Other justification
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Nordland Hospital intends to enter into agreement with Karl Storz Endoscopy Norway AS for upgrading integrations and endoscopic equipment for theatres. The estimated total cost for the entire upgrade is NOK 36 million excluding VAT, the maximum estimated cost is NOK 46 million excluding VAT. The service costs are estimated to NOK 400,000 excluding VAT per annum. Nordlandssykehuset HF has 11 theatres and 6 theatres for day surgery, which currently have endoscopy and AV systems with integrations from Karl Storz Endoscopy Norway AS. Karl Storz Endoscopy Norway AS was awarded a contract for this equipment in the announced competition: U.12.E Integrated theatres and endoscopic equipment. The contract was signed in January 2014. The Endoscopy and AV systems are of the age of ten years and ought to be replaced as soon as possible. The park of endoscopes and cameras varies in age, and a lot of the equipment shall be reused after the planned upgrades. The equipment consists of AV systems, endoscopy equipment, software for temporary storage and editing, as well as a system that integrates all components, including third-party equipment, together, so that all equipment can easily be controlled and monitored from the same system. Nordlandssykehuset HF has carried out thorough investigations of the market in winter 2023/2024 through conversations with equivalent operating units and through visits to other hospitals in Norway. It was apparent from these surveys that there are only two suppliers who can cover the need for fully integrated theatres with endoscopic equipment. Reference visits and meetings with both suppliers were carried out. The theatres are planned to be upgraded over a period of five years, of which 2 theatres will be upgraded in 2025. It is not possible for the hospital to upgrade all the theatres simultaneously. This will cause major capacity problems for the hospital and postponement of many operations. The time frame for upgrading the equipment per theatre can take over 6 weeks, as construction engineering work with ventilation and ceiling/ceiling shall be carried out at the same time. These six weeks do not include training. The Operations Department at Nordland Hospital comprises 6 disciplines: gynaecology, gastro, urology, vessels/thorax, orthopaedics and ear-nose-throat. The theatres are co-housed and are used interchangeably by different disciplines. The theatres currently have identical set-ups of surgical equipment, so that personnel can easily move between the different operating theatres. In the evenings, nights and weekends there is one team on duty who take care of all patients no matter what they are operating for. This is ø-hjelp ́s patients and relatively often acute situations, such as sections of hashtags or aortaanurism, which must be operated immediately. All theatres have the same equipment, including operating tables, lamps and other third-party equipment that is connected with Karl Storz's integration, this is important for the personnel being able to work efficiently and see to the patient safely. It also makes the operations department more flexible so that personnel can make the most of their living room capacity. If one of the theatres needs to be closed, operations can be more easily moved to other theatres, without the need to change the set-up of the equipment. It is, therefore, very important for the sake of stand-by, patient safety and work flow that the operating theatres are equivalent equipment and systems. All of the components in the current theatres are also only compatible with products from Karl Storz Endoscopy Norway AS in order for the system to function seamlessly and to maintain the same functionality, compatibility and integrations as today. The alternative to direct procurement is the replacement of all the existing equipment, which is estimated to have a value of approx. There will also be reconstruction costs, training and changes in the IT infrastructure, which will be considerably higher cost than direct procurements. This is not considered to be in accordance with the law ́s objective of effective resource utilisation, cf. The Public Procurements Act § 1. Furthermore, replacement will lead to a period over several years where the theatres that are upgraded will have different set-ups as the existing living rooms, which will be a very heavy workload for personnel and prevent good work flow. There are, thus, no reasonable alternatives, cf. The Public Procurement Regulations (the Public Procurement Regulations) § 13-4 letter b second section. The competition is considered impossible for technical reasons, as there is only one tenderer who can deliver, cf. the procurement regulations § 13-4 letter b second point.