ALL HANDS TO THE PUMPS SOCIETY

When COVID-19 filled hospitals with patients with breathing difficulties, the UK’s engineering community rose to the challenge. In record time, engineers from disparate industries created production lines to make ventilators for intensive care units, redesigning equipment, negotiating unfamiliar certification processes, and building new supply chains almost overnight. Michael Kenward OBE discovered how engineering teams achieved this in weeks.

running out of the respirators at the top of the country’s and ventilators that could VENTILATOR engineering companies and, provide oxygen to patients. CHALLENGE almost overnight, created the The NHS entered the On 16 March, the government consortium that came to be pandemic with 7,000 put out a call to UK industry to known as VentilatorChallengeUK ventilators. The government rapidly produce up to 15,000 (VCUK). predicted early on that the NHS ventilators for the NHS in just a This was no simple task. would quickly run out, with couple of months. Companies As Elsy put it: “ventilators are little chance of a rapid increase such as Ford, more famous intricate and highly complex in production. Two established for mass producing cars, and pieces of medical equipment”. medical device companies, Rolls-Royce, better known for The consortium had to balance Penlon and Smiths, produced making expensive jet engines, the need for speedy delivery ventilators for different stages were quick to react. The motor with adherence to regulatory Guru Krishnamoorthy (left), CEO of Penlon, and Dick Elsy CBE FREng (right), Chairman of the Ventilator Challenge UK Consortium and CEO of the High Value of the patient journey. Smiths racing industry also stepped standards. On 18 March, the Manufacturing Catapult with the Penlon ESO 2 ventilator. The consortium of more than 33 UK engineering and technology businesses from the aerospace, produced portable ventilators, in with McLaren, Williams and government asked industry to motorsport, automotive, and medical sectors produced more than 13,000 ventilators in 12 weeks in response to the COVID-19 pandemic, and received a President’s Special Award for Pandemic Service from the Royal Academy of Engineering © thisisjude.uk often used to move patients in other Formula 1 teams offering throw itself into the production ambulances, between wards the services of engineers who of what it called rapidly and in areas where connection suddenly saw their racing season manufactured ventilator systems to mains power is difficult. stranded in the pits. (RMVS). The Medicines and When COVID-19 patients began These work complementary to Industry was keen to help Healthcare products Regulatory to arrive in hospitals in early a Penlon unit, which is for use but, as Dick Elsy CBE FREng Agency (MHRA) published 2020, doctors did not know in ICUs. recalled at an online Q&A event a document with a general how the virus would affect The combined production organised by the Royal Academy specification for ventilators. them. With flu-like symptoms, capacity of the two companies of Engineering*, there was a It was then up to industry ALL HANDS TO early sufferers struggled for was 100 ventilators each deafening silence as companies to decide how to meet the breath as the virus attacked month. The government’s thought: “what do we do next?”. specifications. their respiratory systems and forecasts suggested that the UK Elsy, CEO of the High Value The VCUK consortium hospitals faced a surge of would need many thousands Manufacturing (HVM) Catapult, a concluded that there wasn’t patients experiencing breathing more. Gearing up to meet the group of manufacturing research time to design a new ventilator, problems. Intensive care units anticipated demand became a centres in the UK, decided to which would take time to get THE PUMPS (ICUs) were concerned about priority. step in. He called his contacts regulatory approval, a task that

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“We needed to get to something closer to 3,000 units a week,” says Hoare. “A massive scale up was required. It wasn’t about a 11k–11,683k (2 days) 10k–11k (3 days)

single machine being manufactured by a single individual over 9k–10k (3 days) 10k maybe 20 hours over a week. We had to break it down into about 8k–9k (4 days)

7k–8k (3 days) 250 different activities in what became one of industry’s most 8k 6k–7k (6 days) Cumulative units

interesting production lines.” 5k–6k (4 days)

6k 4k–5k (5 days)

3k–4k (5 days)

4k

2k–3k (6 days)

1k–2k (9 days)

2k can take six to eight months set up new parallel supply chains two to three years to develop Even something as seemingly 101–1000 (11 days) in normal times. The quickest and acquire the required 42 and launch. As industry started basic as trolleys to move 0–100 (29 days)

response would be to work with million parts at peak lockdown; work to meet the challenge, ventilators required rapid 0 13 Apr 14 Apr 15 Apr 16 Apr 17 Apr 18 Apr 19 Apr 20 Apr 21 Apr 22 Apr 23 Apr 24 Apr 25 Apr 26 Apr 27 Apr 28 Apr 29 Apr 30 Apr 01 May 02 May 03 May 04 May 05 May 06 May 07 May 08 May 09 May 10 May 11 May 12 May 13 May 14 May 15 May 16 May 17 May 18 May 19 May 20 May 21 May 22 May 23 May 24 May 25 May 26 May 27 May 28 May 29 May 30 May 31 May 01 Jun 02 Jun 03 Jun 04 Jun 05 Jun 06 Jun 07 Jun 08 Jun 09 Jun 10 Jun 11 Jun 12 Jun 13 Jun 14 Jun 15 Jun 16 Jun 17 Jun 18 Jun 19 Jun 20 Jun 21 Jun 22 Jun 23 Jun 24 Jun 25 Jun 26 Jun 27 Jun 28 Jun 29 Jun 30 Jun 01 Jul 02 Jul 03 Jul 04 Jul 05 Jul existing design. On 19 March, and recruit and train a frontline Team Penlon brought in action to manufacture by the VCUK put its weight behind an assembly team in a new age of a group of heavyweight thousands. McLaren Group WK3 WK4 WK5 WK6 WK7 WK8 WK9 WK10 WK11 WK12 WK13 WK14 existing design made by Smiths social distancing. signatories from industry, took on the task, a technology This graph shows the rate of the scale up of the Penlon ESO 2. The first unit of the new model was produced four weeks after the Cabinet Office set the challenge; Group. The ParaPAC Plus is including Ford, Siemens, business with expertise in 12 weeks later there were over 11,000. The acceleration of production was exponential as teams gained knowledge and solved issues. At the peak, essentially a mechanical, mobile Airbus, and McLaren, with the simulation, engineering, the consortium was building 200 times quicker than previously achieved in Penlon. The second 50% of volume was produced in just 23 days, averaging 260 units per day device that has been used in PRODUCTION HVM Catapult as a focus for electronic systems, and high- ambulances and hospitals in the By the end of March, 5,000 the collaboration between performance design. As Elsy supplied ParaPAC units for over parts from around the world Working with Airbus UK, AMRC In normal circumstances, it can UK and overseas for more than companies offered support for the companies. Bringing in described it, the Formula 1 a decade, but in relatively small and, by working over 12,000 quickly stripped out new take a year to create a new a decade. This device would this venture. VCUK split into engineers from Formula 1 team was grounded and there numbers. hours in April alone, the team equipment intended for work on factory to assemble something meet the needs of patients in two distinct work streams for injected a sense of urgency and was “an enormous amount When it came to mass was able to get production back wings and transformed it into a as complex as the Penlon transit and less severe cases in the Penlon and Smiths devices. pace into proceedings while the of engineering talent sitting production, VCUK needed on track. ventilator production line. Within ventilator, with its 700 parts. hospitals. ‘Team Penlon’ was led by Dr bigger companies contributed there and waiting to get its to ensure that there were a week, 500 Airbus operatives The first lockdown was far Following a request from Graham Hoare OBE FREng, their larger scale processes. teeth into something”. McLaren enough test boxes at each new were preparing to work four from normal circumstances: the Cabinet Office, VCUK then Executive Director of Business The larger medical industry threw its weight into the rapid production site to run final ASSEMBLY shifts making sub-assemblies the ventilator makers had to looked at an idea from Penlon, Transformation and Chairman players, including Siemens manufacture of components for testing on the Smiths ventilators It takes substantial to be incorporated with other move more quickly and set up which had concluded that it of Ford in Britain. The pre- Healthineers, brought their ventilators, as well as the trolleys. coming off the production line. manufacturing effort to units into the manufactured factories where workers could could meet the specifications for pandemic production rate at own special skills and rigour to McLaren Group set up a Mark Mathieson, McLaren’s assemble the hundreds of ventilators. By 26 March, they operate within the constraints the RVMS if it took key modules Penlon was between six and ten the process. Siemens was not production line that turned Director of Innovation, explained: components that go into a knew that their role would be of social distancing. Siemens from its original anaesthetics ventilators a week. “We needed active in the ventilator market, 45 kilometres of aluminium “the Smiths device has a very ventilator. Airbus offered the to make two sub-assemblies Digital Industries drew on 100 system and built a smaller and to get to something closer but has been a key player in extrusion into 250 trolleys a day. complex production process. Advanced Manufacturing for Penlon’s device on eight people from its operations in less expensive unit. Penlon’s ESO to 3,000 units a week,” says medical engineering since the On the broader manufacturing It’s incredibly rigorous and Research Centre (AMRC) Cymru assembly lines with 88 operators Manchester and Congleton, 2 was designed to increase the Hoare. “A massive scale up was 19th century. front, in just 10 weeks McLaren employs 18 different scientific in Broughton in North Wales as per shift for each sub-assembly. including apprentices and young supply of ventilators to ICUs. required. It wasn’t about a single Each player in Team Penlon manufactured more than test boxes to validate all the a candidate assembly line. AMRC AMRC Cymru was one of engineers at the start of their Within 24 hours, a small team of machine being manufactured by brought specialist engineering 100,000 individual components. different components inside Cymru had opened its doors in seven manufacturing facilities careers. Within just 48 hours engineers from the consortium a single individual over maybe expertise to the challenge of As Piers Thynne, Production that device.” With only outdated November 2019, with a focus on set up from scratch as a part they had created a computer looked at Penlon’s technology 20 hours over a week. We had creating a mass production line. Director of McLaren Racing, design specifications available, manufacturing sectors including of VCUK to complement the model of the AMRC Cymru and decided to scale up the to break it down into about The goal was to make, in less said: “not a single McLaren- this was a major hurdle that aerospace, automotive, nuclear, production at Smiths and plant, using Siemens’s plant production of that device. 250 different activities in what than three months, as many manufactured part reached the threatened to halt production and food. Airbus, the first major Penlon. There were also ‘pop up’ simulation software to optimise As the virus took hold and became one of industry’s most devices as Penlon would, in production line with a deviation of the devices. Instead, McLaren tenant at AMRC Cymru, had factories at Ford in Dagenham, the factory’s layout. Ben Apps, wards filled up, the businesses interesting production lines.” normal times, deliver in 20 years. from the design or specification.” dedicated a team to reverse barely started work on next- GKN Aerospace in Luton and a plant layout and virtualisation worked against the clock to The manufacture of medical The production work involved McLaren also played a key engineer, design, procure, test, generation wing technologies Cowes, McLaren in Woking, engineer at Siemens Congleton, establish, from scratch, seven devices is highly regulated. making everything from simple role in the team that worked on and build 144 new test boxes. when the call went out to the Rolls-Royce in Filton, and Surface described the process: “By new large-scale manufacturing According to Penlon, a new hardware to complex electronic producing more of the Smiths It used its extensive Formula 1 UK’s engineering sector to make Technology International in creating a digital twin of the sites; conduct vital clinical trials; medical device typically takes control systems. ventilators to market. Smiths had network to source over 35,000 ventilators. Hook, Hampshire. AMRC, mapping every inch of

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a logistics organisation to approval for the Penlon ensure that everything came Prima ESO 2 device, in just together when much of the UK under three weeks, and could was in lockdown. To handle 3.2 accelerate production at the million parts, DHL Supply Chain Penlon site in Oxfordshire and created a distribution network the new VCUK production Augmented reality headsets stepped in when it came to assembling from scratch. It collected parts lines in Broughton, Dagenham, The socially distanced assembly lines at Airbus, AMRC Cymru (left) and Ford in Dagenham (right ventilators. The Advanced Manufacturing Research Centre (AMRC) at the from new sets of suppliers Woking, and Hook. University of Sheffield rushed Microsoft HoloLens headsets to the AMRC’s volunteer engineers and start of the programme, the It was the speed of execution worked, sometimes away from R&D facility in North Wales. HoloLens played a key part in training the and ensured that they ended As the number of assembly workers, while allowing them to keep a safe distance from one up at the right manufacturing participants shows, VCUK technicians to turn these ideas consortium had to move quickly: that impressed Hoare, families, often from home under another. The headsets provided guided instructions and mixed reality to and concepts into reality in the 50% of problems were sorted something that he plans to take lockdown but the team remained support the assembly of ventilator parts, and connected new factories around locations to be turned into was a complex exercise in the country with skilled ventilator engineers at Penlon, Oxfordshire ventilators. At the same time, engineering management. blink of an eye.” within two days and all critical back into Ford. “The biggest focused and passionate knowing “We have all personally issues were resolved within 22 thing,” he adds, “is the ability to that every ventilator produced the available space, and using “The parts side of the activity DHL also increased its support Alongside creating production learned a huge amount. Our hours, seven days per week, 24 bring a diverse team together, can save a life.” 3D design tools, we were able to was phenomenally complicated,” for the NHS with deliveries of lines that could assemble companies have too,” says hours a day. “We created cloud- even though many of us hadn’t Unlike much of the response maximise production massively. says Hoare. Simply ensuring personal protective equipment thousands of machines, each Hoare. When the project got based systems,” Hoare adds, met personally, and to be able to the pandemic, the ventilator What was also remarkable the supply of the 700 or so (PPE) and supplying Nightingale made up of 700 parts in the under way, there were none of which has led to an invaluable to rapidly trust.” Choose the challenge grabbed few was that digital tools enabled parts that came from all over hospitals. case of the Penlon device, the usual systems in place for database. “All of that is mineable right people, he advises, and headlines during its lifetime. us to design the production the world was a key challenge. Manufacturing a medical participants in VCUK had problem-solving, accounting and harvestable.” Ford is just then miracles are possible. To a certain extent this was line virtually in six days, saving When production was in small ventilator is a part of a complex to put their heads together and other tasks. With problems one business that plans to mine Brian Holliday, Managing a deliberate policy. As Elsy thousands of pounds and hours numbers, if parts were no longer chain of events. Before they can to consider numerous turning up at a rate of about this repository for lessons for its Director of Digital Industries, explains, they wanted to be left in the real world.” being made Penlon could draw be used on patients in the UK, seemingly smaller issues where one every 14 minutes at the wider operations. Siemens UK and Ireland, has his to get on with the job. After the The digital tools also played on its existing stock. That was new medical devices must be manufacturing meets medicine own take on the success of Team event, he says, they were much their part in training the no good for the anticipated approved by the MHRA. Penlon at the bench level. Penlon. “VCUK has been a project happier to talk, partly because operators who would run the production rates. They even and Siemens Healthineers guided VCUK IN NUMBERS of extreme collaboration. This of the story that it tells about production lines. Siemens took had to reinstate production the consortium through the • 13,437 ventilators, enough to meet the normal demand for 20 was achieved with ownership the engineers’ response to the 3D CAD data and converted it so lines in Israel to produce printed intricacies of manufacturing COLLABORATION years, were delivered to the NHS in 12 weeks culture and leadership without crisis. “It is a great story. It is a that it could be presented in a circuit boards. Hoare praises devices according to the MHRA How did it all work out? While • Production reached a peak of over 400 devices a day ego. Internal divisions and celebration for engineering standard web browser to make McLaren’s supply chain efforts. guidelines. It also advised the the rest of the country was • Parallel supply chains acquired around 42 million parts and competitor norms were carefully and engineers. We have got a it easier to train 550 volunteer “They managed it as you would coalition on assembly and in lockdown, some of the electronic components from over 22 countries set aside for the greater good real determination to play that operators from Airbus. hope a Formula 1 team would testing and helped to ensure UK’s leading engineers were • The Penlon ESO 2 contains 365 unique items from 88 suppliers for society. Long hours were out fully.” The complete production manage their supply chain – that, from the outset, the venture navigating what was for them line of Penlon machines ran very timely, very precisely.” The took on board the MHRA’s unfamiliar territory. Hoare • The Penlon ESO 2 device achieved full MHRA approval in just from AMRC Cymru to Ford in team sourced parts from over strict regulation requirements, summed up the effort that the three weeks *Information and quotes attributed to Dick Elsy CBE FREng, Chief Dagenham where the ventilator 22 countries, with the furthest ensuring that no time was lost UK’s engineering companies • The consortium recruited and trained a frontline assembly Executive of the High Value Manufacturing Catapult, were taken from system was built, to Hook where distance travelled by a single in the accelerated production put into the work when he team of 3,500 workers an online Q&A event, organised by the Royal Academy of Engineering, the components came back part being 5,226 miles. process. As it leaves the said: “It was a wild ride for the • Production involved seven large-scale manufacturing facilities with him and Dr Graham Hoare OBE FREng, Executive Director (Business together, and finally back to production lines, each ventilator leaders of these companies. at Ford, Airbus, Surface Technology International, McLaren, Transformation) & Chairman, Ford of Britain, on 29 May 2020. Penlon for the final test, which requires 30 pages of test and The companies provided Rolls-Royce and GKN Aerospace in Cowes and Luton inspection documentation. everything that could be asked With thanks to Dr Graham Hoare OBE FREng and John Gardiner is critical for certification. Team LOGISTICS • The McLaren Racing machine shop alone manufactured Inevitably, the massive increase By 16 April, Elsy announced for and more, including teams from Ford, and Maeve Harte and Rosa Wilkinson from the High Value Penlon ended up with around 113,506 individual components 2,200 people making machines. in production meant creating that VCUK had secured MHRA of exceptionally talented Manufacturing Catapult for their contributions to this article.

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