Donating medical equipment: report

Executive summary

The World Health Organisation (WHO) estimates that up to 70% of donated equipment is non-operational. This suggests that globally we are still not getting equipment donations right and this is leaving a deficit and a burden on the receiving country as well as wasting resources in terms of time, effort and potentially costs in donor countries.

In anticipation of how Scotland's many aid organisations and community groups with overseas connections might respond to a post-pandemic world, the Chief Medical Officer commissioned a review of the standards required for medical equipment donations to low- and middle-income countries.

The review took account of recent work to review the Scottish Government approach to International Development.

"Scotland plays an important role in working with global development, whether at a national, university, charity or community group level. In particular, our healthcare expertise helps supporting care for patients around the world and I have asked a small working group to review guidelines for donating medical equipment to low-resource countries to make sure we are at the forefront of best practice."

Professor Sir Gregor Smith, Chief Medical Officer

A short life working group chaired by David Cunningham CEO of Kids Operating Room, was established to take the review forward.

This report was commissioned to review the guidance on donated medical equipment which is often high risk due to its complexity. Medical equipment is defined^[1] as a capital asset and usually requires professional installation, calibration, maintenance, user training and decommissioning, which are activities usually managed by clinical engineers. The working group are conscious that many other types of equipment are donated including consumables, therapeutic and rehabilitation equipment that this report could not cover. However the working group considered the underlying philosophy and considerations are applicable to other types of donated equipment such as those mentioned above.

This reports sets out the findings of the review and recommendations for further work.

Summary of findings

Throughout this review the working group has come to recognise that donated medical equipment is often at the heart of patient care in many hospitals across low- and middle-income countries. Our review found that there is a wealth of good advice available, but the advice is frequently not easily accessible, both in terms of finding it and then in terms of consuming it, especially for smaller organisations. We also identified that although there are clearly several organisations operating at the highest standard, our research strongly suggests that current best practice is not universally deployed. A number of particular areas for practice improvement were identified including communication between donor and recipient, expert biomedical engineering advice and support, evaluation and feedback – these are detailed in the report.

Recommendations

The following lists the recommendations of the working group –

1. There is no requirement for additional new guidance as there is sufficient existing authoritative guidance to allow the safe donation of medical equipment currently available.

2. There should be a new high-level framework written to take donors through the key steps of making a donation. Rather than duplicating the existing guidance, this document will signpost available guidance and make it easier for donors to assess whether to proceed with the donation, or importantly whether to exit the process as needed. The working group has developed a 10 step framework to guide the donation journey and signpost key guidance. This was tested at focus groups in early 2022 and feedback taken into account in the version that accompanies this report.

3. Opportunities for collaboration should be explored with organisations dedicated to the maintenance of high-quality guidance to develop an education and training offer for Scottish stakeholders involved with donations.