Chris Watts

Principal Aseptic Technician

Guys and St Thomas’ NHS Foundation Trust

Aseptic services have evolved massively in a

short period of time

1968 Medicines act

Had huge impact on the preparation of medicines

Breckenbridge report

Stated that all I.V. medicines should be prepared in a

central location

Kennedy Report 2001

Stated that patients can expect to be treated by staff

with the relevant experience and up to date training

Loss of crown Immunity in 1991 by NHS

hospitals

Removed the NHS belief that they didn’t need a

manufacturing license to make medicines

Farewell report

Pulled NHS unlicensed aseptic into line with

industry

Regular audits following set guidelines

All of the above legislation has changed the

way that Aseptic services have developed

When I started working in pharmacy we had

our isolator in the back of the dispensary

Background environment wasn’t considered key

issue

In the mid to late 90’s legislation demanded that

isolators be sited within graded rooms

This hospital now doesn’t have an aseptic

services due to the high cost of running their

graded rooms

Rooms now converted for other uses

EL Audits

The introduction of EL audits from 1997 started

the process of driving up standards and forced

departments and hospitals to asses the risk of

their services and premises

Standards driven up to meet that expected of

industry

Essence of the audit is to improve patient safety

Standard of audits have become tighter and as such

driven up expectations for auditors and patients

Aseptic services within the NHS are in serious

decline

Why?

Cost

NHS Hospitals facing financial difficulties

Aseptics are an easy targets to cut costs

Staff

Quality staff getting harder to find

Employment of band 3 posts

Supposed “Production Technicians”

Lack of interest in Tech services everyone

wants to do clinical

Lack of support nationally for aseptic services

Changes to legislation

High standards expected = higher costs

Introduction of sporocidal step to disinfection

Introduction of gassing to aseptic disinfection

Modernisation of NHS manufacturing services

Trusts have cut their manufacturing and aseptic

services

Money is being diverted to other areas

Once it’s gone it’s hard to get back

The rise of the special manufacturing aseptic

services

This could be seen as the greatest threat to NHS

aseptic services

Trusts are seeing the out sourced product as a true

alternative to in house units

Once services are out sourced financial restraints

will see keep them out

Skills are being lost

The NHS has to look at how we hold on to the

highly skilled specialist techs that are still around

The role of the aseptic tech is being eroded with the

reliance on the senior assistants and the use of cheap

labour from disposed employees from Specials

companies or large NHS manufacturing units

Senior management roles can be fulfilled by

experienced techs Staff progression through to senior roles has to be seen

to help recruitment of staff

De-skilling of staff

Staff who will undertake “occasional” preparation

can they be considered competent?

The role of the aseptic tech will become

obsolete in the near future

I seriously believe that we could be the last

generation of aseptic techs within the NHS if the

current rate of out sourcing continues

Services offered today

Parenteral Nutrition

CIVAS services

Oncology

Gene therapy

Home care services

With the out sourcing that is available should

we just give in and except the inevitable?

Trusts will save money by closing units

Staff can be moved to fill other pharmacy gaps

NO!!!!!

As aseptic units we need to get smart and sell

ourselves as well as the out sourcing units

How can we compete if prices are difficult to

match with

Units to get smart and use their procurement

departments to source direct from their suppliers

and negotiate better prices

We need to start to look at our consumables

As a department we always buy from the NHS store

This isn't always the cheapest option

We are encouraged to shop around for

insurance/energy suppliers then why not our

consumables and raw materials

Use the expertise of their staff to sell a better

service

Staff do come at cost but managers need to sell their

staffs special skills and attributes to keep their

services alive

Be smart and look to buy helpful equipment and

products

For example we have been using for the last bespoke

syringe pack for adult PN. Although there is a small

increase price between the new packs and the

individual components we were using before we have

saved up to 2 hours a day of time for making and

spraying in.

This time saving has allowed to increase our

capacity with out the need to increase our

staffing = cost saving = happy managers

Not only has the use of these packs saved us time

but has added a quality aspect to the product. As

the new packs are sterile triple packed (just

what the MHRA wanted!!)

Join together with other aseptic units to

increase buying power and buy in larger bulk

to get better prices

Offer truly flexible services

Work shift patterns to give Dr’s the opportunity

to change medications to suit their patient’s ever

changing needs

True 7 day working to allow weekend

adjustments

The cost of out sourcing companies to offer

weekend services would price them out of the

market

Make ourselves so important to the medicines

service so that outsourcing becomes a scary

alternative for managers/clinicians

As I see it the future for aseptic services

really lies with the following changes

The NHS units set themselves up as

commercial units offering the same services

as the special aseptic manufacturing units

These can pull together the best of the best

aseptic staff to produce super units

Look towards offering specialist homecare

services

Civas homecare products

As hospitals look to discharge patients early supplies of

antibiotics via a homecare service

Take on more clinical trial work

Become specialist centres for trials/work closer

with trial companies to encourage the work to

come to your hospital/unit