WATER HYGIENE AND SAFETY


Aquatools compact filters maximise the activity space to prevent retro- contamination.


Aquatools 2-month shower head filters deliver 6,000 litres of qualified water


throughout their lifespan.


teams must identify the risk level and put in appropriate measures to eradicate the risk where possible, or control it if not. The resulting plan should include multiple barriers to provide a failsafe, should one method of infection prevention fail.


Filters as a secondary barrier can be beneficial in healthcare settings.


Devising a solution At the heart of the guidance is the possibility of removing all non-sterile water from high-risk patient areas. It asks the question: Are water outlets necessary in high-risk patient areas? For some very vulnerable patients, the risk of exposure to non-sterile water, and the associated risk of contracting a life-threatening infection, is too high. As with Legionella and Pseudomonas, a risk-assessment is required to verify this need.


Some areas, such as post-operative areas for organ transplant patients, will emphatically not require non-sterile water. In these areas, wash-hand basins should not be located in the patient’s room. Washing stations and clinical sinks should be positioned outside patient bedrooms, either in an ensuite facility or in the lobby. Since NTM infections are typically caused by inhaling the bacteria in microdroplets, this will prevent exposure to sprays and aerosols. However, for patients


further down the recovery route, where the risk assessment


50 Health Estate Journal October 2025


deems it safe, a wash-hand basin may be installed. Here the guidance recommends avoiding exposure to waterborne pathogens by fitting a mixer tap that can be removed for disinfection purposes, and also fitting a sterilising-grade point-of-use (POU) filter. The design of the basin must minimise splashing and the outlet must not be directly over the drain to avoid retro-contamination. Patient’s personal items, including the bed, must be located at least two metres away from any sink, basin or shower to minimise the risk of splashing. Where necessary, effective splash screens should also be installed.


Complying with guidance during the specification stage At the specification stage, NETB No. 2024/3 requires that any equipment, components and fittings used for the delivery and drainage of water must not have an adverse effect on the microbiological or chemical quality of water, both at the point of installation and over time. Manufactured items can no longer be wet-tested or pressure-tested using water prior to installation in their final location, whether this testing takes place at the manufacturing site, or at a test bench in the care facility itself. The guidance also states clearly that there must be no compromise to patient safety. Any potential conflict between Net Zero carbon sustainability targets and safe water management must always consider the patient risk. However, in augmented care facilities, NETB No. 2024/3 suggests that specifying a stand-alone hot water distribution, with an independent supply, local hot water production and shorter pipe runs, can have a two-fold benefit. A dedicated unit in augmented care facilities allows greater control of the water temperature within the system; it simplifies capacity planning so water circulation is guaranteed and dead-legs are avoided; and it prevents over consumption of water and energy.


Once installed, facilities teams must ensure adequate water quality throughout the delivery and drainage system, including verifying that the control measures are effective. This involves monitoring the water quality;


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