MD Oliver Law explained the background and thinking to the change in strategy, and discussed the company’s ambitious future plans, with HEJ’s Jonathan Baillie.
Despite having only been with Trumpf Medical Systems for a relatively short 14 months, Oliver Law has, in that time, already made a significant and successful mark, having, for example, successfully masterminded and overseen a substantial re-structuring of the company’s salesforce and customer service departments, and established a new service department, project manager unit, and commercial team. The re-structuring had, he explained, as we sat talking in an attractive glass-fronted office overlooking the large Luton showroom where some of the sizeable machinery used to manufacture the company’s medical equipment is the first thing visitors see, occurred first and foremost to ensure that the company, which is part of the German-headquartered manufacturing enterprise the Trumpf Group, is even more responsive to changing customer needs and sector trends. Alongside the restructuring, and “an almost seamless transition” from its former Malmesbury location to its impressive new operating base in a sizeable industrial unit on the Luton Business Park, the company has also recently completed and opened (see HEJ – October 2009) an impressive new medical technology centre within the building (adjacent to the showroom). This incorporates simulated intensive care and operating theatre environments equipped with some of the latest, and most sophisticated, Trumpf equipment. Officially opened last September, the self-contained centre is designed so that anyone from an orthopaedic surgeon to an estates and facilities director can get to know, hands-on, the capabilities of Trumpf Medical Systems’ latest pendant, lighting, and operating table systems, in an environment that mimics, as closely as possible, the set-up typically encountered in a modern-day hospital. One of the many technologies visitors can see without, of course, disrupting the flow of a busy operating theatre list, is AmbientLine, a lighting system just launched in the UK designed to speed post-operative recovery by using different brightness and colour phases to simulate natural daylight and darkness in areas such as ICU units where a lack of windows, and thus natural daylight, may otherwise (studies have shown) slow down recuperation by rendering individuals depressed, anxious, and confused “after as little as a few days”.
Meeting current challenges
The exciting new technologies and products showcased in the simulation suite will be the subject of another article in a future issue of HEJ, but before touring the facility I was keen to discover from Oliver Law, an honours graduate in business management who joined Trumpf with seven years medical sales’ experience under his belt, both how much of a challenge he believes the company currently faces in selling its “added-value” equipment at a time when many NHS hospitals are under tough financial pressure, and, equally, how it is responding. “One of the key things we are finding,” he told me, “and this is reflected in the type of salespeople we are now looking to recruit, is that, whereas 5-10 years ago it tended to be surgeons who held the balance of power when it came to specifying operating theatre equipment, this is by no means always any longer the case. “The reason, I believe, is that many other departments, including estates and facilities personnel, procurement teams, senior nursing staff, and even SSD unit managers, now get involved in purchasing, and all hold a varying degree of sway.” Conceding that it would still largely be procurement teams and board members who actually signed off purchase of new capital equipment for, for example, operating theatres and ICU suites, Oliver Law said estates and facilities managers would nevertheless increasingly be asked for their input and views, since not only would it subsequently fall to them, in partnership with the supplier’s own engineers and any external contractors, to oversee the installation of new equipment but also, increasingly, to subsequently help maintain it. He said: “To be honest there is no single NHS, or indeed private sector model today, for how such equipment is procured and maintained.
Estates involvement
“Nevertheless,” he continued, “EFM teams may well have substantial involvement in budgetary and purchasing decisions, and of course individual hospitals can now go out and select equipment on the open market. Estates teams are also increasingly expected to be multi-skilled and multi-disciplinary, which may well mean them being more involved in maintaining operating theatre equipment than in the past.” With the NHS already facing tight budgetary constraints, and indications that things could get even tougher with the swingeing public spending cuts forecast over the next 3-5 years, I asked Oliver Law how concerned, as a supplier of equipment at the premium end of its particular market, Trumpf Medical Systems is about the implications of tighter diminishing NHS budgets. “To be honest,” he said, “so far we have escaped the recession pretty well unscathed, one reason, I think, being that contracts for, for instance, new hospitals and substantial re-builds, are generally long-term, and the Government or other funders cannot simply pull the plug on a development already well under way. In the short-tomedium term I am confident that, with the restructuring we have completed, coupled with products built to offer both reliability and high performance for many, many years, and field-leading functionality, we will ride out the downturn. What worries me more are confidence levels among specifiers within the NHS especially, since if purchasers genuinely believe that things are bleak economically, and that they will be slow to improve, they may well put spending plans on hold.” Given the growing shift toward multidepartmental involvement in purchasing, and an environment where it is increasingly the individual hospital, rather than necessarily the Trust, that makes the buying decision, Oliver Law said one of the company’s recent priorities had been to respond by recruiting salespeople who possessed not only the requisite commercial and negotiating acumen, but equally the maturity, gravitas, interpersonal skills, and confidence, to be able to talk knowledgeably with anyone from a Trust CEO to the head of a hospital SSD department, an estates and facilities director, a senior nurse, or a leading surgeon. He added: “Our salespeople today really must be extremely sharp, both commercially, and in terms of wider people skills, and must equally understand, as perhaps never before, the different standpoints from which, say, a surgeon, and an estates manager, may be coming. They clearly also require sufficient technical understanding to be able to discuss the benefits, and the pros and cons, of particular equipment, but, should we identify knowledge gaps, we pride ourselves on the quality of our training facilities.
Focus on training
“Over the next 12-18 months one of our other goals will indeed be to further build up our training offer both for our own and customers’ staff.” Even taking into account this renewed focus on training, I asked Oliver Law how Trumpf Medical Systems was addressing the issue of making its equipment easy to service and maintain, given its increasing sophistication, functionality and features, at a time when the healthcare estates sector appears to be struggling to recruit new personnel with the sound engineering training, knowledge, and expertise, which have been a hallmark of their predecessors. He said: “With all our products CE marked and, in newer equipment’s case, under warranty, our general view is that there are limits as to how far we would advise Trusts’ own estates and facilities personnel to go in undertaking servicing and maintenance. For instance to replace a bulb in one of our iLED surgical lighting ‘petals’ simply requires removal of the cover and insertion of the new bulb. Similarly, cleaning and lubrication of, for example, bearings, is a task many estates teams will want to undertake themselves. However many of our pendants, for instance, are gas-driven, and here and say, with re-calibration of operating lights, we would recommend that any servicing is undertaken either by our own service personnel, or by one of the many specialist sub-contractors we work with.” Although there will always, for example, be occasions where a bulb needs replacing, Oliver Law pointed out another key selling point of Trumpf equipment – its extremely high quality construction, from premium materials and components, means many items will have an extremely long lifespan. The iLED bulb, for instance, is designed to operate for around 30,000 hours He said: “Having introduced the iLED surgical lights in 2005, we have recently fitted our millionth iLED light emitting diode at our factory in Germany, and have completed some 6,500 installations worldwide. While our focus is on developing cutting edge products – our AmbientLine lighting is another good example, we also recognise the pressure on customers to reduce energy costs. This is reflected in many of our products’ design. LED lights, for instance, which we now incorporate extensively into our lighting systems, use as little as 15-30% of the power of older gas discharge systems such as xenon and halogen lighting, in addition to offering more sophisticated functionality and enhanced performance.”
Lower energy consumption
The energy consumption of a surgical or operating light, alongside the cost of replacing components when necessary, and of maintaining the system as a whole, are, of course, significant considerations for the estates and facilities personnel whose input and influence in specifying “big-ticket” equipment Oliver Law maintains is now considerable. He said: “There is no question that there are lowerpriced alternatives to many of our lighting and pendant products from competitors, but we now find that estates and facilities, clinical, surgical, and board-level personnel considering purchasing such equipment not only want the optimum features and functionality, but also components manufactured and assembled to the highest standards that will still operate efficiently, and costeffectively, in 20 years’ time. If I had to identify one single trend in the NHS, especially, on which we now base our whole product and service philosophy, it would be the need to provide long-term value. While in the past an estates or facilities manager, or indeed a surgeon, might have been more concerned with buying equipment that would effectively meet a short-to-medium term need, today it is all about buying equipment which is not only future-proof, but on which a good return on investment can be made over a calculated lifetime. “Of course,” he cautioned, “there are also the shorter-term financial benefits to consider, and NHS Trust board members will now often ask, say, of a new surgical lighting system: ‘What will the key benefits be, in terms not only of better clinical outcomes and enhanced patient safety, but equally faster throughput, on a surgeon’s list on any given day?’ Similarly, with, say, our AmbientLine lighting, if the board knows that faster patient recovery will reduce the length of bed-stay in an ICU (Trumpf says keeping an NHS patient in an ICU currently costs around £1,500 a day), they have a significant business reason for investing, as well as the more ethical and patient-centric argument that such enhanced lighting will create a more comfortable care environment.” Returning to the task of maintaining operating theatre and ICU equipment, Oliver Law stressed that Trumpf Medical Systems now offers a tiered service package, with the top tier, Premier, for example, giving the customer, such as an EFM team, benefits including a guaranteed call-out within a set time (usually 24 hours), and the option of loan equipment on a temporary basis. He added: “If something as seemingly small as a bulb fails within an operating light, and the Trust’s estates team does not have spares to hand, it could mean cancelling several operations, entailing significant costs to the Trust. By offering a rapid response we can ensure that vital surgical and treatment hours are not lost.”
Modular build initiative
Coming to the end of our discussion, Oliver Law told me excitedly that, conscious of the increasing pressure on large acute hospitals particularly to meet Government-imposed targets for certain surgery types, Trumpf Medical Systems hopes, in the next few months, to unveil a new alliance with “a leading UK modular building supplier” which will result in it being able to design, assemble, and commission, a fully equipped operating suite, or series of operating rooms, within a modular structure, for customers requiring such a facility, for instance during a planned re-fit of an existing operating suite, or following an unforeseen event such as a fire. “In fact,” Oliver Law said, “the operating theatre and ICU room in the Medical Technology Centre here in Luton are modular in design.” To prove the point he showed how easy it was to remove one of the composite panels which make up the walls, which are simply, but securely mounted on a metal frame. The ease of removal, and indeed the system’s design as a whole, he explained, greatly simplifies installing the cabling and other mechanical and electrical services, including medical gas terminals, required in a modern operating theatre. In addition, Trumpf Medical Systems plans to offer the option of a Microban or other antibacterial coating on the wall panels while, as demonstrated in the operating theatre unit in the simulation suite, the walls can also be fitted with vision panels with blinds and other glazing options.
All-round package
“Our aim, in this new alliance, will be to offer the customer a fully equipped operating theatre or ICU suite, fitted out with all the necessary equipment, from lighting and pendants to control panels, storage equipment, the operating table, and beds,” Oliver Law explained. “While we clearly do not manufacture all the required components, a Trumpf project manager on each modular scheme will co-ordinate the design, development, build, and fitting out of the entire facility based on individual customer needs. We don’t, for instance, manufacture laminar flow canopies but, should the customer require one, we will be happy to co-ordinate its incorporation. “We are extremely excited about this new venture. Although there may be one, or at most, a handful of other suppliers able to offer this ‘one-stop shop’ design and build service for modular operating theatre and ICU suites, we are confident our offering will lead the field. We would hope that, depending on the complexity and size of the modular suite, we will be able to complete each unit, from initial drawings to full operation, within as little as a couple of months.” Adding somewhat self-effacingly that, in the past 12 months alone, the company’s turnover had increased by 545%, Oliver Law concluded our discussion by emphasising to me how much he was enjoying the challenge of heading up the fast-growing company and that, with the recent new appointments and restructuring, Trumpf Medical Systems was now “very well positioned” to build its UK profile and “meet the expectations” of its five-year growth plan. A confident prediction, but one I left the new facility in no doubt he genuinely and enthusiastically believed in.