2. Is this how you view commercial organisations?

3. Pioneer and world leader in endoscopic surgery 70 years of experience, expertise, innovation, quality KARL STORZ is the largest privately held Endoscopy company in the world Who are we ?

4. Karl Storz, M.D. h. c. (1911-1996)Dr. med. h. c. Sybill Storz, CEOKarl Christian Storz We are a family company

5. Professor Harold H Hopkins (1918-1994) British Innovation, German Engineering

7. Philosophy  Quality – we don’t do 2 nd best  Working with clinicians  Training and Education Future has tradition, tradition has a future

8. Neurosurgery since 1983 Oral & Maxillofacial Surgery since 1988 Ear, Nose, Throat since 1945 Plastic Surgery since 1994 Anaesthesia & Emergency Medicine since 1954 Cardiovascular Surgery since 1996 Thoracic Surgery since 1971 Gastroenterology since 1963 Laparoscopy since 1971 Gynaecology since 1971 Urology since 1963 Proctology since 1975 NOTES since 2009 Arthroscopy and Sports Medicine since 1975 Spine Surgery since 1997 Paediatrics since 1969 Microscopy since 2008 Navigation since 2008 Fluorescence Imaging since 1995 KARL STORZ OR1™ since 1993 Hygienics since 1995 Units since 1945 Industrial Group since 1976 Veterinary Medicine since 1989 Military & Defence Medicine since 2009 EndoProtect1 since 2004 Telepresence since 1964

9. Can we rethink how we work ? Industry NHS Representative Clinician Procurement Transactional Relationship R & D Education Training Global perspective Academic Research Marketing Innovative Procurement Quality Systems Commercial Awareness Problem solving Service Initiatives Financial Constraints QIPP Change of Service Provision Increasing demand Cost management Five Year Forward View CRES Improved patient outcomes Introduction of market forces

10. Can we rethink how we work ? Industry NHS Representative Clinician Procurement Transactional Relationship Transparent, sustainable engagement at different levels across the organisations, working in partnership to improve patient outcomes Collaborative Relationship

11. What we now know…. Severe limitations on funding for new equipment Resources stretched to the limit A lot of poor standard of equipment in use Technical competency issues within theatres Training issues in Theatres Equipment management issues suck up huge amounts of time Time costs a lot of money! Lots of areas of risk within theatre Cancelled operations cost money and cause grief Budgeting is a nightmare due to unanticipated costs YOUR FUTURE IS OUR FUTURE!

12. Potential Solutions A Fully Managed Surgical Facility – SMART Solution A comprehensive support solution where higher volumes / values of equipment are needed. Includes:- Equipment provision Full repair / replacement maintenance Dedicated and trained On-Site Technician Defined and mutually agreed Service Level Agreement with penalties for under-delivering Option to include clinical training at all levels Longer term commitment – typically 5-7 years Full Governance via Quarterly review meetings Available via two existing NHS frameworks for rapid adoption

13. Potential Solutions Surgical Instrument Managed Service – SIMS A ‘mini’ managed service Tray specific / apparatus specific Monthly equipment health checks by trained engineers Maintenance included ‘Easy-in, easy-out’ arrangement Rapidly deployed Scalable as confidence grows / needs change Flat lined costs for term of the agreement

14. The result Karl Storz needs Hospital needs Good Patient Outcomes SMART The ultimate ‘Win, Win, Win’ situation

15. Is this how you view commercial organisations?

16. Finally, from me Not all businesses are looking to exploit the NHS – your future is our future. Together we are SMARTER – let’s look for ways we can work together. If you…. –have MAS equipment needs but no funding –need to effect a service change but no funding –are opening up more than 1 instrument tray / procedure –want to offer more/new services but think you cannot afford –have had to cancel patients due to unavailability of MAS equipment –have manpower, technical competence issues, inconsistent theatre staff –need to save money –know of an operational or financial risk that you want someone else to manage –don’t know who else to talk to –want a SMART discussion in your hospital PLEASE SPEAK TO US

17. Thank you