IHEEM ROUNDTABLE – PART ONE
system in place to allow us to look at the trends and to monitor how infection spreads.” JB: “Which you could do if you had better access?” GS: “We just need a better
understanding from the other side – the hospital managers, estates departments, and infection control managers – they need to be able to see it from our perspective as academics.”
Getting Board approval JB: “Claire, Ghasson has raised some interesting points. Do you think part of the problem is around bureaucracy and getting Board approval? Is there any difference at a teaching hospital?” CH: “The actual processes for conducting research and developing projects are still the same. You’ve still got to collate business cases, get Board, and often also external, approval – depending upon the project cost – for instance from the Treasury or NHSI. One of the things I found in my last role at a teaching hospital, aligned to Oxford University, was that you have much a more ‘joined up’ scenario when the university board and the Trust’s board are in communication. When it came to talking about ventilation – high or low voltage, for example – we had standard meetings quarterly with our individual Authorising Engineers for each HTM speciality. We had Water Safety Groups, Electrical Safety Groups, and Ventilation Groups etc, and always invited the university to attend. At the meetings, attended by infection prevention and control personnel and all the other key hospital stakeholders, we talked about hospital issues, what’s going on currently, what the prevalent potentials are, what we’re aiming for. We could then move forward as a team. I think that’s what’s different – with a teaching hospital you have that link. When you don’t, you’re working outside the system.”
Authorising Engineers’ involvement KS: “And I think that’s worked quite well for you as well, Claire, because the Authorising Engineer is then able to talk to the university, and discover that the university has similar problems with its buildings, so there is a little bit more collaborative working.” JB: “Evangelia, what’s your experience of this with your teaching and lecturing? Do you find you can get access to healthcare facilities if you need to? What’s the relationship like between academia and the healthcare engineers / healthcare estates managers?” EC: “My main challenge has not been getting access for research, but rather time to secure ethics approval. I never had a problem with recruitment. Hospitals wanted to participate, and indeed I sometimes had too many keen to be
36 Health Estate Journal February 2019
The Members’ Area at the Institution of Structural Engineers was the venue for a drinks and networking reception that followed the IHEEM President’s Address.
involved. There was no feeling among hospital staff that they were doing me a favour by participating in my research – because they could justify the hours. I suspect my research put them to less trouble than some other ‘high risk’ highly clinical research.” JB: “So what sort of areas have you looked at working with hospitals on?” EC: “My research was mostly on mental health and ageing, but I guess the ethics approval mechanism would be the same as if it had involved drugs, pharma, and very high risk equipment. I had to go through the same ethics approval. For me that was not a problem, because I started my career at a medical school and then went to a built environment school. I was thus familiar with the procedures and problems, and what they wanted to see for me to gain the required ethics approval. I know that some of our PhD students working with other supervisors without previous healthcare research experience couldn’t get approval. In one instance they referred to literature on the ethics approval procedures in other countries, so they had the wrong guidance; I assume that each country has its own procedure. When I undertook research in France, for example, I didn’t need ethics approval, but simultaneously did require it in the UK.
Time-consuming form-filling “My experience,” Evangelia Chrysikou continued, “is that there is a big barrier in, for instance, completing the many required forms, which takes up valuable time; if you have funding for two years, and it takes six months to get approvals, the upshot is less research. The other problem is the literacy among some of my colleagues from the school of architecture on some aspects of healthcare. The hospital might sometimes be asking too much, but simultaneously you can’t expect a PhD student to go into a hospital and necessarily know how both to safeguard a patient, and to protect him or herself. I thus wouldn’t say ‘bad NHS’ and ‘good academics’. There is a common responsibility. I believe that when it comes to research costs, NHS hospitals can claim
money for participating in high quality research, which is something I found they did.” JB: “Richard, What’s your experience?” RB: “My view’s going to be different to that of most people here. Obviously there needs to be more knowledge sharing. From a consultant’s standpoint, how often are we invited to a Water Safety or Ventilation Group meeting? It’s alright getting academics in and giving them recorded BMS data, for example, for their own research, but how much of that filters through to the industry? For example, with cold water tank sizing, in some of the guidelines the numbers are based on 1960s research. Pipe sizing has a similar issue. So it’s all very well talking about knowledge-sharing with academia, but you need to get the actual consultants who are designing the healthcare building in early, to ensure that you get what you want from the scheme. We also need to be involved afterwards more; invited in on those groups to see if there’s lessons learned, and, if so, whether we can take the learnings to the next design, the next project. So there’s several aspects.
“Another thing is the actual degree courses for undergraduates. How many modules actually talk about HTMs or SHTMs? They talk about CIBSE, the Institute of Plumbers, and the IET etc., but possibly not about IHEEM or the HTMs. I think Trusts need to share a bit more, and try to get the consultants in, so everybody has to talk more. That’s my view.”
Gaps in knowledge JB: “What about from your standpoint, Kim?” KS: “I fully support what Richard has just said. I’ve spoken to quite a few graduates that I’ve engaged with recently, who have never even heard of HTMs. These could be people studying for a Master’s in Building Engineering Services.” RB: “They probably don’t even realise that there are HTMs until they go for a job and then see that you need a working knowledge of them. If it’s not fully covered at university level, how would the students know?”
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©The Institution of Structural Engineers
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