regulations implementing all of the Medical Devices Directives and amendments to date;

2008 No 2936 which transpose Directive 2007/47/EC into UK law, were passed by Parliament in December 2008 and fully come into force in March 2010.

Statutory Instrument 2002 No. 618 (Consolidated legislation), 2003 No. 1697 (Amendments to cover the re-classification of breast implants and additional requirements covering devices utilising materials from TSE susceptible animal species), Medical Devices Regulations 2007 No. 400 (Amendment to cover the re-classification of total hip, knee and shoulder joints) and the Medical Devices (Amendment) Regulations

They have been issued under the Consumer Protection Act and can be found on the Office of Public Sector Information (OPSI) website: www.opsi.gov. uk/index.htm Other useful information can be found on the European Commission’s website covering the medical devices sector: http://ec.europa.eu/consumers/ sectors/medical-devices/ index_en.htm

MHRA welcomes a new Director of Medical Devices John Wilkinson OBE has joined the Medicines and Healthcare products Regulatory Agency (MHRA) as Director of Medical Devices. John’s role will be to lead on the safety of medical devices and he will be instrumental in reviewing future medical devices regulation. John Wilkinson said, ‘As the new MHRA Director of Medical Devices, my aim is to ensure high levels of patient safety whilst creating the right environment for medical devices to develop at a pace which continues to improve people’s lives and contributes to a sustainable development of our health services’. John has wide-ranging experience of the medical device technology sectors in Europe, the United States and UK and he is a respected figure in this field. His most recent position was as Chief Executive of EUCOMED, the leading Brusselsbased medical technology organisation. Prior to that he was Director General of the Association of British Healthcare Industries (ABHI) for four years, the leading trade association for the medical technology sector in the UK.


Journal of Perioperative Practice PROCUREMENT GUIDE March 2012 Volume 01 Issue 01 www.afpp.org.uk

––– Upon completion, users can then print certificates as evidence and record for CPD purposes, whilst the MDDL logs each assessment, making it easy for the practitioner to generate a list of training undertaken. This could be useful when undergoing annual appraisal reviews, or for use in job interviews.

––– The Regulations implement the EC Medical Devices Directives into UK law. They place obligations on manufacturers to ensure that their devices are safe and fit for their intended purpose before they are CE marked and placed on the market in any EC member state.

––– John Wilkinson said, ‘As the new MHRA Director of Medical Devices, my aim is to ensure high levels of patient safety whilst creating the right environment for medical devices to develop at a pace which continues to improve people’s lives and contributes to a sustainable development of our health services’.

The medical device driving licence A key consideration in the procurement process is the need to consider the level of training or educational input the supplier will provide to the purchasing organisation. From a trust or private healthcare perspective, and indeed that of the patient, it is vital to ensure that practitioners have been appropriately trained to a standard that ensures a safe delivery of patient care. In my own trust, we request that the external company aim to train 80% of end users as part of the purchase process. The benefit of using the product manufacturer in the training process is to ensure a consistent delivery of teaching.

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Devices Regulatory bodies, such as the Care Quality Commission (CQC) will require training records to be maintained and stored, and to be available for inspection upon request. This can often pose a problem for employers, as with staff leaving and joining an organisation it can be difficult at times to maintain an up to date record of staff training. To overcome this, and to assist with ensuring the delivery of consistent standards of training, the Medicines and Healthcare Regulatory Agency (MHRA) have developed the Medical Device Driving Licence (MDDL). Practitioners can access the MDDL website (www.mddl.org. uk) and following registration work through a basic ‘Devices in Practice’ module, followed by a choice of a number of areas, such as Anaesthesia or Surgery dependant upon individual need. These modules are developed with varying levels of pre-knowledge requirements, for example the ‘bedside monitoring’ module is rated as basic, where as the electrosurgery module is advanced. Upon completion, users can then print certificates as evidence and record for CPD purposes, whilst the MDDL logs each assessment, making it easy for the practitioner to generate a

list of training undertaken. This could be useful when undergoing annual appraisal reviews, or for use in job interviews. As the MDDL system evolves, it is planned to enable employers to be able to set determined requirements for employees, which in turn will lead to demonstration of compliance to regulatory bodies. This record of training will then remain with the individual as they move from one employer to another, and eliminate the current difficulties whereby records of training tend to be linked to a department or employer and are retained when the employee chooses to move jobs. The MDDL will also assist in ensuring ongoing competency is maintained, as it is stated that certain modules will carry an expiry date and users will be required to update by repeating the module assessment on a regular basis. In terms of the future, and especially in relation to the procurement process, medical device manufacturers will be encouraged to embrace the MDDL and develop product specific modules to relay the key messages around the safe use of their own devices. Darren Brand Medical Devices Educator, Conquest Hospital, Hastings

Procurement of medical devices From a baseline country survey on medical devices in 2010: 29% of 145 countries have a national list of approved medical devices for procurement or reimbursement and 58% of 143 countries carry out the procurement of medical devices at national level.

Source: World Health Organization, www.who.int/ gho/health_ technologies/ medical_ devices/ procurement/ en/index.html [Accessed January 2012]


Journal of Perioperative Practice PROCUREMENT GUIDE March 2012 Volume 01 Issue 01 www.afpp.org.uk

––– It is well known that patient warming equipment is essential in the modern theatre facility. Medline’s new PerfecTemp table pad helps by combating hypothermia and reduces the risk of pressure ulcers. PerfecTemp monitors the temperature at the point of contact between the pad and the patient’s skin ensuring the patient’s temperature is constantly monitored and maintained for normothermia.

––– Invisishield drapes offer convenient features, making the clinician’s job easier. Our fluid pouches feature convenient adhesive-liner tabs that make removal easy, even when gloved. Capped, closeable ports eliminate the need to cut the pouch for drainage, improving fluid control and setup times.

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Product News

PRODUCT:

Compared Item PerfecTemp Forced Air Warming Patient Access 100% Limited At the recent AfPP Exhibition and Congress Medline displayed Noise* 0 dBA 55 dBA the PerfecTemp patient warming system. This was the first time Ease of Use 1 step 7 steps Medline had displayed this product in the United Kingdom. It was Blowing Air No Yes hoped that it would bring interest from the visitors to the stand Disposables Required No Yes and spark a conversation that would help Medline gain a further Underbody Warming Yes No understanding of the UK market. Full Patient Access: Open Heart Surgery Yes No It is well known that patient warming equipment is essential in the C-Sections Yes No modern theatre facility. Medline’s new PerfecTemp table pad helps Neuro/Spine Surgery Yes No by combating hypothermia and reduces the risk of pressure ulcers. Senses Temperature at Patient Interface Yes No PerfecTemp monitors the temperature at the point of contact between Pressure Reduction Yes No the pad and the patient’s skin - ensuring the patient’s temperature Helps Prevent Shear Yes No is constantly monitored and maintained for normothermia. Automatic Timer Yes No PerfecTemp’s unique and reusable surgical table pads offer silent Energy Consumption* 96 W 1550 W warming from underneath, allowing effective patient warming - even Patient Interface Safety Alarm Yes No during C-sections, heart and spinal procedures. Warming can begin Reduces Carbon Footprint Yes No as soon as the patient is positioned on the OR table. The device * As reported in the service manual senses temperature through two sensors near the patient’s skin to continuously monitor and control the heat generation. Medline also entered PerfecTemp and two other products for innovation of the year awards and I am delighted to say that all PerfecTemp’s pressure redistribution surface aids in the avoidance three products, PerfecTemp, DASH and Eco-Drape won their of perioperative pressure ulcers. PerfecTemp helps you reduce respective categories. This is something we would like to enter unwanted pressure* and associated costs. every year, as having three large plaques on the stand also brought visitors and conversation as it showed the breadth and quality of • No disposables - with forced air systems, a disposable blanket the Medline product portfolio. is thrown away after every procedure • Improve turnaround time - simply disinfect the PerfecTemp PRODUCT: surface, and you’re ready for the next case • Reusable pads - no need to maintain additional inventory • Low energy use - save on your electric bill and reduce your carbon footprint Available through NHS Supply Chain and direct from Medline, Invisishield products offer solutions for all major applications with Because the pads and the control unit remain in theatre, there’s very little setup. With the built-in timer, PerfecTemp can even be set to turn savings up to 60% per item*. on automatically before the first procedure of the day, eliminating setup time altogether. The easy-to-use system consists of three components: Transparent Easily viewed areas around incision sites, while equipment drapes • Table pads – replacing your existing table pads make it easy to see microscope knobs, X-ray machine switches, • Control unit – small and light weight; mounts to IV poles or bubbles in ultrasound gel and more. flat surfaces • Two cords – connection and power. Impervious Made of a tear-resistant polyethylene and polyurethane, Invisishield PerfecTemp has two layers of advanced foam: drapes provide superb protection from fluids. • Visco-elastic “memory foam” - better than ordinary foam at reducing pressure Drapeable • High-resilience foam - below the memory foam and the heating Invisishield drapes have optimal amounts of malleability and element, for maximum support even with bariatric patients (up softness for superb drapeability. to 220kg.).

PerfecTemp

Invisishield – Specialty Drapes & Equipment Drapes

Carefully constructed

The high-tech synthetic pad cover reduces friction - a factor known Our thorough manufacturing process includes machine to contribute to skin breakdown: construction, for consistency and efficiency; and hand • Stretches in all directions – so it yields instead of rubs against a construction, for precision in adhesive placement and folding. patient’s skin • Strong yet conformable – not rigid. Useful features Invisishield drapes offer convenient features, making the clinician’s job easier. Our fluid pouches feature convenient adhesive-liner tabs Medline Industries Ltd. that make removal easy, even when gloved. Capped, closeable Greenwood Drive, Manor Point, Runcorn, WA7 1SE ports eliminate the need to cut the pouch for drainage, improving Tel: 08443345236 Fax: 08443345238 fluid control and setup times. Web: www.medline.com/en Email: sales@medline.co.uk *Based on VJD2417 sell price through Supply Chain, as listed in Please contact your account representative for additional information. October 2011 catalogue.

The Association for Perioperative Practice is a registered charity (number 1118444) and a company limited by guarantee, registered in England (number 6035633). AfPP Ltd is its wholly owned subsidiary company, registered in England (number 3102102). The registered office for both companies is Daisy Ayris House, 42 Freemans Way, Harrogate, HG3 1DH.


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