HEALTHCARE VENTILATION
Simon Everett A smaller UCV theatre from the early 2000s.
n Maintain a good working relationship between the Director of Finance and the Estates Director. This is good practice for the sound management of finance, but it also helps nurture a relationship of mutual trust – via which the Estates Director’s concerns are taken seriously, and the DoF’s management of Trust finances respected.
n Assess and maintain a risk register, considering which risks are appropriate for the Trust risk register, ensuring that the DP can inform the board of any significant risks.
n Consider retrofitting where appropriate – savings in both carbon and finances can be the major benefits of this strategy, although not at the cost of patient safety.
n Also consider additional mitigations to provide early warning for system failure for high-risk systems such as theatres – e.g. settle plate testing, 1 m and 2 m velocity readings, and increased frequency of visual inspections.
Conclusions Managing critical ventilation systems in healthcare facilities is an intricate and demanding task for Estates teams, especially when balancing the competing priorities of capital investment and clinical needs. The growing backlog (and therefore temperamental legacy equipment), along with limited funding options, continue to challenge Trusts, and make it essential for Estates teams to adopt a proactive, strategic approach to maintenance and risk management. Ensuring that these systems meet the
standards outlined in HTM 03-01 is crucial for patient and staff safety. Where there is a lack of comprehensive data on the
70 Health Estate Journal September 2024
condition of these systems, combined with the pressures of addressing other urgent infrastructure issues, Trusts should be prepared for complex decision-making, and should implement processes to support teams in reaching decisions. However, by introducing the recommendations I have discussed, Estates teams should find themselves in a much stronger position for managing ventilation systems’ lifecycles moving forward.
Collaboration the key Collaboration between Estates teams, clinical leaders, and finance departments is vital to managing the risk holistically. Establishing robust governance mechanisms, such as the VSG, and maintaining an accurate risk register, ensure that issues are communicated effectively, and senior leadership can then make informed decisions. The importance of Continuing Professional Development for all stakeholders is just as important, not only because it helps maintain high standards in the face of changing guidance and legislation, but equally because stakeholders will then have an appreciation of the importance of their roles, and the role of healthcare ventilation systems in the context of patient safety.
While the opportunity for significant capital investment may remain uncertain for many Trusts, adopting interim measures and mitigations can help manage the risks associated with legacy AHUs. Enhanced inspection schedules, early warning systems – such as the use of settle plates, and considering retrofitting can offer substantial benefits. Developing a culture of collaboration across
Simon Everett is a Senior Lecturer in the Built Environment at Wrexham University. He has 20 years’ experience in the building services engineering sector – more than half of which has been spent in the NHS in Estates and Facilities operations and strategy roles, with a significant proportion of that time spent at The Robert Jones and Agnes Hunt Orthopaedic Hospital at Oswestry. Simon Everett left his latest NHS role – as head of Sustainability at Wirral University Teaching Hospital NHS Foundation Trust – in 2023, to follow his passion for teaching full time. He is a Module leader teaching on the Degree Programme at Eastwood Park.
departments will strengthen the case for necessary funding and improve the overall resilience of the estate. By focusing on these strategies, Estates
teams can improve the reliability of critical ventilation systems, and ensure they continue to protect the health and wellbeing of patients and staff, despite limited resource and day-to-day operational challenges.
References 1 Health Technical Memorandum 03-01: Specialised Ventilation for Healthcare Premises. Department of Health and Social Care. 22 June 2021. https://tinyurl. com/yukabxcf
2 NHS England (2023) Estates Returns Information Collection, Summary Page and Dataset for ERIC 2022/23. https://
tinyurl.com/5n8sah5p
3 Wickens C. The NHS estate continues to deteriorate. The King’s Fund. 14 December 2023. https://tinyurl. com/3awsufjh
4 Capital Investment in the NHS. The King’s Fund. 29 January 2024. https://tinyurl. com/2whnwkph
5 Land and Property Appraisal. NHS England. 2007. https://tinyurl. com/2a4xah8f
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