COMMUNICATIONS
Communications and operational resilience
Medical emergency communications still rely on single channel systems vulnerable to a single point of failure. James Bushell, head of product at Critico, explains why communication resilience must be considered with the same engineering discipline applied to other critical services.
Modern hospitals are engineered with resilience at their core. Estates teams routinely design redundancy into critical infrastructure such as power distribution, water supply, HVAC systems, and medical gases to ensure that essential services remain operational during failures, maintenance work, or major incidents. Yet one area of hospital infrastructure is often overlooked in resilience planning: medical emergency communication systems. Effective communication is central to hospital
operations. From estates response teams dealing with plant failures, to security teams managing incidents, to clinical staff responding to medical emergencies, the ability to deliver critical alerts quickly and reliably is fundamental to safe hospital operations. However, many medical emergency communication systems in healthcare environments still rely on legacy one-way, ‘send and hope’ bleep systems, with their single channels inherently being a potential point of failure. When failure does occur, you have nothing until the system is repaired, and an alternative means of communication needs to be put in place during the outage period. These single points of failure can compromise response times during incidents. As healthcare estates continue to modernise infrastructure and digitise operational systems, communication resilience ought to be considered with the same engineering discipline applied to other critical services. By identifying vulnerabilities and implementing layered communication strategies, estates teams can ensure that critical alerts continue to reach the right people, even when individual systems or individual networks fail.
Understanding where communication vulnerabilities exist Healthcare environments present unique challenges for communication systems. Hospitals are complex structures built from reinforced concrete, steel, and specialist materials that can significantly reduce signal propagation. Basements, plant rooms, service corridors, and stairwells are often particularly difficult environments for wireless communication. That said, many hospital alerting systems have evolved
organically over time. Legacy ‘send and hope’ paging systems, mobile-based messaging tools, Wi-Fi dependent applications, and standalone alerting platforms are often introduced to solve specific operational problems rather than being designed as part of an integrated communication infrastructure. This can result in environments where critical alerts rely heavily on a single technology or network.
For example, a hospital may introduce smartphone- based alerting to modernise communications, but in doing so becomes reliant on mobile network data coverage or Wi-Fi availability. In busy urban hospitals, mobile network congestion can affect message delivery. In large facilities with complex structures, coverage may be inconsistent across the estate and the application itself is a single point of failure. Similarly, alerting systems that depend on a single
server or network route may become vulnerable during maintenance activity, infrastructure failure, or cyber incidents. These vulnerabilities often remain hidden until an incident occurs.
The physical challenges of hospital environments Healthcare estates present some of the most demanding environments for reliable communications infrastructure. Unlike office environments or commercial buildings, hospitals often consist of decades of expansion, refurbishment, and redevelopment. As a result, many sites include a mixture of construction materials, structural layouts, and underground service spaces that can significantly affect communication systems. Locations that are naturally shielded from external signals, including basements, imaging suites, plant rooms, and service corridors, are often precisely the areas
June 2026 Health Estate Journal 67
Delivering critical alerts quickly and reliably is fundamental to safe operations.
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