Last October, Reinsberg Group, the medtech holding of Prague-based private equity firm, BHM Group, acquired a majority stake in Brandon Medical – as ‘part of its strategy’ to build a strong group of independent European medical manufacturers. Simultaneously, Brandon, a long-established independent UK manufacturer and supplier of theatre and ICU equipment, unveiled ‘a bold rebrand’ to reflect its recent evolution and increasing focus on ‘smart’ integrated theatre and ICU technology. HEJ editor, Jonathan Baillie, met by ‘Teams’ with Brandon Medical CEO, Adrian Hall, Executive Chairman, Graeme Hall, and Reinsberg Group CEO, Dr Markus Keussen, to find out more.
Headquartered in a modern 50,000 ft2 office and manufacturing facility in Morley, Leeds, Brandon Medical is a well-established UK designer and manufacturer of technology solutions for operating theatres, critical care areas, and primary care institutions, that has provided healthcare professionals with ‘reliable, high-quality, and affordable’ medical equipment packages for over 75 years.
The company has considerable expertise in medical lighting, medical power and control systems, medical video, and medical AV systems. Brandon not only installs and commissions equipment for operating theatres, ICUs, and examination rooms in hospitals across the UK and overseas, but also offers servicing on all supplied systems. Brandon Medical components sold either direct or via distributors in 70 countries today range from LED surgical lighting and medical and critical care pendants, to theatre control panels, operating tables, and medical power supplies. In the past five years — in response to the growing digitisation of healthcare spaces — the company has focused increasingly on developing the integration capabilities and connectivity of such equipment — the goal being to enable customers such as NHS Trusts and private healthcare providers to create increasingly ‘intelligent’, ‘connected’, and ‘future-proof’, operating and clinical spaces within their hospitals.
Continuing investment in its production facilities, a strong emphasis on R&D, and a focus on innovation, have seen the business establish a strong reputation for the quality of its equipment and its advanced features; it also prides itself on the levels of expertise and service provided to customers.
Opportune time for re-brand
Around 18 months ago, Brandon Medical’s senior management decided that while the business’s existing branding had served it well for a quarter of a century — reflecting its pedigree and 75-year history, and its pride in being ‘rooted in British manufacturing values’ — with its increasing focusing on bringing ‘smart’ equipment to healthcare spaces, the time was right for a significant ‘rebrand’. The goal was to better communicate both Brandon Medical’s growing focus on, and expertise in, ‘smart and integrated solutions’, and its determination to lead the field — for instance by ensuring that as AI matures to the extent that medtech devices harness the technology almost by default, its equipment will be ‘ready and waiting’.
In unveiling the new branding — at around the same time that news broke that the Reinbserg Group had acquired a majority stake in the firm — Brandon explained that the re-brand had taken 18 months’ work, being built around what it dubs its ‘SMART’ approach. Here the acronym stands for the following key elements:
- Standardisation: to ensure that all operating theatre components are ‘consistent and interoperable’ — ‘reducing complexity and minimising the risk of errors’.
- Modularity: allowing components and systems to be easily added or replaced, ensuring that theatres can evolve as new technologies emerge without requiring extensive re-designs.
- Adaptability: to enable an operating theatre to be rapidly reconfigured to meet the specific needs of different procedures.
- Reliability: a ‘cornerstone’ of Brandon Medical’s design philosophy.
- Technology integration: ‘combines a host of digital solutions — from advanced lighting systems to comprehensive data-sharing platforms — into a cohesive ecosystem that enhances patient safety and staff efficiency’.
Literature and online collateral
Brandon further explained that the ‘purpose’ of this SMART approach is ‘to support the building of SMART healthcare spaces’ — through ‘Self-monitoring, Analysis, and Reporting Technologies’. The company says the new branding underlines its ‘vision’ of ‘bringing SMART equipment / a SMART approach to setting up healthcare spaces — to play a vital role in shaping the hospitals of the future’.
To find out more both about the re-brand, and the Reinsberg acquisition, I met by ‘Teams’ in mid-December with Brandon Medical’s CEO, Adrian Hall, the company’s Executive Chairman, Graeme Hall, and Reinsberg Group CEO, Dr Markus Keussen.
I began by asking Adrian Hall about the re-brand. He explained: “The re-brand is an activity we were heading towards to mark the progression of Brandon Medical from the business we acquired in 1993 — that made strong but basic operating lights and control panels. Since then, our strategy has been to develop the business into a recognised and respected medtech business.”
Importance of data recognised
Explaining how this evolution had occurred, he continued: “A decade ago we identified the growing importance of data in life sciences and the healthcare environment, and started to see that the operating theatre had become much more technology-laden. It was clear that the theatre or ICU space would evolve into a more integrated environment, with more and more technology — including both AV and patient-aware devices, and equipment gathering information from the patient. Ultimately, all this data would need to be effectively gathered, directed, and collated, into what we now recognise as the electronic patient record, so we started on a journey, and were proud to be one of the earlier businesses to identify this start on the journey to create ‘smart’ equipment that is able to communicate in an integrated environment.”
The evolution of such ‘smart’ medical equipment had gathered pace, with Brandon Medical ‘contributing as a thought-leader’, Adrian Hall explained. He elaborated: “Just a few years ago, people would refer to ‘integrated’ operating rooms or theatres — a development mainly driven by the move to more minimal invasive surgery. These were generally ordinary operating theatres with minimally invasive surgery equipment and some video routing or capture. We recognised the importance of the shift towards minimally invasive equipment, and subsequently the introduction of robots. However, we could envisage this developing much further — to a point where users such as an NHS Trust would want to gather information from both the patient environment and the patient journey. This entailed not just taking information from the clinical team, but also from equipment that is part of the built environment. Here I’m not solely referring to our operating lights, but also our control panels, which integrate with medical gas systems, and our electrical systems. All this data is quite difficult to gather for the traditional players in the electronic patient record space, because their focus has always been on gathering information from the clinical equipment and team.”
Creating a ‘roadmap’
Brandon Medical’s first step to address the requirement for more advanced technology to collate, analyse, and then transmit, data on, say, the ICU or operating theatre environment, had been to create a ‘5-7-year roadmap’. Adrian Hall elaborated: “We used this period to start to coalesce the different equipment we made into an integrated environment. The first stage was to start incorporating smart technologies into the separate components — such as the theatre lights, and the power and control systems. Once these products can communicate, you need an information hub at the room’s centre, capable of collecting and gathering information from the equipment, bringing it together, putting the data into meaningful ‘packages’, and processing it.”
He continued: “Brandon had made control panels for 30 years, but previously they simply incorporated ‘dumb’ buttons, switches, and indicator lights. We thus pivoted to develop a digital information hub able not only to indicate the operating condition of the medical gas or ventilation system, or the theatre light, but equally of gathering data from the equipment and passing it into a package of information that can be made available to the building, or to the patient record.”
The next step was ‘not just to passively gather that information, but rather to start making inferences from it’. Adrian Hall elaborated: “So, for example, you can start gathering information about the room temperature, and either just report it, or put some intelligence around it, perhaps saying: ‘In fact 20 °C is not warm enough for an operating theatre when the patient will be opened up and is suffering heat loss on the table’. ‘Conversely, 28 °C is too hot, creating an uncomfortable working environment, and potentially endangering the patient’.”
The iTCP
Adrian Hall explained that the control panels in question had become Brandon Medical’s iTCP, or Intelligent Theatre Control Panel (see box, below) which had gone beyond simply being a control panel to becoming ‘a data concentrator and data hub’. The launch of the first version six years ago entailed digitising an existing control system of lights and switches. He said: “The subsequent iteration saw us incorporate the software to allow us to analyse some of the data and make inferences — for example to identify that the condition of the battery on a particular operating light is different to last week, and it perhaps needs changing. Then, we introduced the portal technology to allow the control system to communicate, and tell, say, the healthcare engineering team, of a component’s changing condition.”
Adrian Hall continued: “What you then start seeing is smart technologies gathering sensor-generated information, and making inferences. This starts converging with Internet of Things (IoT) technology, allowing us to communicate through our data hub, to tell the hospital BMS system. Equally we can pass the data on to the shift engineers’ hand-held device, or report it back to our data centre for analysis, or to our control centre. We can then tell a hospital: ‘We need to schedule some maintenance on your operating table or theatre lighting.'”
Remote monitoring capability
With such connectivity, remote monitoring increasingly became a possibility. Adrian Hall explained: “As operating theatres and ICU rooms become more complex centres of technology, all this equipment needs maintaining. It simply isn’t practical for a man in a van who calls twice a year to do this. Not only is it too expensive, but the engineer may only be on site 2-3 days a year, and not on the day the plant breaks down. With online monitoring, we can predict faults, and when an issue arises, can have an engineer on site rapidly, equipped with the right kit and information to fix it first time. This drives much higher room and equipment availability.”
Adrian Hall explained that Brandon’s iTCP system can already make a much more feature-rich set of information available to the ‘in-house’ BMS or to, say, a healthcare engineer monitoring it. He said: “Many NHS Trusts lack the resources to undertake much proactive maintenance themselves. We see remote monitoring and asset management developing in the coming years. Beyond that, we’re working on greater capacity to analyse that data, either within NHS datasets, or our own data warehousing, using Big Data-type analysis, to offer our healthcare customers predictive advice.
“So, for instance, if the theatre temperature is too low, via monitoring you could identify this and potentially correlate it to the number of infections there, identifying trends and threats so that the Trust concerned can work on its best practice, better manage risks, and deliver improved clinical outcomes.”
In the past 2-3 years, Brandon Medical has increasingly focused on incorporating smart technology into individual pieces of equipment, and developing a control environment that will allow it to start joining those together. Adrian Hall said: “We’ve completed a lot of the preparatory work of ‘smarting’ the equipment, and most recently have been working on developing those control environments to enable us to deliver some of the more advanced feature sets I’ve referred to. Now we have those base technologies, we’ve been seeking collaborations with people working in the information gathering and the electronic patient record environment, and outlining our capabilities to them.” I guessed that the key to this ability to collect, gather, analyse, and disseminate information was sensors incorporated into theatre and ICU components such as Brandon’s operating theatre lights.
Sensors in the environment
Adrian Hall said: “SMART is indeed about having more sensors in the environment, so you know more about it, but you also the need the connectivity, and to transmit the data. We have wired, Ethernet-based, and bespoke coded wireless connectivity. Once you have the information, you need to collate it in a data hub, and be able to process it to draw conclusions. You then need the connectivity to inform an end-user of these. We’ve been working on these four elements for some years. Put it all together and you can create some fantastic added functionality in what is now a very smart operating theatre environment.”
I asked him for some practical real-life examples of how such added functionality and information might help, say, a healthcare engineering department at a large acute hospital. He said: “A simple example is maintenance of the operating theatres’ battery systems. Previously, engineering staff have often had to test the batteries and run them flat for 2-3 hours on a Saturday to prove they’re working. This takes time, and can only be undertaken outside of operating hours, and at the end, the theatre is left without its emergency battery provision because the batteries are flat. If there’s a power cut, the theatre cannot function.
“With this technology, however, we can build inferencing. For instance the smart theatre control panel knows the time, whether the lights or ventilation are turned off, and that nobody’s moved in the room for the last hour, so can make as complex an inference as you like, to say: “I’m pretty confident the operating room is empty, so I’ll turn the operating lights on to full power, and tell the battery system to go to ‘mains fail’ mode. I can then monitor the battery status for 20-30 minutes, and compare its condition to the same time the previous week. I can then trend predict that that battery needs replacing proactively, instead of waiting for failure maintenance, which is what happens most of the time.”
Theatre ‘refurb’ projects
Another example is in theatre refurbishment projects. Adrian Hall explained: “When we refit, refurbish, or even build a new operating theatre, the information we need is not 100% available on most projects. Equally, with many theatre environments now ‘digital’, there’s considerable flexibility in terms of the layout, and with our technology we can now create ‘wizards’ to configure the room. For example, we may not know the exact configuration of the medical gas system. Previously we’d have spent considerable time detailing all of this, and gathering the information to build the control system. Nowadays, if the theatre will need a five-, instead of a four-gas system, at the push of a button we can reconfigure the medical gas system to any one of a number of templates.” This could be done ‘even at the last minute’, at the point of commissioning, without major re-work or re-programming. The greater flexibility of these digital systems also greatly simplified the delivery and updating of systems, even remotely, Adrian Hall explained: “So,” he added, “if we have a project on site, but no engineer, or there’s a complex change, our technical centre can dial onto that theatre and reconfigure it to meet the requirements of the project that needs to be handed over, whether it’s in Norfolk, Newcastle, Pakistan, or Nigeria.”
I wondered to what extent this sort of ‘remote reconfiguration’ was now happening.
“Risk management of digital room reconfiguration is very much happening now,” Adrian Hall explained. “In fact, about 80% of the projects we’re delivering now take advantage of this functionality. It de-risks the project massively, both for the constructor, and the hospital — which is often under considerable pressure to get those new facilities operational to provide additional capacity.”
Having discussed some of the key trends in theatre equipment and configuration, and how Brandon has responded, I asked my three ‘interviewees’ to elaborate on the rebrand, its timing, and the reasons behind it. Adrian Hall said: “The re-brand is based around our enormous development as a technology business since our last rebrand in the late 1990s. The familiar Brandon ‘lozenge’ is over 25 years’ old, and while it carried some heritage dating back to the 1940s, we wanted to signal our evolution into a technology business and a leading thinker in creating smart buildings using the modern smart technologies of the mid-2020s.”
An 18-month process
Consequently, the company spent about 18 months developing the rebrand. Adrian Hall said: “It’s not just about changing the logo, but also about understanding the values behind that brand, and what the visuals represent. Brandon Medical considers itself an ethical business, with values, and we were keen to develop a way to communicate that. ‘SMART’ is not just about the technology. That acronym represents considerable work that sits behind that in our values around innovation, doing the right thing, and delivering value into the healthcare space, and doing all this while working in a considerate, kind, and good-humoured way with each other.”
I next asked about the Reinsberg acquisition. Dr Markus Keussen explained: “Reinsberg is the medtech holding company of the BHM Group, a family business based in the Czech Republic that invests in four main areas — retail, venture capital, renewable energy, and private equity. The Group is positioned within the private equity part within the medtech business. In the last 11 years, BHM has invested over €1 bn into these key areas. We’re independent from banks, and have a long-term perspective, differentiating us from other investors with a specific exit strategy. BHM and Reinsberg are thus looking for long-term investments.”
Dr Keussen explained that the medtech business had started some three years ago when he joined BHM, and was named the Reinsberg Group in 2023. He explained: “Our goal is to become a major European player in hospital solutions, so we’re investing in companies headquartered in Europe, but that act globally. We are also looking for medium-sized companies that complement each other.”
Recent acquisitions
He went on discuss the successive acquisitions of ALVO Medical, Famed Żywiec, medifa and — last October — Brandon Medical, touching on some of each’s key products. Famed Żywiec, a producer of operating tables, hospital beds, examination and treatment chairs, and other medical equipment, for over 75 years, has an advanced factory near Żywiec in south central Poland, which is the main manufacturing hub for parts for other Reinsberg companies.
Dr Keussen explained that Brandon Medical had been an attractive proposition for Reinsberg for three main reasons. He said: “The company is one of the UK market-leaders, and Reinsberg Group has not been very active here to date, so that is very complementary to us. Secondly, Brandon has a full-blown portfolio of medical, operating, and examination lights, that Reinsberg hasn’t previously had — apart from one range from medifa. Thirdly, Brandon has invested in, and possesses the know-how in, integration and smart technologies.”
Dr Keussen said the acquisition would give both the Reinsberg Group and Brandon clear future growth opportunities. He said: “In the UK, Brandon’s existing range will be complemented by Reinsberg Group products now sold via Brandon — a good example being operating tables. The acquisition will also enable Brandon to sell its products via Reinsberg’s sales channels globally.” Reinsberg currently sells — both directly and indirectly — into about 130 countries. Dr Keussen added: “There is thus a huge sales footprint for selling Brandon products worldwide, and Reinsberg will also integrate Brandon Medical’s smart technologies into our projects — such as the modular solutions from ALVO Medical.”
A well-managed business
Dr Keussen added that Reinsberg also knew Brandon Medical was a well-managed business. He said: “We have similar philosophies, and will be retaining the existing management so we can grow together.” I asked about any plans to invest in more staff or equipment, or — for example — to increase Brandon Medical’s R&D spend. He replied: “Yes, we certainly do plan to. Historically, the three medtech companies within the group have grown consistently every year — sales, profit, and investment-wise. We’re investing heavily in three areas — increasing productivity and production via machinery and recruitment, in new products and R&D across the group, and in our sales footprint and channels. We have invested in locations including DACH markets (Germany, Austria, and Switzerland), the Czech Republic, Slovakia, and notably in India, as one of the largest markets. We also plan to invest in regional offices in Asia-Pacific and into other countries. Our aim is to increasingly capture market share via our direct salespeople, rather than via third-party distributors.”
Adrian Hall interjected: “Reinsberg outlined a strategy that was very attractive to us — namely for Brandon Medical to become the global excellence centre and lead brand for our range of medical and operating lights and ‘smart’ control platforms. Brandon Medical will a become a central plank of the strategy, trading as Brandon Medical, manufacturing here in Leeds, and developing, investing in, and expanding, that capacity. Indeed, Reinsberg has made a substantial and long-term commitment in the site here. It’s important to say that this is a genuine investment not just in Brandon Medical, but also in the UK and the UK healthcare space.”
Plans to triple manufacturing output
Graeme Hall explained: “Our plan is to triple the manufacturing output of our Leeds site over the next three years. Brandon is a medium-sized company, so we have a certain amount of resources, and are a very innovative business. As a medium-sized business, however, taking innovations to market fast enough can be challenging against very large competitors. Becoming part of a much bigger, 750-strong group, with wider access to international markets, increases our sales channels enormously — something that would have taken us many years to do organically.” I asked how Brandon planned to achieve this tripling in output. Graeme Hall said it would require considerable investment in new equipment and personnel, while Adrian Hall explained: “We have already identified the capacity to cover expansion over the next 9-12 months, which will buy us time to plan in investment in the factory and equipment to create the capacity for the coming years. We’re growth-ready to take advantage of the global opportunity joining the Reinsberg group brings us.”
Graeme Hall said: “Our 50,000 square foot factory in Leeds is still underutilised. So, we’ve got plenty of space to grow into.”
Dr Keussen said: “In the last three years, we’ve invested seven-digit sums in machinery for the other medtech companies we own, to increase productivity and output volume. Simultaneously, we’ve hired new people, in line with double digit growth rates every year. We do recognise though the importance of managing these companies within their heritage, and that their brand is key — a major reason why the new branding for Brandon Medical was so vital — to demonstrate that it is a new era for the business and its products, and its new entity within the Reinsberg Group. However, every brand has its own heritage, culture, and people, and we respect that. For this reason, you won’t see Reinsberg products going forward, but rather products from the different brands within the Group.”
Business owner’s vision
Graeme Hall said: “I think the vision of Reinsberg’s owner and founder, Tomáš Krsek (a successful entrepreneur and manager, who led Skoda Transportation in its modern era as a CEO and Chairman of the Board), is interesting. He says is that ‘if Europe stands still, the world is going to pass us by’. His goal is to form a globally competitive group by bringing together medium-sized businesses like Brandon that can be stronger as part a €100-220 m business, and grow in the future, to compete both against the traditional economies from the West, but also the East.”
As our discussion neared the end, I asked — on a more general footing — whether my ‘interviewees’ felt there was significantly more potential for use of Artificial Intelligence in medtech equipment. Here Brandon Medical’s Global Marketing manager, Christina Hooley, who had facilitated our ‘virtual’ meeting, said: “That’s in fact the core philosophy behind the re-branding. What Adrian was explaining was that Brandon Medical developed the smart ecosystem. While sensors and ‘smart’ technology aren’t new, our goal is to apply both really effectively into a healthcare space so that it is ready not just for today, but also future-proof.”
She continued: “AI has changed dramatically in the past year, as have all the clinical innovations we’ve discussed — with robotics in surgery, for example. We don’t know what medical technologists will invent next year, but the spaces we deliver — our ‘smart ecosystem’ — are ready for all of this — as a database for AI, for 8K video, and with places where you can plug in — the really pragmatic things nobody thinks about.”
Lack of sensors currently
Adrian Hall added: “To be able to collect the datasets we discussed earlier, we’ll need the fundamental sensors in the room to be able to learn more about what’s happening within it. Currently, most traditional projects and buildings have neither the sensors nor the connectivity to gather that information and make it available to the AI platforms which can deliver so much enhanced functionality. Moving forward, there’ll be partnerships that grow between people like ourselves at Brandon that can provide those datasets, and the functionality that can feed off them to create more intelligent inferencing. These will ultimately be looking at exception-based decisions, trending, and predictive decision making — all the things that will transform healthcare and improve patient outcomes. In coming years, we may well look back and think that what we’ve done to date is almost unintelligent.”
Graeme Hall said: “AI is a topic of great conversation everywhere. Essentially though, to use any kind of intelligent decision making and software, or even human intelligence, you need information to start off with. Our smart environment is collecting that information, putting the sensors into place, bringing that data together, and bringing it into an environment where you can process it and communicate it. That is the foundation for any AI. Without that, there is no AI, because you don’t have anything to analyse.
“Within our ‘smart systems’ at Brandon,” he continued, “we’re starting to use the information we’re gathering to do some things that are valuable and useful to our customer groups — the clinicians and hospital engineers. Basically, it’s the intelligent use of that information to create value, save money, and increase both patient safety, and efficiency. Our aim is to expand the market with a new paradigm on how to build a healthcare space that is ready both for today and for tomorrow.”