Industry accreditations are highly sought after certificates that represent a commitment to standards, which in the healthcare and mobility sector, are especially valued.
Medequip was duly pleased therefore when it recently secured corporate accreditation for each of its community equipment services from CECOPS, the user-led independent certification and standards body, whose job is to raise the standard of all assistive technology related services across the UK.
Aside from the prestige that comes with the accreditation from CECOPS, the achievement places Medequip in a stronger position during the tendering process for community equipment contracts. Therefore, along with the various ISO accreditations the company has achieved over the years, the importance of Medequip’s most recent milestone, and its significance for the business, should not be underestimated.
The accreditation was not gleaned overnight however, and Medequip has undergone evolution and change to bring it to the position it currently sits. Instrumental in leading some of the most recent developments, head of safety, health, environment and quality (SHEQ) and governance, Marie Martinalli, says that various improvement projects across the business have demanded hard work, time and resources.
Building on the groundwork laid out by her predecessor, Martinalli says the team has spent time to ensure the systems at each of Medequip’s depots are lined up so that processes and procedures across the portfolio mirror each other. Consistency, she says, has been key to corporate accreditation.
“Some things are slightly different at certain sites because they are contract based. But to be fair, we’ve traditionally been quite consistent. I think the thing that’s made it easier for us, from a SHEQ point of view, is the internal audits that we do.
“Our internal audits are the same across every single depot and they look to make sure that everybody is following the same procedures and policies. And our audits have strengthened so they’re not just looking at what we do as a company, but they also consider all the relevant accreditations. We look at everything surrounding ISO 14001 (environment management), 9001 (quality management), 18001 (health and safety) and we’re now going for our ISO 27001 (information security).”
Because Medequip’s audits pull on clauses from across various accreditations, including CECOPS, it has made it easier to apply a comprehensive strategy across each depot and ensure each one is benchmarked the same. It seems that being proactive has been a core reason for Medequip gaining its latest accreditation and scrambling around weeks before an audit to get things in order will simply not cut it.
But it is also important for organisations to work closely alongside the awarding bodies and know inside out the clauses they are working to. Only looking inwardly is not enough and Martinalli explains that open and frequent communication and engagement with CECOPS was pivotal when working towards corporate accreditation. Regular meetings and conversing even when an audit was not going on helped build an ethos of two bodies working in partnership and looking at evidence in unison.
It is clear then that a lot of thought went into Medequip’s strategy for gaining its latest certificate and the benefits for the company are evident. Better standards should mean a better experience for the service-user which should theoretically improve business. But what does Medequip’s milestone mean for the rest of the equipment provision industry?
Martinalli comments: “As an industry, I think it opens up opportunities for other organisations, including our competitors, and spurs them to go for the same thing. That’s going to be good for the service-user and that’s what we’re all here for at the end of the day. When we are going into partnership on tenders with other companies, it makes it easier for us if they’ve got a corporate accreditation as well, so that’s an incentive and an opportunity.”
But the industry still has a way to go before standards are satisfactory across the board. Martinalli thinks the extent to which the industry must improve differs from one provider to the next, depending on what kind of foundation they have. She adds that as a company, Medequip likes to think that it is “quite open” and happy to advise and support other organisations, so long as there is not a conflict of interest, to help raise standards. She admits however, that companies can be limited by their resources and Medequip has been fortunate to have the financial muscle to be able to really invest in achieving its accreditations.
Martinalli adds: “It’s also about having the right skill set and people; especially people with experience of audits because if we weren’t able to do the appropriate internal audits in the first place and be proactive then we probably wouldn’t be where we are now.”
For a £160m business, you could rightly expect investment to be made in areas such as recruitment and improvement projects, but it is the level of detail that Medequip has gone to that really impresses.
Staff training has been a core part of the business’s development and it continues to refine its training to the extent that staff are learning to train others. What’s more, the company ensures that each staff member really understands the accreditations and audits themselves and encourages them to become involved.
Martinalli says: “Staff involvement is key. We have an initiative called Eureka where staff put ideas forward to make changes to systems. Take GDPR for example. Because of the legislative changes we had to think about what was best for our service-users, so that even included changing the users’ names on equipment receipts to a reference number. It’s small changes that make an impact.”
Approaching and adapting to the changing market
While the corporate CECOPS accreditation and ISO stamps spell good news for Medequip, like any firm in the business of providing community equipment, there are common challenges it must overcome. A particularly topical issue is that of timescales and waiting times, which are a key concern for everyone in the supply chain, from CCG, to provider and ultimately the service-user.
Where timescales are concerned, Martinalli says that Medequip works “extremely hard” and that with each contract, while the CCG sets out KPIs, the provider has its own internal KPIs that are raised slightly higher.
“The expectation is always slightly higher with regards to what our staff need to meet and achieve so we try and over-deliver. We’ve been making some really good process with regards to delivery times and that side of things with the business improvement team, particularity with software and the way we do our routing for equipment deliveries so that they are more streamlined.
“The service-user isn’t waiting all day for a piece of equipment. We also have a profit and performance related bonus scheme for staff and the KPIs are integrated into that. We consider mentality, enthusiasm and compassion in staff during the recruitment process so staff know the impact of their work on the service-user.”
Aside from time constraints, Nigel Cook, director of HR and SHEQ, says that customer expectations, not just on Medequip, but on everyone in the sector, are becoming greater. Customers are expecting more in terms of cost, quality and service, Cook feels, meaning providers are essentially expected to do more for less. Naturally, this means efficiencies are increasingly important.
A difficult correlation of CCG budgets tightening while both expectations and the number of service-users increase, means that Medequip, like its competitors, must make efficiency a priority. Cook explains: “The way most organisations will approach it is to become more efficient to keep costs down in order to offer the service at the price the customer wants. In days gone by, when you did a tender, it was heavily weighted towards quality.
The emphasis now hasn’t moved away from that, but certainly cost is becoming much more of a consideration. Within the business for example, we’ve got, in the broadest possible sense, a number of improvement projects ranging from operational efficiencies, system improvements and people development. The projects are centred on service delivery and cost efficiencies.”
While CCGs are naturally placing more focus on cost during the tendering process, each one operates independently and so providers have to remain flexible. Martinalli says that each tender’s requirements vary and more of them are now focusing on service-user engagement, which is something Medequip is aiming to respond to. For example, the provider is looking at using service-user forums which would mean greater feedback and input from end-users.
Cook adds that commissioners now look for service improvements at either the same cost or service improvements at a reduced cost: “Those improvements can be in any number of areas. Things like speed of delivery and so on. When we’re tendering, not only are we competing against our traditional competitors. There are other people entering the healthcare market, for example Virgin and others that are logistics driven, like Amazon, and they’re a potential risk to any business in the sector.”
But how far can a company like Amazon, arguably a logistics firm at heart, compete with established equipment providers that invest as heavily as they do in the service-user experience? While companies like Amazon may be perceived as ‘box shifters’ by some observers, the efficiencies they can offer can be attractive. Cook says that companies like Amazon do not have the experience of reverse logistics and the re-cycling of equipment required by the NHS neither do they have ethos required in the care sector to deal with vulnerable people with complex medical needs.
In the interest of driving efficiencies however, providers like Medequip cannot simply keep bringing costs down indefinitely and remain sustainable. So what else can organisations do to get an edge on their competitors when tendering?
Cook comments: “It comes back to your service delivery but also what you can add back. There’s a bigger emphasis on that so that’s how you gain an edge. You can gain an edge by being cheaper but you gain another edge by offering capability that other organisations don’t have. Social value is one example. We would say that our IT system is added value compared to other organisations. It is about the way you go about things and the organisation as a whole and how it delivers efficiency and what developments it has ahead of it.”
Having achieved the corporate accreditation it set out for, Medequip’s sights are now set on further developing the business as much as possible and placing itself in a strong position for when more tendering opportunities inevitably arise.
Martinalli says that on the accreditation side of things, Medequip is targeting ISO 27001, which relates to new GDPR regulations, as well as CECOPS approval for its wheelchair service in Suffolk. Aside from accreditation, Medequip’s natural goals moving forward will be winning more tenders but the two go hand-in-hand. Martinalli says that having robust systems in place already puts the business in a better position for getting more accreditations and therefore tenders.
The company will also be looking to diversify, reveals Cook. He says: “We’ve traditionally focused on community equipment services and we’ve recognised that while there are certainly still opportunities there, as an organisation, if we want to continue to grow then we need to diversify.
We’re not looking to diversify in completely different areas. Instead we are looking at areas you would regard as complementary and a natural fit for the company. We’re looking at how we might re-enter wheelchair services, telecare and other primary areas. The business is looking at other things strategically that we haven’t yet got involved with but are complementary to what we do.”
Finally, Medequip’s recent partnership with Cefndy Healthcare in Newport, South Wales, hints at scope for more partnerships on certain tenders. In today’s industry, companies must be prepared to compromise and work together on contracts and when the tendering opportunity came up in South Wales, Cook says it suited both parties.
He concludes: “Cefndy had the local knowledge and sheltered workshop experience, we had the logistics expertise, systems and processes. Both companies thought it would be advantageous to local residents that we work together rather than try and tender separately for the work. And obviously Medequip wasn’t widely known in Wales. For us it was partly a strategic opportunity to gain a foothold in Wales.”
It is evident that Medequip is continually looking to diversify and evolve to stay ahead of the game. This has meant being proactive, flexible and open to change, which for one of the larger organisations in the sector, is admirable. More importantly though, its strategy for attention to detail, staff involvement and pursuit of approval from industry bodies, is setting a positive example for similar companies. While it admittedly has much greater resources than smaller firms who might be competing for contracts, lessons can nevertheless be taken from its model.
If these teachings can help to raise standards and drive efficiency across the whole industry, then not only will service-users benefit, but the most innovative and responsible providers will reap the rewards. That can only be a positive direction for the sector to move in in what are very challenging times