WATER SYSTEM HYGIENE AND SAFETY
Don’t take the ‘tick box’ approach to fight Legionella
In this article, Greg Rankin, CEO at ‘pioneer in the rapid testing industry’, Hydrosense, looks to raise awareness of some of the key areas of Legionella exposure in hospitals and other healthcare settings, noting that this risk is ‘just as relevant’ for new construction sites, refurbishments, and even fully operational, fit-for-purpose buildings.
The NHS and its building infrastructure are undoubtedly facing challenges that could impact the health of vulnerable patients, but there is another risk which could add to these if not taken seriously – Legionella. Legionella is a waterborne bacterium that lives in the natural environment, but generally only becomes a major risk to human life when it enters the built environment. It can cause a severe form of pneumonia called Legionnaires’ disease, which can be deadly. Legionella is a rapidly multiplying bacteria that can – even if small amounts are present – infect a complete water system in no time. Legionella doubles every 24 hours.1
The hospital environment should
be considered as a serious risk area for Legionella due to the large number of vulnerable and/or immunocompromised patients, in addition to 37% of A&E attendances and 63% of admitted patients in England alone falling within the higher- risk ages category (50+).2 The NHS, as one of the largest and
most complex healthcare systems in the world, provides care to more than
67 million people in the UK. Over the years, this system has faced several challenges, including funding shortages, staff shortages, and rising demand for healthcare services. One of the most pressing challenges, however, is the outdated infrastructure of many NHS hospitals. A recent investigation conducted by ITV News highlighted the poor state of some, and particularly ageing, NHS buildings – from year-long leaks and collapsing floors, to ageing roofs and the potential for falling brickwork, and the risks these pose to the health and safety of patients and staff alike.3
Unresolved structural or maintenance issues
Alarmingly, 50% of the responding hospital Trusts in England highlighted that as of October 2022 they had at least one unresolved structural or maintenance issue. The Walton Centre NHS Foundation Trust in Liverpool, for example, has suffered an ongoing stairwell leak for eight years; a leak at Lewisham and Greenwich NHS Trust has been left for nearly two
years, and a leaking roof at University Hospital Southampton NHS Foundation Trust has remained for nearly 18 months so far. With some hospitals dating back as far as the 1930s, their walls and ceilings are crumbling and collapsing. Doctors fear that these environments are not fit for the purpose of patient care. To address this problem, the
Government has committed to investing over £3.7 bn in the construction of new hospitals across the country. This funding will also be used to refurbish existing hospitals, upgrade facilities, and provide state-of-the-art equipment and technology. The aim is to improve patient outcomes, increase capacity, and create a more modern and efficient healthcare system.
Reports of delays There are already reports of delays to this ambitious face-fit and construction programme, however, and government critics argue that this funding is not sufficient to address the scale of the problem. A focus on new, leading-edge hospitals and facilities could be ignoring the significant needs of the existing estate. That said, a commitment to investment in NHS hospital construction is a significant and much-needed step forward for the UK healthcare system. Even so, however, a programme of this scale will take many years to undertake, so the reality of the here and now needs to be the focus. With respect to the risks posed by Legionella bacteria in these existing buildings, there are several areas of concern which should be considered: n Ageing pipework – complicated and ageing pipework with deadlegs poses a real threat, as it provides ideal conditions for the formation of rust, scale, sludge, and amoeba, which provide nutrients, and support rapid Legionella growth and spread.
Legionella bacteria.
n Leaks and flooding – any standing water can become stagnant; this could be hidden in cavities, broken
May 2023 Health Estate Journal 45
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