The SMTL physical testing department has recently completed a testing programme for the NWSSP Procurement Services (ProcS) Lymphoedema contract, working closely with Lymphoedema Network Wales. This was the second time SMTL and ProcS have undertaken this exercise, the first being in 2014 and most recently in 2018.
The aim of the test programme was to standardise and rationalise the range of garments in use within NHS Wales whilst addressing a number of known quality issues (such as sizing) for lymphoedema garments identified by the clinical members of the group. Using this information, a performance specification was agreed with the lymphoedema specialists, based on average patients' leg and arm dimensions ProcS then grouped the different products into Lots, and manufacturers were then asked to supply appropriate off the shelf and made to measure garments to fit the selected patient's dimensions in specific Lots. Using these clinician-specified dimensions, SMTL set up their Hatra Mark 2 hosiery tester (specified in a number of British Standards) to mimic the size of these patients, and then undertook a programme to test the pressures exerted by the garments, and assess whether they complied with the specification.
For the 2018 contract 6 manufacturers tendered garments for the various lots that SMTL would test. Only 2 out of 5 sets of upper limb garments (such as arm sleeves) and 17 out of 28 sets of lower limb garments (stockings) passed the pressure requirement specification, with most failures being due to pressures falling below the minimum compression level.
Alongside testing for contracts, SMTL also investigates medical device defects and incidents for the NHS in Wales. When the contract process for lymphoedema was first started many clinicians were not aware of the defect process and dealt directly with manufacturers. However, since explaining the defect reporting process for medical devices to the lymphoedema clinicians in 2014, the SMTL has investigated over 150 incidents, with most reports being due to incorrect sizing, durability and manufacturing issues . The combination of a highly specified contract process and a well-publicised defect reporting system has lead to the number of defective garments dropping significantly, with only 10 incidents being reported to SMTL between January and August 2018.
The success of this initiative has been resulted in the team winning two prestigious awards - the 2015 Government Opportunities (GO) "GO Procurement Innovation Award" and the 2016 "Procurement: Patient Safety Award" at the Patient Safety Congress (organised by the Health Service Journal and Nursing Times) where Dr Gavin Hughes and Louise Barry from SMTL were in attendance to receive the award.