Leaders in
Mobile Lithotripsy
Effective · Flexible · Experienced
Yasir Hassanein
Lead Consultant Urologist
Calderdale & Huddersfield NHS Foundation Trust
July 2021
‘We have been using the Focus Medical mobile lithotripsy service at Huddersfield Royal Infirmary for more than 5 years……..we have found Focus Medical to be most flexible and accommodating to our needs when additional patients need to be listed at short notice. The service is highly cost effective for the trust and revenue generating.
We find the service to be of a high quality as efficacious in terms of stone fragmentation and well supported by technical staff who come along as part of the service.
We would strongly recommend this service to other NHS trusts without reservation.’
What our patients say
‘Had lithotripsy today by Ian and Steve they were so kind and reassuring and very professional made me feel at ease thank you’
‘I received treatment today and the technicians were absolutely fantastic. Totally supportive, informative and kind for what was a first time for me.’
About Us
Establishing in 1999, Focus Medical Services have been consistently delivering a high quality, comprehensive Mobile Lithotripsy Service to the NHS and private hospitals throughout the United Kingdom and the Republic of Ireland.
Our highly skilled Lithotripsy Technicians perform over 10,000 treatments annually and operate to best practice, utilising all of the most up to date and proven treatment techniques to maximise effectiveness whilst minimising risk to the patient.
Unlike many static units that rely heavily on x-ray guided stone targeting, the extensive training our staff have undertaken enables us to provide a service that is heavily focused on Ultrasound guided treatments. This significant reduction in radiation use makes our service a safer option for patients and staff.
Our staff are based in a variety of regions around the UK, this enables us to provide a Lithotripsy technician to your hospital at very short notice thus making us an ideal candidate for emergency ‘Hot’ Lithotripsy procedures on request.
During the pandemic, we were very proud to continue supporting our client hospitals throughout this extremely difficult period. We adapted our infection control and treatment protocols and also suggested and subsequently implemented changes to treatment areas to keep both patients and staff safe.
Our Committment
Our Company is focused (forgive the pun) on delivering high quality, safe and timely treatments for patients. Whether the patient has been referred through the NHS or privately, they will always experience a professional, friendly and reliable service. Our highly conscientious and empathetic staff’s primary aim is to make patients comfortable, answer any questions they may have about the procedure and to provide advice on where they can find information which may assist them to avoid producing kidney stones in the future.
We are positive agents for change in the healthcare system. The values of our staff guide our actions and behaviour and influence the way we interact with patients and colleagues. Each value is inspired by our primary objective to deliver high quality healthcare.
We are an experienced company and the largest Lithotripsy providers in the UK and Republic of Ireland with many long-standing contracts. Our flexible and dynamic approach helps our customers to meet some of their most pressing challenges. We consistently receive excellent feedback from patients as well as staff.
We are adaptable, professional, approachable, and friendly. Our experience is second to none and there are very few difficult scenarios we have encountered and not overcome successfully.
Our Services
Our technicians are heavily conscious of the needs of a busy hospital, we therefore arrive early and deliver the equipment into the proposed treatment area. The equipment is then cleaned, installed safely, and tested prior to commencement of the session.
We have safe systems in place to ensure that identification and suitability of the patient is checked prior to treatments and that infection control is strictly adhered to before, during and after procedures.
We have devised a computer based auditing system, which allows for accurate treatment records to be maintained.
We also provide a personal patient treatment sheet following each treatment, this is placed in the patients notes and details all aspects of the treatment received, including any follow-up treatment suggestions.
On request we can provide the Trust with an audit of patient treatments, and also a full breakdown of attendance details for each session covering total number of patients on the list; how many were treated, how many did not attend, and how many were cancelled prior to treatment (due to high blood pressure, infection, etc.).
Our flexible and friendly attitude has always been to operate around the existing pace of the department and to ensure that the list goes seamlessly with minimal fuss.
At the end of the day, the equipment is cleaned, uninstalled, and removed safely from the hospital.
Equipment
We supply all of the equipment needed for a successful lithotripsy session;
- A Storz Modulith SLK
- Aloka Ultrasound Unit
- An integrated GE Image Intensifier (Including our own Radiation PPE).
- A specially adapted treatment bed, with a weight limit of 28 stone enabling us to carry out treatments on bariatric patients
We have been using Storz equipment since the inception of our company and find them to be reliable, sturdy, and effective. We find that the Storz SLK lithotripter’s over-couch therapy head is unparalleled for lithotripsy use. Because we predominantly target stones under real-time ultrasound we are able to apply subtle changes to the target area should the patient move slightly out of position. This equipment also enables us to remain close to an anxious patient during treatment to offer our reassurance and support throughout.
We maintain spare capacity on all of our equipment and with our own maintenance site and designated engineers ideally located in Central England we can ensure that all of our equipment is maintained to the highest standards andany replacement equipment needed will be delivered in adequate time so as not to disrupt a list.
Our Team
All of our Lithotripsy technicians are HCPC registered and are DBS checked.
Our Lithotripsy technicians have a wealth of experience in this field and you can rest assured that each technician will bring with them all of the skills required to make the session a success, in fact, the longest standing members of staff have over 20 years of experience each. Our workforce mirrors today’s diverse population and are able to work collaboratively as one highly effective team.
We undertake continual training and are always kept up to date with the very latest findings and studies in our industry. We constantly strive for improvements and are relentless in looking for new and better ways of doing things even if they drive marginal benefits.
Our staff also have vast experience in administering treatments to Paediatric patients, indeed we supply the service to numerous Children’s Hospitals across the UK and Ireland. Our technicians work efficiently and safely with consistently excellent results.
Please note that this service is provided solely under ultrasound guided control.
‘Following my appointment yesterday…. I would like to express my thanks for all the staff for their politeness and professionalism. They were extremely helpful and very approachable.’
‘I would like to say thank you to Ian and Alan for the lithotripsy treatment I had today at Bedford hospital. Very professional and kind.’
Patient Information
Link to NICE guidelines
www.nice.org.uk/guidance/ng118
Link to NHS Kidney stones
www.nhs.uk/conditions/kidney-stones/treatment
What is lithotripsy, how does it work?
Lithotripsy, also known as ESWL (Extracorporeal Shockwave Lithotripsy) is a non-invasive treatment using a high-powered pressure wave to target your kidney stone(s). We use ultrasound and sometimes X-ray to help us target your stone(s).
The overall aim is to weaken the structure of the stone, eventually enabling it to break into very small pieces so it can be passed easily in your urine.
ESWL is not performed under general anaesthetic. The treatment can sometimes be uncomfortable and so mild pain relief is offered to help you tolerate the treatment successfully.
It may take more than 1 session of ESWL to successfully treat your kidney stones. It all depends on the density and location of the stone in your urinary tract.
What will happen to me on the day?
- Once you enter the treatment room you will be greeted by a friendly lithotripsy technician who will introduce themselves. They will then ask you some questions to confirm your ID and ensure you are safe to have ESWL.
- Depending where your stone is in your urinary tract, they will ask you to either lie face down, or on your back on the treatment table. They will expose a small portion of your back/stomach and place an ultrasound gel covered therapy cushion to your skin.
- A live ultrasound image will guide the technician to your stone and enable them to target. Once your stone is targeted, the technician will start the machine.
- A rhythmic clicking noise will start and the technician will gently increase the energy level of the shockwaves throughout the treatment. What begins as a faint flicking sensation will gently increase to a feeling of what a lot of patients describe as ‘being flicked by an elastic band’.
The whole procedure normally lasts around 30 minutes.
What can I expect after my treatment?
- There will be a slight reddening of the skin where the cushion has been placed against your body. This normally resolves over the next few hours.
- You may also experience blood in your urine following this treatment. If bleeding is still noticeable after 48 hours, please seek medical assistance.
- There is always the risk of kidney stones moving and causing pain and/or discomfort following this procedure, please seek medical assistance if this occurs.
- It is important that you drink plenty of water alongside your normal beverage(s) for the next few weeks (We recommend between 2 & 3 litres). This will help to further damage your stone and increase your chances of passing the fragments. In line with national guidance, to prevent reoccurrence, consider adding freshly squeezed lemon to the water.
- Rest for 24 hours following your treatment.
John Greaves, ESWL Patient, Broomfield Hospital, August 2021
“I am a Kidney Stone sufferer and today started a new course of lithotripsy at Broomfield Hospital. I was seen by two great guys called Ian and Alan who are a credit to your team. I’m not nervous of such procedures but had I have been, I am sure they would have quickly put me at ease. They were so easy to talk to and happy to answer my questions. I work as a musician and a while back, wrote a fun song about Kidney Stones called “The Kidney Stone Blues”…so could someone let Ian and Alan know they were much appreciated and I would like to dedicate this song to them both.”
Job Opportunities
Focus Medical Services Ltd is a small independent company which was established in 1999 to provide mobile lithotripsy services to NHS and private hospitals throughout the UK and Republic of Ireland. If you enjoy patient contact and would like the opportunity to be more involved with patient treatments, then this could be the ideal role for you.
We are looking for
Diagnostic Radiographers
to join our team of Mobile Lithotripsy Technicians
starting at £30,000 p.a.
About the Job
You will be involved in providing a comprehensive service to our client Hospitals, working in a different site each day, this will involve:
- Delivery of equipment to the Hospital (this is transported in a Mercedes Sprinter sized van which you must be happy to drive)
- Installation and set-up of equipment
- Treatment of patients (typically 10-14 patients per day)
- Removal of equipment at the end of the day
- You will work in pairs, alongside another fully trained Mobile Lithotripsy Technician
Working pattern:
- Average 3 days per week in UK (will involve some overnight stays, depending on distance travelled)
- Every 4-6 weeks spend 1 full week away working in Ireland with reduced workload the following week
No previous experience is required as in-house training will be given and a programme of training will be discussed with you.
About Lithotripsy
Lithotripsy, also known as ESWL (Extracorporeal Shockwave Lithotripsy) is a non-invasive procedure using high energy shockwaves to target the stone in the kidney or ureter where they break the stone into grains of sand which will then be passed in the urine.
The stone is targeted using x-ray and ultrasound localisation – full training will be given in both modalities.
About You
Excellent communication skills – you must be able to liaise effectively with patients and all levels of Hospital staff
Be conscientious and motivated to maintain high levels of patient care
Be able to work independently as well as part of a team
Capable of working on your own initiative
Hold a full UK driving licence
Physically fit – moving of medical equipment is required (training will be provided).
How to Apply:
Please e-mail Kate Lievesley (kate@focusmedical.co.uk), Director, for an information pack and application form. Please state your location when applying.