VENTILATION
The interior of an air- handling unit with a
pool of water inside the unit carcass, indicating complete failure of the plant – which will lead to iron corrosion (rust) within the AHU, which may indicate a specific Legionella hazard.
from the service-provider, particularly in the Operating Theatre Department. Here, it is often the case that theatres can only be accessed during the weekend or in the evening. This could require in-house staff to work a 6 or 7-day week on overtime rates to carry out these checks. A private company whose job role is to carry out ventilation verifications sets its standards by being able to meet clients’ expectations. In an Estates Department, where staff are expected to fulfil many different roles and tasks, as well as dealing with emergencies, they would not be able to solely focus on verifications, as well as PPMs, and maintain that level of flexibility. Gareth explains: “There have been many cases where
Person carries out the checks. By NHS standards this role is typically a grade 5. The Authorised Person (Ventilation) is usually a grade 6 or 7, and would be the Line manager for the CP(V). This would potentially present a problem. The CP(V) verifier could be unearthing issues with the critical ventilation that could involve significant amounts of capital spend. They might also discover areas of poor maintenance. Both of these scenarios could present stressful issues for the CP(V), in that they could be unsure how their feedback would be received. In contrast, when an independent company undertakes
Louise Webb
Louise Webb MBChB, MSc Computer Studies, PGCert, Chartered IT Professional, FBCS, APMP, is a director of DRLC, with her partner of over 40 years, David Livingstone. DRLC works with healthcare providers supplying Authorising Engineers in many areas – including Pressure Systems, Water Safety, and Medical Gases. Louise started her career as a Medical student at Edinburgh University, before going on to gain a MSc in Computer Studies. As a senior Project manager at BT, she project-managed the first Google servers to be installed in the UK. A believer in lifelong learning, she is currently nearing the end of a MSc in Building Services Engineering at Heriot Watt University.
these checks, it can deliver the reports safe in the knowledge that its staff will be at arm’s length from any spending decisions based on their findings. Gareth Twynam describes his experience as an independent ventilation verifier: “Can you imagine a situation where a band 5 has to communicate to the director of Estates that the operating theatre has failed its checks and it cannot be put back into use? The pressure they could be put under to ensure that the theatre ‘passes’ would be very unfair. “This,” he continues, “is the beauty of using an independent provider of verification. We’re so used to talking to, and dealing with, a whole variety of different people, levels, and roles – including AEs, that our staff develop that ability to assess a system pretty quickly after verifying, and then communicate that to everyone with potential solutions. We operate at a distance from the local politics, which can often cloud judgement.” It could be argued that the in-house verifiers should be supported by the Ventilation Safety Group (VSG). Let’s consider that idea in detail. The membership of the VSG, as described in HTM 03-01, includes the director of Estates, Consultant Microbiologist, the head of Estates, the Infection Control lead, and the AE (Ventilation). This group of people meets to discuss the strategy of the organisation, capital projects, exception reports on problems with ventilation, and the risk register. On balance it would not be appropriate for this group to get bogged down with the minutiae of how to verify an air-handling unit.
Is in-house verification more flexible than using outsourced providers? The ability to carry out checks on ventilation which supplies critical areas of the healthcare estate requires flexibility
24 Health Estate Journal March 2025
emergencies have arisen, and we make it happen to get there within 24 hours. We understand the fast-moving nature of the NHS, and the clinical need to get these critical areas verified and back into action.” The role of the AE (Ventilation) is multifaceted. Such individuals are independent consultants, and need to be able to keep up to date with all aspects of the relevant topic. To do this they are typically members of professional organisations, attend conferences, and maintain good professional networks – including with ventilation verification companies. The ability to talk to verifiers about how they are implementing aspects of the HTM 03-01 guidance as they go about their business is a very important part of the AE (Ventilation) role. Louise Webb explains: “Our AEs will critically assess the reports that verifiers produce, and give feedback to the verification company as necessary. If each Trust created their own verification reports, this quality improvement feedback loop would be enormously complex.”
In addition, when new facilities are built, it is essential
that Validation Reports – a type of testing which proves the performance of the air-handling unit, are delivered as part of the commissioning. The AE (Ventilation) ensures that this task is carried out by an independent company. This is in line with HTM 03-01 guidance.
Specialist equipment for the right airflows “The airflows in a UCV theatre require specialist equipment, which would be unlikely to be part of an Estates Departments toolkit,” Louise Webb continues. “So, in these cases the Trust may have to purchase this equipment and then pay to get training in how to use it. Alternatively, the Trust could bring in independent experts, and thus the AE (V) would be presented with three different reports for the same estate. This would also mean that the reports would probably be produced at different times, meaning it would be very difficult to take a time-stamped view of the state of the ventilation provision.“ Independent verifiers, by and large, produce reports in
the space of a few weeks. This means that the overall view is a snapshot in time, which is useful for forward planning. The area of ventilation that would not be able to be verified in-house is Local Exhaust Ventilation (LEV), which must be tested by a competent person (P601 Certified) every 14 months to ensure that the system is tested throughout the changing seasons. The AE (Ventilation) is also involved in checking the accuracy and regularity of these reports to ensure that all LEV systems are being used safely.
In summary, to quote Scott Adams, creator of the Dilbert cartoon, “Normal people... believe that ‘if it ain’t broke, don’t fix it’. Engineers believe that ‘if it ain’t broke, it doesn’t have enough features yet’. In this case the authors believe that the methodology of using external verifiers of healthcare ventilation systems is the most appropriate way of ensuring compliance.
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