INFECTION PREVENTION AND CONTROL
HLM Architects worked on the design and construction of the new North Wing development at Altnagelvin Hospital in Londonderry. The standout feature of the project is the eight-bed cluster layout for the 144 single bedrooms.
partnership with the IPC teams, other healthcare staff, and service-users, to prioritise patient safety as a core requirement. This allows for the delivery of facilities in which IPC risks have been anticipated, planned for, and met or managed, resulting in buildings which are safe to occupy. Again, how Net Zero-compliant is a building that can’t be occupied?
Neil Orpwood
Neil Orpwood qualified as an architect in 1995, having started his degree at North East London Polytechnic in 1985. He is a Chartered Member of the RIBA, and has worked at HLM Architects in Sheffield since leaving full-time education (albeit initially spending a one-year spell as a shop assistant in London, waiting for the economy to improve, in 1992). As an integral part of HLM’s Healthcare Team both nationally and internationally, Neil has a detailed knowledge of this specialist sector, working on a spectrum of projects, from small refurbishments through to multi-million-pound facilities.
Considering specific IPC ‘overlay’ Knowing at which stage to include what level of detail is vitally important, and to this end here at HLM we have been assessing the requirements against the RIBA Plan of Work and NHS Blue Book work stages. Considering specific IPC ‘overlay’ helps prompt a timely consideration of specific elements. For example, understanding and testing clean to dirty workflows as part of early departmental layout option appraisals helps to prevent costly unpicking of designs at later stages, thus reducing incompatible workflow crossovers.
Design decisions at early stages can impact risk
exponentially further along the design process and, like the requirements in the new Building Safety Act, these decisions can be tracked through ‘golden thread’ monitoring within the Building Information Management (BIM) model. This can make it easier for the ever-expanding project team to understand the strategic end goal, and therefore input into the programme more effectively as the team’s knowledge and experience grows. Despite the increasing age of some of the current
healthcare guidance documents, such as Health Building Notes (HBN) and Health Technical Memoranda (HTM), these still form a vital baseline for delivering successful projects. Written as guidance documents rather than legislation, they are often references in legal and regulatory contexts, and can underline the key considerations for compliance with broader health and safety legislation. The requirement to document derogations against HTMs and HBNs through scheduling,
risk assessing, and central reporting, is often avoided through a reluctance to do anything other than what has always traditionally been done; therefore an essential feedback loop and opportunity to standardise best practice are lost. Similarly, derogating too much without understanding the wider implications or associated risk profile is also problematic. As a very simple example, the location of clinical
washhand basins is a much-debated topic. Positioning close to the entry / exit of a room – but still near to the patient zone, within 2 metres, especially in acute hospital settings, can help support appropriate use by clinicians at appropriate moments – such as in between patients and tasks, but little guidance is provided on the more detailed constraints – e.g. the distances travelled by aerosols generated from water splash which, if not considered, can reach the patient. Typically, the space between the clinical basin and the patient tends to be about elbow room, rather than the 2 m travel-range of aerosols containing water, which can harbour pathogens from biofilms within poorly maintained outlets or drains.
Ramifications of the NHP With the Government’s New Hospital Programme (NHP) progressing with 100% single bedrooms as its base strategy, ostensibly to help with infection control, the consideration around en-suites and clinical washbasins is ripe for discussion, not least through doubling the amount of pipework and potential sources of infection that need to be well maintained. At HLM Architects, our team worked on the design and construction of the new North Wing development at
Despite the increasing age of some of the current healthcare guidance documents, such as Health Building Notes and Health Technical Memoranda, these still form a vital baseline for delivering successful projects
48 Health Estate Journal October 2024
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