WATER MANAGEMENT
Trio of ‘experts’ focuses on key safety issues
Eastwood Park Training employs ‘healthcare experts’ to contribute to the training delivered at its South Gloucestershire training centre, with its philosophy that the sector perspective ‘ensures that the learning reflects what really takes place in hospital estates’. Here, with the focus on water safety, three Eastwood Park water trainers provide different perspectives on the topic and the issues facing estates teams currently.
The holistic management of water systems should be instrumental in driving cultural, technical, and organisational challenges and changes – but has it gone far enough?, wonders Authorising Engineer (Water) and Eastwood Park trainer, Mike Quest. He says: “The 2016 revision of HTM 04-01 and its regional derivatives in Wales and Scotland cemented the concept of Water Safety Groups and Water Safety Plans originally introduced in the 2013 addendum, with the revised Part B including updated guidance on their remit and aims. The introduction of ‘holistic management’ of water systems, and a shift away from Legionella and scalding as the primary risks, have significantly changed the way that healthcare organisations govern water safety, bringing with it cultural, technical and organisational challenges. But what are some of the key impacts of these changes from the perspective of an Authorising Engineer (Water), and what is new? The biggest change is cultural – while in the past estates operations were central to water risk management, and were perceived to be able to offer a solution to all problems – especially in the control of Legionella, over time, evidence has shown us that those who design and use the water systems have an equally significant part to play. Their attendance at Water Safety Group meetings, and an understanding of their role in holistic management of the risks, have thus become essential.
Eastwood Park provides in-depth training for Authorised and Responsible Persons.
drawings, have helped to identify problems and improve water distribution via engineering intervention, resulting in better temperature and biocide control. “Despite this, the application of such controls relies on the system being used as intended. Water hygiene compliance audits commonly highlight a lack of awareness and activity with regards to identifying and flushing little-used outlets. Where representatives from the clinical departments attend Water Safety Groups, along with their Infection Prevention and Control counterparts, vast improvements are being made. Effectively delegated ownership, and the acceptance of the responsibility for identifying and flushing outlets not in regular use on a daily basis, supported by simple training and the use of straightforward auditable records, are undoubtedly essential steps towards success.
Appropriate risk assessments and thermostats
Investment pays dividends “Over recent years,” Mike Quest continues, “many healthcare organisations have invested widely in the application of good water hygiene practices in the built environment. High standard Legionella risk assessments, and the development of far more accurate schematics or ‘as-built’
“The prevention of scalding using thermostatic mixing devices has long been an overused practice, and hospital water systems are often fitted with them in areas where they are not required, resulting in high maintenance costs and elevated Legionella risks. Decisions to install these devices have long been overtaken by
standard designs and a lack of attention to detail. The responsibility for assessing the risk of scalding and applying sensible controls is often unclear without a Water Safety Plan, and designers have been taking a ‘safe at all costs’ approach, without understanding the longer-term operational impact. Scalding is a clear safety hazard, and any risk assessment should be undertaken by competent health and safety persons with knowledge of waterborne risks and controls. Estates capital project teams undertaking small refurbishments or major build projects have an obligation to avoid risks through design, installation, and commissioning, and their involvement in the Water Safety Group is essential in ensuring that the most effective and appropriate solution is provided to the operational end-user.
Is your ‘WSG’ truly representative? “Yet, despite the clear need for cross- departmental involvement, many Water Safety Groups are still driven by estates operations, and poorly attended by clinical and other departments, which in itself evidences an ongoing need for change. Standards of competence and awareness of risks throughout the whole organisation, and the sharing of knowledge and experiences, still need to improve. Water Safety Groups are the place for this, driving both policy and practice, and sharing governance responsibility. Training also has a huge part to play, and the Water Safety Group has a collective responsibility for setting requirements and measuring the competence of all persons – from those who devise and govern strategy, to those whose work involves working on the water system or cleaning water outlets.” The refreshed range of water hygiene courses offered by Eastwood Park Training includes up-to-date guidance
August 2018 Health Estate Journal 59
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