WATER SAFETY
Managing water safety with Internet of Things
Becky Allen, healthcare solutions lead at MRI Software, looks at how the Internet of Things can strengthen Legionella control by giving facilities managers real-time visibility into water system performance across entire buildings and healthcare estates.
Recent reports1 of a cluster of Legionnaires’ disease cases
under investigation in London have once again highlighted the critical importance of water safety management in public buildings. While investigations continue following coverage from BBC News, incidents like this serve as a reminder that controlling Legionella risk requires constant vigilance.
Having spent years working with NHS estates teams,
I have seen first-hand how a single oversight or gap in water system management can escalate into a significant risk. It is not just about ticking boxes on compliance forms – it is about ensuring that every patient, visitor, and staff member is safe every day. That personal responsibility is what drives the adoption of smarter, technology-enabled approaches to water safety. In healthcare environments, the stakes are even higher. Hospitals and care facilities support patients whose immune systems may already be compromised, meaning exposure to Legionella bacteria can have particularly serious consequences. For estates and facilities teams across the NHS, managing water safety is therefore not simply a compliance exercise – it is a critical component of patient safety. Over the years, I have heard from engineers and estates managers about the anxiety of knowing that a missed check or an overlooked outlet could have real consequences. These are not abstract risks – they affect individuals directly. That is why any conversation about improving Legionella control needs to be rooted in operational reality, human impact, and practical solutions. Yet maintaining consistent oversight of water systems
across complex healthcare estates remains a significant operational challenge.
The complexity of healthcare water systems Many NHS estates have evolved over decades, resulting in buildings with varying plumbing systems, pipework layouts, and infrastructure of different ages. Large hospital campuses may contain hundreds, or even thousands, of outlets that require regular monitoring. Each building tells a story. Older wings may have pipework dating back 50 years, while newer wards have state-of-the-art plumbing. Managing water safety across such a diverse estate is like trying to maintain a fleet of vehicles of different makes and ages, each one requires tailored attention.
Under current guidance from the Health and Safety Executive (HSE), organisations must follow strict procedures to manage Legionella risk, including routine
temperature monitoring and flushing regimes set out in Approved Code of Practice L8 and the NHS’s water safety standard, HTM 04-01. Traditionally, this has relied heavily on manual
processes. Engineers visit outlets across the estate to record temperatures, complete flushing tasks, and maintain paper or spreadsheet-based compliance records.
It is clear how exhausting and repetitive this work can be, especially in large hospitals with multiple floors and hundreds of outlets. It is easy for human error to creep in, and the stakes are high when every missed measurement could represent a potential risk. While these processes meet regulatory requirements,
Legionella pneumophila bacteria in water.
Hospitals and care facilities support patients whose immune systems may already be compromised, meaning exposure to Legionella bacteria can have particularly serious consequences.
October 2026 Health Estate Journal 153
AdobeStock / Axel Kock
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