INFECTION CONTROL
(IPC) in healthcare settings, launched the Built Environment Infection Prevention Initiative (BEIPI). BEIPI brings leading professionals from architecture, manufacturing, procurement, and the healthcare design and construction industries together with experts in IPC, representatives from the NHP, NHS capital, and estates. Together, they are working to address the danger of AMR in the built hospital environment before the first brick is laid. In a series of workshops in London and Manchester,9 multidisciplinary groups came together to solve problems in the commissioning, design, construction, installation, and handover of new build hospitals. Those in positions of responsibility over the design and build of a new hospital must understand these issues and seek to address them in the earliest stages of their work to avoid preventable outbreaks of AMR infections once the building is operational.
Communication and Stakeholders Infection prevention professionals are brought into hospital design projects too late. Those working to sign contracts, finalise designs, and begin construction are often unaware that these early stages have serious implications for the effective prevention and control of AMR outbreaks in the future. Opportunities are missed to integrate infection prevention and control into fundamental design decisions. A leader should communicate the importance of these issues to all stakeholders in the project, and increase the sense of responsibility each one of them feels for the safety of occupants in the future hospital. One a project is handed off, there is no formal review
process to capture and share lessons learned - what worked, what did not, and what decisions meet real- world demands versus ticking a box on paper. Leaders in hospital construction must embrace transparency round mistakes, in order for the industry to improve.
Education To build a safer hospital which limits the spread of AMR, design considerations must prioritise infection prevention principles from the beginning. However, there is a two-way knowledge gap to contend with. James Gordon, Associate Director, Healthcare Lead at P+HS Architects and a member of the BEIPI Committee, noted that “if you’re training to be a microbiologist, you probably wouldn’t look at the construction industry. And if you’ve joined the construction industry, you wouldn’t necessarily go towards microbiology.” By participating in BEIPI workshops, he says, “I’ve got a far better understanding … of the risks associated with AMR. That helps us when we’re putting this back to trusts and clients,” making his practice more competitive when bidding for healthcare design work. Knowledge-sharing goes both ways: leadership should ensure that the IPC professionals they are working with are familiar with the RIBA design stages and the points in the process they should introduce IPC considerations.
Design and Innovation The hospital building should be a weapon in our armoury against AMR, rather than acting as an accelerator. One attendee at a BEIPI workshop commented: “Before attending the session I didn’t know about AMR. My eyes were opened during the event and I found it fascinating. That’s why I wanted to get involved. I suddenly realised there’s a definite opportunity in here to improve design standards, design out infection control risks. That became clear.” Leaders in this area should prioritise the prevention of infection as an innovative design challenge. This will
entail embracing the Hackitt Report’s recommendations and taking a risk-based approach to problems and their solutions. Another attendee noted that “some of the HBN and HTM guidance documents are 20 years old, so they’re immediately out of date, but they are the mechanism that we have to comply with. In some instances, they are contradictory, in some instances they are vague. We have to address that.” Strong leadership and accountability allows for derogation and innovation to achieve safer results.
Get involved The approach promoted by BEIPI is very new. It cannot yet provide all of the solutions. But the current way of doing things is out of date and is failing patients. Without urgent structural and policy changes away from box-ticking and towards innovation and a risk-based approach, the situation will continue to deteriorate, and AMR will continue to endanger human health. The group has just run its inaugural conference, Building Safer Hospitals 2026, which shared vital experiences in this area, and offered insight into how to embed infection prevention principles into every stage of hospital building, improve occupant safety within the built environment to save lives, and reduce the threat of AMR, and save money for the NHS and construction firms by reducing costly remediation works. The group hopes to hold similar events into the future, and readers are encouraged to keep an eye on the Healthcare Infection Society’s website for information on future events, innovations, and advice from BEIPI. The fightback against AMR must be built into our hospitals from day one.
References 1
https://www.manchestereveningnews.co.uk/news/joshua- abbott-litter-death-christie-33610118
2
https://www.bbc.co.uk/news/uk-scotland-glasgow- west-56971954
3
https://www.theguardian.com/uk/2012/jan/23/belfast- hospital-deaths-baby-infected
4
https://publications.parliament.uk/pa/cm5901/cmselect/ cmpubacc/646/
report.html
5
https://amr-review.org/sites/default/files/160525_Final%20 paper_with%20cover.pdf
6
https://www.who.int/publications/i/item/B09585 7
journalofhospitalinfection.com/article/S0195- 6701(26)00097-6/fulltext
8
https://www.who.int/publications/m/item/global-technical- consultation-report-on-proposed-terminology-for-pathogens- that-transmit-through-the-air
9
https://www.healthestatejournal.com/story/51827/new- beipi-report-states-need-to-embed-infection-prevention-in- healthcare-design
Discussion groups at the BEIPI Manchester workshop.
Christine Fears
Christine Fears is head of publishing and research communications at the Healthcare Infection Society, a charity representing experts in infection prevention and control. She has worked with the BEIPI group since its inception, supporting its work to foster collaboration, knowledge exchange, and greater understanding across industries, with the ultimate aim of reducing the spread and impact of AMR in healthcare settings.
November 2026 Health Estate Journal 51
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