Digitising Make Ready

2nd of February 2023
Digitising Make Ready
Digitising Make Ready

Make Ready is a UK system that ensures ambulances are prepared by a dedicated team of specialists who clean, restock and check the equipment before the beginning and at the end of every shift. Currently Make Ready methods vary across the country – this is why James Bradley at services provider Churchill believes they should be digitalised.

In September 2018 Lord Carter published a report into operational productivity and performance in English NHS Ambulance Trusts. The report identified unwarranted variation in the delivery of ambulance services, as well as the potential savings of £500 million that could be made in efficiencies by 2020/21.

Lord Carter submitted nine recommendations to improve patient care, efficiency and support for frontline staff who had responded to a significant rise in demand for ambulance services in recent years.

Then the pandemic hit. Ambulance Trusts that were already under strain faced unprecedented demand, while the importance of hygiene - already critical in healthcare settings - increased further. Even as we exit the worst of the pandemic, NHS Ambulance Trusts are dealing with the need to increase efficiencies, cut costs, protect staff and safeguard patient safety.

One solution that addresses all of these needs is digitising the Make Ready process.

Make Ready

Make Ready is a system which sees ambulances prepared by a dedicated team of specialists who clean, restock and check the equipment on ambulances before the beginning and at the end of every shift. Currently Make Ready methods vary across the Trusts, including specialist centralised centres with workshops or adapted ambulance stations.

The Carter Report identified that a Make Ready programme can affect positive change, create significant financial savings and is referred to as a key enabler.

However, the adoption of traditional Make Ready process alone will not be enough for many Trusts to reach their objectives. It will certainly deliver efficiencies for those Trusts that have not already adopted a Make Ready Programme, but digitising the process will take productivity, best practice, transparency and resilience to the next level.

We are the UK’s largest provider of Make Ready services and were the first private company to collaborate with England’s NHS Ambulance Trusts in delivering a Make Ready solution. Churchill has been delivering Make Ready services for over 10 years; this knowledge and experience has enabled us to invest in developing a digital platform that enables a more efficient, cost effective, data driven solution that ensures governance.

The case for digitising Make Ready

In 2017 the total expenditure for ambulance services was £2.3 billion. It was forecast that demand was expected to increase by 38 per cent by 2027 – and that was before taking the pandemic into account.

At the same time, a study by the National Audit Office (NAO) in 2017 revealed the NHS had to deliver efficiencies of between two and three per cent per year by 2021, effectively placing a 10-15 per cent real terms cost reduction target on Trusts.

The NAO also reported in 2017 that 500,000 ambulance hours were lost due to delayed transfers of care at hospitals in 2015-16. This is impacted by ambulance change over time, ambulance and crew location.

All of these stats paint a picture of ambulance trusts in need of support. Digitising Make Ready is a powerful solution that can impact everything from ambulance turnaround time to staff retention.
13 benefits of digitising Make Ready

There are numerous benefits to digitising the Make Ready process, including:
1. Saving a minimum of 15 minutes per Make Ready.
2. Immediate location and recall of equipment via RFID tagging.
3. Immediate location and recall of all medicine pouches.
4. Complete control of all consumables usage through a fully integrated tagging and stock control system.
5. Removal of record pads currently used in a manual Make Ready system.
6. Designated managers have immediate access to any Make Ready job over several years, instantly viewing what
was checked, what was missing,
damage, issues relayed to oncoming crews, and more.
7. Make Ready Operatives (MRO) are guided around the vehicle in the most efficient and effective way, ensuring consistency in training, and allowing more than one MRO to process the same job, by dividing the job into sub-activities.
8. Complete control over MI and KPI reports; agreed reports can be generated daily/weekly and managers can access dynamic data, by region, site, operative.
9. Integration with existing NHS Trust
IT systems.
10. MROs can locate all tagged items in a matter of seconds, removing the need to individually check items.
11. Oncoming crews are notified of
the vehicle allocated to their shift, along with any specific issues they should be aware of.
12. All vehicle or equipment damage is instantly reported to the relevant Trust department, along with photos for clarity.
13. If a key asset is moved from one vehicle to another – or just removed from vehicle – the Trust will immediately get an alert, showing that the equipment has moved and showing which vehicle it is now on. This allows Trusts to quickly recover missing items, potentially saving thousands of pounds.

Our work with the South East Coast Ambulance Service (SECAmb) NHS Trust is a great example of the impact from digitising Make Ready. Noticeable results include an 11.11 per cent productivity time saving per Make Ready, an increase in vehicle availability, enhanced asset management and improved patient safety.

How the digital Make Ready process works

One key feature is RFID tagging. By adding a scannable codes to all stocks, medicines and equipment in an ambulance, MROs can carry out a stock check with a single scan as the RFID gun scans every single code in one go. In traditional Make Ready processes there can be up to 67 manual checks, so this is an immediate time saver.

This enables teams to check, remedy and log all supplies, internal and external damage, lights and sirens, cleanliness and more to ensure the vehicle is fit leave the site. The process also acts as an audit as all data is stored and can be accessed whenever needed.

RFID tagging is also a great tool for managing medicine recalls, perhaps in the case of expired stock or a national recall. The amount of time saved by scanning versus manual checks cannot be overstated.

Make Ready can also be improved for cleaning and hygiene purposes. At SECAmb, 100 per cent of vehicles are deep cleaned every six to 12 weeks across 17 Make Ready Centres. This involves the vehicles being stripped down of all equipment and furniture and cleaned. The percentage outside
the Make Ready system is 75 per cent. This has led to improved infection control rates, which in turn supports increasing patient safety.

Let paramedics focus on the job

NHS Trusts that don’t have a solid Make Ready plan often rely on their paramedics to support the process. This takes them away from their core role, increases stress and makes it harder to retain staff. Even in traditional Make Ready processes, the difficulty in easily tracking down an audit or having to manually check stocks is time-consuming and not a good use of a paramedic’s time.

With a digital process, paramedics spend less time on Make Ready and have increased confidence that their ambulance is fully stocked and ready for use.

The pandemic will only have made the recommendations from the Carter Report more pressing, and challenging, so the case for digitalising to improve performance might be stronger than ever.



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