HEALTHCARE ESTATES 2022 KEYNOTES – ENGINEERING
Recommendations from Phase 2 of the work that culminated in the publication of the detailed report, Infection Resilient Environments: Buildings that keep us healthy and safe.
technology’. Addenbrooke’s Hospital in Cambridge was, for instance, currently undertaking a major trial on this using combined HEPA and UV filters, to see if staff see a reduction in bioburden, and would hopefully be reporting on infection rates soon. Prof. Noakes said: “There is already some precedent data from Singapore, which shows that installing such filters can reduce Aspergillus infections.” Another ventilation technology well recognised by healthcare engineers was upper room UV, which employs UV light to disinfect pathogens in the environment. The Professor said: “It’s not suitable everywhere, and needs careful consideration in designing it in in the right place. I don’t know, currently, of any UK hospital which uses it, but it’s a well- established technology that works well.”
Use of Far-UV There were also ‘some new technologies on the horizon’. She elaborated: “We’ve been working on some research on the use of Far-UV, which is much safer than conventional UV, and can have a spectacular impact on pathogens, but is not some ‘magic’ new technology. There is a whole raft of considerations around safety and practical implications etc. We should, though, be looking at where these new technologies are.” Longer term, Professor Noakes said
there was an imperative to think about how we embed ventilation and infection prevention and control together. She said: “It’s not a case of ‘Estates’ does ventilation, and ‘IPC’, everything else. We need learning between the two disciplines, and we need the importance of the air in healthcare facilities to be recognised; some still seem to see it by as a ‘niche’ thing. We also need to balance that risk across different aspects of patient care. I think there are lots of questions around technology. There’s some brilliant innovation out there, but how much do we need? How much ventilation and air cleaning are needed in different spaces? A really big question is whether natural ventilation is still appropriate – a really
Professor Noakes said: “We also know that when things go wrong in a healthcare setting, they can go spectacularly wrong.”
tough one? From an energy perspective,” she added, “it’s very hit and miss, while from the perspective of ensuring that the environment is appropriate, the same conundrum applies. Where should we use it, and how do we make sure it’s done well?
Challenges around Net Zero “Equally,” the Professor said, “if we’re going to put in other technologies, where should we install them, should we apply them long term, and how do we ensure they are used correctly?” The speaker said she felt there was ‘a real challenge’ over infection control and Net Zero. She said: “This is probably the biggest challenge we’ve got now, because there’s a real risk that we hunker down this winter, seal everything up, and focus solely on trying not to spend money on energy. My worry is that this will have a massive set of health consequences, not just in hospitals, but also in homes, workplaces, and schools. And then,” Prof. Noakes said, ‘How do we learn the lessons?’ We don’t have resilient environments; we can’t just go back to where we were before. We have to move forward and be more resilient, because the next pandemic
might be even worse, and there almost certainly will be another.
Potential for things to ‘go spectacularly wrong’ “We also know that when things go wrong in a healthcare setting, they can go spectacularly wrong,” the Professor said. “I think you probably all know of the hospitals in Scotland where there are official inquiries at the moment. It costs lives, and vast amounts of money.” Coming to her presentation’s close,
Professor Noakes said she wished to thank the many people she had worked with, adding: “Remember, there’s no magic bullet, and watch for the snake oil out there, because there is some. Finally,” she added, “for anybody who loves ventilation, we are going to launch World Ventilation Day on 8 November. So, for that day, plan your activities, run something online, tweet about it, put it on your social media, and use it as a day to celebrate everything that’s great about ventilation.” This brought the Professor’s presentation to a close, and she handed back to Pete Sellars to introduce the next speaker, Professor Peter Guthrie of the University of Cambridge.
IHEEM Immediate Past-President, Paul Fenton, puts a question to the panel at the close of the presentations.
November 2022 Health Estate Journal 51
Courtesy of Cath Noakes / University of Leeds
Courtesy of Cath Noakes / University of Leeds
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