HEALTHCARE ESTATES 2021 CONFERENCE


looking at the critical ones maybe slightly earlier.”


Malcolm Thomas urged all those with a professional interest in, or responsibility for, healthcare, to read and familiarise themselves both Parts A and B of the new HTM 03-01 – ‘including the appendices and the accompanying explanations’.


historical schemes for those of you with older, smaller, theatres.”


The authors of the new HTM had also created quite a lot of application-specific guidance – for instance dividing up applications into ‘Treatment and Procedure Facilities’, ‘Airborne Protective Facilities’, ‘Airborne Isolation Facilities’, ‘Maternity Facilities’, ‘Pharmacy Facilities’, ‘Sterile Services Facilities’, and ‘Extract systems and local exhaust ventilation’. Malcolm Thomas said: “We have presented that information in terms of tables.” Here, by way of example, he showed a slide of an ‘Airborne Isolation Facilities’ table, covering Isolation rooms, Categories 2 and 3. He explained: “If you want to know what the categories are, look at the bibliography in the index at the back of the HTM, and it’s all explained.” Down the side of the table were the areas or zones being discussed, with the next column highlighting the reasons and purpose of the ventilation, and the next ‘some typical design factors to help make it easier for people to understand what’s required’.


Part B


Turning to Part B and its ‘major themes’, Malcolm Thomas said that, in writing it, the authors had sought to ‘clarify things’, ‘plug up the holes’, and ‘explain more clearly what we require’. So,” he continued, “there is a legal requirement to keep records and information on ventilation systems, but many hospitals don’t, so they have broken the law.” In fact, he explained, Part B now includes a requirement for an inventory with a uniform system of identification. He said: “Go round some hospitals and they have 10 air-handling units all called ‘Air- handling unit number 1’ in 10 different plantrooms, so we obviously need to be a lot clearer. Part B thus suggests that each ventilation plant has a unique number,


corresponding to all the information about it, what it is, the spaces it serves, all the parameters and information about the equipment, the system performance over the years, and when we should ‘scrap it’. Then,” he continued, “we archive that information with its number plate, and put a new number plate on the new plant. We thus have an auditable trail. Generally, when you go around hospitals, a lot of information about systems is in people’s heads, so when they leave it goes with them.” This, Malcolm Thomas argued, was not only ‘not conducive to running an efficient system’, but was also dangerous.


Phased replacement Part B of the 2021 HTM also discusses ‘mid-life refurbishment’, and phased plant replacement. The speaker explained: “We suggest that after 10 years, the air- handling unit should be taken out of use, cleaned, examined, and any corrosion treated, fitted with new controls, updated to get the best from the technology available, and then put back into use. After 20 years, plant should be replaced. If you don’t start thinking about this when you put the plant in the equipment doesn’t get replaced, and you then find 30-40-year-old plant still in use in the NHS. We want to take the best, get the most efficient systems, and take advantage of the latest technology; not cling to the older things.”


The Ventilation Safety Group Malcolm Thomas explained that the Ventilation Safety Group had a key role here in getting a phased replacement programme going. He said: “With a brand new hospital, there may be 50 ventilation plants installed, all of the same age; you’ll have a mountain to climb to replace them all at the 20-year period, so you need to try to split that up somehow, and start


At any time they needed specialist guidance or help, NHS healthcare engineering teams could, of course, call on an Authorised Engineer (Ventilation) – ‘people with independent knowledge, totally independent of the Trust/Health Board’, and thus ‘there to tell you the truth’. He said: “You may not like what your AE (V) says about your ventilation, but they are there to tell you it like it is, so please listen to them. Similarly,” he added, “they should be involved in the process of providing plant to advise on what goes in. The reason I say this is – and I’ve been a hospital engineer – is that your knowledge here will be limited, and it’s very easy to be bamboozled by an outside design team into accepting something they think is alright. It may be that what’s being proposed is a great solution, but, conversely, it could be that it won’t benefit you long term. Authorised Engineers are there to help with those decisions.”


Observing standards


Nearing the end of his presentation, Malcolm Thomas said: “There are minimum standards for all plants – as I said at the beginning – and they should certainly be observed. They are there because there are legal requirements about access, cleanliness, and the efficiency of the plant, listed in both Parts A and B; most of the major pieces of legislation that affect and handling ventilation systems, in a hospital or anywhere else. In a hospital, we also have the Medicine Act, and the Health Act, which impose a duty of care on us for our patients and what we do in healthcare settings.” These, the speaker said, ‘sat alongside’ other legislation such as the Health & Safety At Work etc, the COSHH Regulations, ‘et al’.


Lastly, Malcolm Thomas explained, Part B of HTM 03-01 (2021) included a section on ‘Verification’. He said: “This requires you to ensure, every year, that the critical systems in your hospitals are still safe to use. They may be getting slightly older, but the things that matter within your ventilation system must still be working correctly, and then there is the annual routine inspection and maintenance. All the standards on these areas have been there for a considerable time, but need to be adhered to.”


He added: “So, to conclude, the HTM has been entirely revised, with many changes, and I would encourage all those with a professional interest in, or responsibility for, healthcare ventilation, to read and familiarise themselves with both Parts A and B, including the appendices and the accompanying explanations.” With this, he closed his presentation, and invited questions.


hej January 2022 Health Estate Journal 29


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