INFECTION PREVENTION AND CONTROL
As part of the infection prevention and control
education upskilling work HLM undertook in late 2023, it was identified that an improved
internal design tool – which could help its team, implement, manage, and track IPC design, derogation and risk, would greatly enhance its ability
to positively impact on IPC measures within its designs.
Neil Orpwood
that design consultants play in CDM across all Business Case Stages (see supplementary annexure volume 3 – CDM Duties).
Alongside our designers’ duties under the CDM
Regulations is our requirement to comply with providing input into derogation schedules. Recently updated in July 2023, a schedule of derogations must be provided by the commissioning organisation for any project requiring external business case approval. Similarly, they may be requested for projects that have gone through an organisation’s delegated internal approvals process. The data provided in externally approved business cases will be collated centrally to help inform future updates to guidance. Applicable to 100% new build, repurposing, or refurbishment, for designers, the standout requirements from the revised guidance and controls include: n Specific criteria against which derogations should be recorded.
n Identifying derogations specifically against schedules of accommodation, in addition to capturing these again in aggregate in the full derogation schedule.
n All agreed derogations should be flagged in BIM data to manage the derogations during construction and the post-construction phases.
n Inclusion of derogations against other standards, in addition to HBNs and HTMs.
n Inclusions of derogations specifically related to the NHS Net Zero Building Standard, ICB, and other ‘green plans’.
Easily translatable to NHS schedule The latter points, while not directly related to patient safety, do highlight the need for designers, BIM, internal schedules, and protocols, to be linkable and easily translatable to NHS schedules. Starting with HBN 00-09: Infection control in the built environment, and given the requirement to interface with other spreadsheets, our ‘in-house’ tool was developed in Microsoft Excel, and consists of several individual worksheets: n How to Use: Guidance on how the tool works across the RIBA stages.
n Dashboards: Showing, at a glance, the number of ‘non-compliances’ against the relevant IPC standards.
n Sign-off: A tracker to ensure that relevant information is reviewed and signed off by the IPC team.
n RIBA Checklist: Relevant design team activities, alongside those of the IPC team, to ensure engagement and aligned consideration.
n General space: Requirements for the size of rooms and the space around elements.
n Waste storage: Requirements for the adequate provision of waste and associated storage.
n Ancillary space: Detailed room-by-room requirements January 2025 Health Estate Journal 45
to ensure IPC protocols within the facilities, e.g. Dirty Utilities.
n Finishes: Requirements to ensure that the correct finishes in support of IPC are specified.
n Fittings and equipment: Requirements around general fittings (excluding sanitaryware).
n Personal hygiene: Requirements around fittings specifically designed for hygienic personal use.
n Engineering: An overview of engineering-related IPC elements, to allow for architects to undertake the lead consultant role on IPC requirements.
n Construction: A works sheet to assist with advising PM/QS/contract administration teams on suitable requirements for Contractors’ Preliminaries and alignment with CDMC regulations.
Schedules of non-compliance created Designed to ask questions with ‘yes’ answers for compliance, the spreadsheet siphons off data to collate schedules of non-compliance, which can then be easily input into NHS Derogation or CDM risk registers and assessments. The headlines from all the sheets also input into an overall ‘dashboard’, which gives at-a-glance risk and derogation profiling using simple RAG (Red Amber Green) colouring. While the current tool has been written around HBN
00-09, in support of HLM’s work north of the border, the tool will be extended to cover the HAI-SCRIBE and KSAR processes for NHS Scotland. IPC issues in Scottish hospitals have been well documented in recent headlines, and with growing awareness and scrutiny around the spread of infections post-COVID, HLM is well placed to ensure the continued competence of its designs.
Neil Orpwood qualified as an architect in 1995, having started his degree at North East London Polytechnic in 1985. He is a Chartered Member of the RIBA, and has worked at HLM Architects in Sheffield since leaving full-time education (albeit initially spending a one-year spell as a shop assistant in London, waiting for the economy to improve, in 1992). As an integral part of HLM’s Healthcare Team both nationally and internationally, Neil has a detailed knowledge of this specialist sector, working on a spectrum of projects, from small refurbishments through to multi-million-pound facilities.
Requirements around fittings specifically designed for personal hygiene in healthcare settings are among a number of key elements in HLM’s in-house tool.
AdobeStock / Brainstorm Solutions
AdobeStock / nik_yurginson
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