HEALTHCARE VENTILATION
How equipment’s efficiency is key to Net Zero drive
Healthcare facilities have unique ventilation requirements. Lee Jenkins-Skinner, CIAT’s AHU specialist, highlights recently updated guidance in this key area for hospital premises.
Effective ventilation is vital to ensure safe, comfortable, and efficient indoor environments. For hospitals and healthcare facilities in particular, ventilation is a critical component in a building’s life-support system. There are a number of reasons that specifications for hospital ventilation systems are significantly more stringent than for typical commercial buildings. Use of healthcare premises is particularly intensive, with high-power requirements and high occupancy and traffic levels due to the constant flux of patients, staff, and visitors. Patients may be highly susceptible to airborne infection risks, and their medical condition may require close control of the indoor environment.
A significant contributor to the UK climate footprint In terms of environmental impact, healthcare is a significant contributor to the UK’s climate footprint. Health Care Without Harm reports that in 2019, hospitals and related buildings were estimated to account for around 5.4% of the UK’s total greenhouse gas emissions. Given the wide range of equipment and engineering systems needed to maintain an optimum indoor environment, the legal and technical requirements applying to ventilation for healthcare premises are complex. Valuable guidance is provided by the Health Technical Memoranda (HTM) reference series, produced by National Health Service (NHS) estate specialists and expert cross-industry panels. Guidance on hospital ventilation is explained in HTM 03-01: Specialised ventilation for healthcare buildings. Published in 2021, this provides updated guidance drawing on the healthcare- specific aspects of current standards and best practices. While not mandatory by law, unless specifically stated, HTM 03-01 is considered an authoritative overview of ventilation requirements for NHS and other healthcare premises. It makes clear that any departure from the guidance it contains requires detailed written justification, as part of the works approval process.
60 Health Estate Journal April 2023
An HTM 03-01-compliant CIAT air-handling system installed in a hospital.
Guidance in two parts The guidance comes in two parts. Part A covers design, specification, installation, and acceptance-testing of healthcare ventilation systems. Part B deals with the ongoing management, operation, and maintenance, of existing healthcare ventilation systems. Together, the documents provide an essential reference for specifiers, designers, suppliers, installers, and Estates and facilities managers. There have been many changes since
the previous edition was published in 2007. A central element in the updated version is a focus on achieving carbon reduction targets, in support of UK legislation to reduce greenhouse gas emissions to Net Zero by 2050. The main principle is that, as far as possible, ventilation should be delivered by natural means, passively, without requiring power input. Next in terms of priority is mixed mode ventilation, involving a combination of natural and mechanical systems. Mechanical ventilation is the next most preferable option. Given the often high heat loads and
intense use of hospital buildings, along with the importance of fine control in managing indoor climate, the guidance acknowledges that it may be difficult to
achieve total ventilation requirements through passive means alone. Some element of hybrid and/or traditional mechanical ventilation may be required.
Minimising energy consumption The overriding principle in HTM 03-01 is to minimise energy consumption by choosing ventilation solutions with the lowest lifecycle environmental cost. To this end, the guidance is to switch systems ‘off’ when not needed, and, when required to support set conditions, set-back to the minimum necessary to achieve and then maintain the desired state. The guidance points out that since the previous edition, there have been significant changes in legislation covering energy use, as well as technical developments that improve equipment efficiency. As a result, system designs that simply follow the pattern of previous installations ‘will not meet the revised energy or operational standards, and will not produce a compliant result’. The revised guidance incorporates the relevant changes relating to healthcare ventilation, and system designers are highly recommended to follow the updated parameters set out. For reducing energy consumption by mechanical systems, it points out that one
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