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Health Technical Memorandum 00:
Policies and principles of healthcare
engineering
Health Technical Memorandum 00 Policies and principles of healthcare engineering
ii
Preface
About Health Technical Memoranda main source of specific healthcare-related guidance for
estates and facilities professionals.
Health Technical Memoranda (HTMs) give
comprehensive advice and guidance on the design, The core suite of nine subject areas provides access to
installation and operation of specialised building and guidance which:
engineering technology used in the delivery of healthcare. is more streamlined and accessible;
The focus of Health Technical Memorandum guidance encapsulates the latest standards and best practice in
remains on healthcare-specific elements of standards, healthcare engineering, technology and sustainability;
policies and up-to-date established best practice. They are
applicable to new and existing sites, and are for use at provides a structured reference for healthcare
various stages during the whole building lifecycle. engineering.
DISPOSAL CONCEPT
RE-USE
DESIGN & IDENTIFY
OPERATIONAL OPERATIONAL
MANAGEMENT REQUIREMENTS
Ongoing SPECIFICATIONS
MAINTENANCE TECHNICAL & OUTPUT
Review
PROCUREMENT
COMMISSIONING
CONSTRUCTION
INSTALLATION
Healthcare providers have a duty of care to ensure that Structure of the Health Technical
appropriate governance arrangements are in place and are Memorandum suite
managed effectively. The Health Technical Memorandum
series provides best practice engineering standards and The series contains a suite of nine core subjects:
policy to enable management of this duty of care. Health Technical Memorandum 00
It is not the intention within this suite of documents to Policies and principles (applicable to all Health
unnecessarily repeat international or European standards, Technical Memoranda in this series)
industry standards or UK Government legislation. Where Health Technical Memorandum 01
appropriate, these will be referenced. Decontamination
Healthcare-specific technical engineering guidance is a Health Technical Memorandum 02
vital tool in the safe and efficient operation of healthcare Medical gases
facilities. Health Technical Memorandum guidance is the
iii
Health Technical Memorandum 00 Policies and principles of healthcare engineering
Health Technical Memorandum 03 Electrical Services Electrical safety guidance for low
Heating and ventilation systems voltage systems
Health Technical Memorandum 04 In a similar way Health Technical Memorandum 07-02
Water systems represents:
Health Technical Memorandum 05 Environment and Sustainability EnCO2de.
Fire safety
All Health Technical Memoranda are supported by the
Health Technical Memorandum 06 initial document Health Technical Memorandum 00
Electrical services which embraces the management and operational policies
from previous documents and explores risk management
Health Technical Memorandum 07
issues.
Environment and sustainability
Some variation in style and structure is reflected by the
Health Technical Memorandum 08
topic and approach of the different review working
Specialist services
groups.
Some subject areas may be further developed into topics
DH Estates and Facilities Division wishes to acknowledge
shown as -01, -02 etc and further referenced into Parts A,
the contribution made by professional bodies,
B etc.
engineering consultants, healthcare specialists and
Example: Health Technical Memorandum 06-02 NHS staff who have contributed to the production of
represents: this guidance.
S T R Y S TA N D A
DU RD
IN S
& EUROPEAN
NAL ST
HTM 07
IO HTM 02
T
AN
NA
INTER
CUMENTS
Sustainability Gases
RDS
HTM 00
RDS
INTER
Policies and
Principles
DA
NA
AN
IO
ST
T
NA
DO
IC
Y S TA N D Systems
IF
C
EC
D
HTM 05 HTM 04
O
Fire
SP
U Water
C
M Safety Systems H
EN T
TS AL
HE
iv
Executive summary
This Health Technical Memorandum (HTM) provides Designers should ensure that they read the HTM as a
general guidance on the engineering, technical and whole, since further engineering guidance may be
environmental aspects of healthcare building design. outlined and cross-referenced throughout.
Specific guidance for individual clinical settings is
available within appropriate Health Building Notes.
v
Health Technical Memorandum 00 Policies and principles of healthcare engineering
vi
Contents
Preface
Executive summary
1 Policy, context and requirements 1
Aims
Scope
Recommendations
Engineering governance
Engineering services
Management of access to engineering services
Development planning
Distribution requirements
Access
Working in confined spaces
Reviews
Exemplar emergency procedures
Sample procedure matrix
Resilience and emergency preparedness
Meeting risk requirements
Resilience of electrical supplies
Mobile units
Utilities
System capacity
Utility supplies
Life expectancy of engineering plant and equipment
Metering
Access to engineering service outlets and controls
Infection control
Space requirements for engineering plant and services
Mechanical services
Heating
Ventilation and cooling
Hot and cold water systems
Acoustics
Internal drainage
Building management systems
Fire safety
General fire safety standards
Fire detection and alarm systems
General electrical services
General electrical installations
Electromagnetic compatibility
Primary electrical infrastructure
Socket-outlets for cleaning equipment
Lighting systems
vii
Health Technical Memorandum 00 Policies and principles of healthcare engineering
General
Emergency lighting
External lighting
Patient/staff and staff emergency call systems
Security
CCTV installation
External services
Car park barriers
Door access control systems
Entertainment systems
IT and wiring systems
General
Telecommunication systems
IT systems
Pneumatic tube systems
Lifts
Lightning protection systems
Audio induction loop systems
Sustainability and energy efficiency
Validation and handover of engineering installations
2 Statutory and legislative requirements 22
Health and safety
Regulations, Approved Codes of Practice, Standards and guidance
Other commonly cited legislation
Electrical
Mechanical
Environment
Radiation
Fire
Food
Public health
Risk and/or priority assessment
3 Professional support 26
Management and responsibility
Management structure
Professional structure
Roles and responsibilities
Designated Person (DP)
Trust Senior Operational Manager (SOM)
Authorising Engineer (AE)
Authorised Person (AP)
Competent Person (CP)
Variation by service
4 Operational policy 29
Operational considerations
Records/drawings
Security
Monitoring of the operational policy
Contractors
Medical equipment purchase
5 Emergency preparedness and resilience 31
Overview
Creating an emergency plan
viii
Contents
ix
Health Technical Memorandum 00 Policies and principles of healthcare engineering
x
1 Policy, context and requirements
1.1 This Health Technical Memorandum provides (v) Fire safety (Health Technical Memorandum
general guidance on the engineering, technical and 05)
environmental aspects of healthcare building
(vi) Electrical services (Health Technical
design. Specific guidance for individual clinical
Memorandum 06)
settings is available within the clinical topic itself.
(viii) Environment and sustainability (Health
1.2 Consultation should take place at project and
Technical Memorandum 07)
design team level to ensure understanding of key
issues, healthcare delivery and the appropriate (ix) Specialist services (Health Technical
standards for healthcare engineering services. Memorandum 08)
1.3 Designers should ensure that they read this (x) Other existing HTM 2000 series guidance
publication as a whole, since further engineering documents.
guidance may be outlined in and cross-referenced 1.5 The design, construction and operation of health
within other sections. and community care bulidings should comply with
1.4 Health Technical Memorandum 00 Policies and all relevant aspects of engineering guidance,
principles of healthcare engineering covers the statutory requirements and best practice to ensure
following issues: high-quality engineering installations and services
suitable for their application.
a. overview of engineering services guidance;
1.6 The healthcare version of the National Engineering
b. statutory and legislative requirements;
Specifications (nes) replaces the old Model
c. professional support; Engineering Specifications and is designed to help
project teams with writing specifications.
d. operational policy;
e. training and workforce development; Aims
f. emergency procedures and contingency 1.7 Everyone concerned with the managing, design,
planning; procurement and use of a healthcare facility should
g. training, information and communications; understand the requirements of the specialist,
critical building and engineering technology
h. maintenance; involved.
j. engineering services. Guidance on specific types 1.8 Only by having a knowledge of these requirements
of engineering services can be found as follows: can the organisations board and senior managers
(i) Decontamination (Health Technical understand their duty of care to provide safe,
Memorandum 01) efficient, effective and reliable systems which are
critical in supporting direct patient care. When this
(ii) Medical gases (Health Technical understanding is achieved, it is expected that (in
Memorandum 02) line with integrated governance proposals)
(iii) Ventilation systems (Health Technical appropriate governance arrangements would be put
Memorandum 03) in place, supported by access to suitably qualified
staff to provide this informed client role, which
(iv) Water systems (Health Technical
reflect these responsibilities.
Memorandum 04)
1.9 By locally interpreting and following this guidance,
boards and individual senior managers should be
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Health Technical Memorandum 00 Policies and principles of healthcare engineering
able to demonstrate compliance with their practical measures have been taken to minimise the
responsibilities and thereby support a culture of elements giving rise for concern.
professionalism which instils public confidence in
the capability of the NHS at local level. Recommendations
1.16 Boards and chief executives as accountable officers
Scope should use the guidance and references provided:
1.10 Healthcare premises are dependent on the safe and
w
hen planning and designing new healthcare
secure function of critical engineering services, the
facilities or undertaking refurbishments;
application of sound environmental measures, and
the support of key services. There are some w
hen developing governance systems which take
common principles that apply across the full range account of risk;
of engineering guidance and support the wider to establish principles and procedures which:
interface of all healthcarerelated equipment and
its environment. (i) recognise and address both corporate and the
individuals responsibilities;
1.11 The concept of providing and maintaining safe and
secure critical services carries a high priority and (ii) recognise the link between critical
applies across the widest range of applications. It engineering systems and emergency
must apply to patients, staff and the general public, preparedness capability;
that is, all users of the healthcare environment. (iii) reflect the important role that engineering
1.12 In a similar way, the duty of care in operational polices and principles, as implemented by
performance can contribute to the overall efficiency suitable qualified professional and technical
and safety of a healthcare organisation. Accessibility staff, can have in support of direct patient
to suitably qualified and competent staff is a key care.
factor when considering governance arrangements. 1.17 Once boards and chief executives have embraced
1.13 Evidence suggests that a comfortable healthcare the principles set out within this guidance and
environment can have a strong influence on the taken the necessary actions, their duty of care
healing cycle. This needs to be achieved in a responsibilities are more likely to be fulfilled, as will
sensitive way, with design having regard to the their ability to maintain public confidence in the
function and purpose of the specific and adjoining NHS at local level.
areas.
1.14 Staff and services must be resilient to ensure
Engineering governance
continuity of business and the safety of patients 1.18 Responsibility and, more specifically, the duty of
and staff, and be capable of providing a suitable care within a healthcare organisation are vested in
response to maintain a level of healthcare in all the management board and its supporting
circumstances. This guidance addresses the general structure.
principles, key policies and factors common to all
1.19 Engineering governance is concerned with how an
engineering services within a healthcare
organisation directs, manages and monitors its
organisation. Key issues include:
engineering activities to ensure compliance with
general health and safety; statutory and legislative requirements.
professional support; 1.20 Systems and processes need to be in place, backed
up with adequate resources and suitably qualified
operational and training requirements;
and trained staff.
emergency preparedness;
1.21 Healthcare organisations should ensure that sound
workforce planning and capability; internal controls, safe processes, working practices
maintenance. and risk management strategies are in place to
safeguard all their stakeholders and assets to prevent
1.15 To determine the right level of approach will often and reduce harm or loss.
require an assessment of the risk and an evaluation
of the factors that remain when reasonable and
2
1 Policy, context and requirements
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Health Technical Memorandum 00 Policies and principles of healthcare engineering
maximum possible changes in the use of hospital a. most, if not all, services may require
departments. modification or renewal during the useful life of
the building. Accommodation should be
1.38 In multi-storey buildings:
planned for this to occur, taking into account
a. most flexibility is achieved by a small number of weight, size and configuration of the item.
large vertical ducts with adequate provision for During non-emergency renewals, it may be
horizontal space above ceiling level and below possible to remove door frames, windows,
structural members; partitions and other non-structural items. The
b. generally, less flexibility is achieved by a large renewal or modification of minor items does
number of smaller vertical ducts with ceiling not usually create problems except where piping
spaces for horizontal distribution as necessary; or cable lengths are restrictive;
c. the omission of space above ceilings produces b. the destruction of finishes to open up a trench
the least flexible arrangement. or vertical duct or existing access could be more
economic than the provision of expensive but
1.39 Convenient access should be provided to all service rarely-used permanent access. Costs versus
spaces. savings must be considered with regard to the
1.40 In single-storey buildings: cost of inconvenience/ disruption to functions
incurred at the time of replacement.
a. sufficient headroom should be allowed for
installation and maintenance purposes; Working in confined spaces
b. if a service trench is provided, where practicable, 1.46 A confined-space permit-to-work system should be
removable covers should be provided over the established, and personnel trained in the use of the
complete length of the trench. system.
1.41 Access to services should be considered at every assessment of the task to be undertaken;
stage of both the architectural and engineering identification of the potential risks/hazards;
design process.
ventilation;
1.42 The frequency of access required should be the
main factor considered. a ir quality testing, prior to entry and
continuously during access requirements;
1.43 Frequent access:
provision for special tools and lighting;
a. immediate access is required for plant, valves,
switches and other controls requiring frequent working methods;
attention for safe operation and maintenance; implementation of the working methods;
b. if enclosed, the access should be by door or monitoring of compliance of the system;
panel;
actions in case of emergency;
c. adequate clearance should be provided for ease
communication;
of working.
first-aid.
1.44 Intermittent access:
a. items that require access at intervals (for Reviews
example monthly) can be provided by means of
floor traps, removable panels in walls, false 1.48 Management should conduct regular reviews of the
ceilings and so on. It is recommended that effectiveness of the healthcare organisations
access panels be fitted by means of retained engineering structure and systems. The review
quick-release mechanisms rather than screws should cover all controls, including strategic,
and cups. operational, safety and engineering risk
management.
1.45 Renewal or modification of service:
4
1 Policy, context and requirements
Exemplar emergency procedures types of format which may be used, and the
different levels of technical content which may be
1.49 The following procedures have been prepared by appropriate on different sites.
trust estates and facilities management (EFM)
personnel to meet the needs of their own 1.51 Further procedures will be required within a
organisations during an emergency. healthcare organisation, and a regular review is
important to ensure that directives, staff and
1.50 They are not intended to be appropriate or equipment remain current.
definitive for all sites, but they give an idea of the
Risk assessment
This procedure is linked to the overall hospital site procedure for failure of electricity supply and departmental
risk assessment register. This document should be reviewed on a regular basis and especially if any alterations to
equipment function, staff and responsibility take place.
Aims
This emergency procedure is intended to highlight the key issues that may arise at departmental level in the event
of electrical power failure. It is appreciated that this may be the result of a full site power failure, but it may also
be the result of a local failure for which notification will be necessary. The main aim is to provide a structured
approach to the safety of patients and staff and to minimise the risk associated with an electrical failure.
Identification of failure
This may be indicated by the failure of key observable elements, for example lighting and computer displays, but
may also be indicated by alarm signals from monitored supply panels on medical equipment, services and
systems.
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Health Technical Memorandum 00 Policies and principles of healthcare engineering
Review procedure
From incident experience and training evaluation, this procedure and any supporting information should be
reviewed and amended as necessary to ensure the document remains up-to-date and definitive for the
department.
This document was first issued on: .. (Date)
Amendments: ... (Brief details and date)
Plan approved and accepted by:
Senior manager
Head of department: .
6
1 Policy, context and requirements
Scope
The following procedure is designed to instruct and advise on the operational requirements for dealing with
contamination of the water supply. It is not considered a definitive guide as the particular circumstances of the
incident will ultimately determine the course of action taken. It will attempt to highlight the responsibilities of
estates staff, clinical staff and on-call administrators.
Causes
Water may become contaminated in a number of ways, including:
contamination of the incoming water supply to the hospital site;
contamination due to substances inadvertently or maliciously added to the water storage systems;
contamination caused by the corrosion or decay of materials in contact with the water supply, for example
rusting metal and dead animals;
cross-contamination of water supply due to the effect of a process carried out on site by staff or contractors
where the safety devices are inadequate or non-existent, for example cross-contamination due to siphonage
from drains and stagnant water;
misoperation/failure of water treatment plant;
migration between domestic hot and cold water services.
Effects
The possible effects of contamination are varied, and will depend on the severity and degree of the
contamination. However, further investigation should be carried out if:
staff complain about the taste of the drinking water;
the water is discoloured;
the water has a distinctive smell (this could be the result of chemicals (for example chlorine), acid, sewage or
decaying matter);
the water appears normal but people using it have become sick.
7
Health Technical Memorandum 00 Policies and principles of healthcare engineering
isolate the affected area from the main supply to prevent further contamination;
take samples at various points within the affected area(s) for future analysis;
contact on-call or emergency administrative staff and advise them to arrange a supply of fresh water for areas
requiring it;
dependent on the nature of contamination, the cause may be obvious or easily located. If this is not possible,
carry out a systematic investigation of water supply systems;
if the cause of the contamination is located, isolate the contamination and carry out necessary works to resolve
the situation;
inform medical staff of the nature of the contamination and await advice on the clinical effect before restoring
the water supply to the area;
thoroughly flush all pipework (run taps, flush toilets, bidets etc) until further analysis shows no trace of
contamination;
when the water quality is restored and confirmed by medical or microbiology staff, allow normal use to
continue.
Further work
Study how the contamination has occurred and carry out preventative work if possible to avoid recurrence.
Review the operational procedure for the incident and modify as necessary.
Note the date and time of the incident, action taken and by whom, for future reference.
Relevant drawing nos: ..........................................................
Additional information
...............................................................................................................................................................................
...............................................................................................................................................................................
...............................................................................................................................................................................
..............................................................................................................................................................................
8
1 Policy, context and requirements
Aims
The aim of this emergency procedure is to provide guidance and a structured approach to the management
response in the case of a major failure in supply of piped medical gases, and to safeguard patients at risk from any
such failure.
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Health Technical Memorandum 00 Policies and principles of healthcare engineering
Damage control
The cause and result of the damage to the system should be investigated by the Duty Engineer/Authorised
Person.
Drawings and schematics should be readily available.
Steps should be taken to limit the amount of disruption, and a temporary supply should be secured by either
valving or capping of damaged areas to enable emergency supply banks to cope during repairs. Failing this,
sufficient portable cylinders should be provided at the point of use.
Following damage limitation, valve-off the damaged section where possible and ensure back-up supply banks are
functioning.
Team members attendance should be confirmed. They should assemble at a predetermined location where
control will be handed from the Duty Engineer/Duty Estates Manager to the responsible Senior Manager.
The areas of responsibility for the various team members are outlined, but this list is by no means exhaustive and
should be further developed in the light of knowledge as the incident develops.
Areas of responsibility
Telephonist
First-line communications.
Initial coordination of response.
Assists with all communications and logs calls and responses.
Senior Manager
Coordination of all team members.
Recovery strategy and repair coordination.
Documentation.
Senior Pharmacist
Ordering and procurement of gases.
Purity checks on reinstatement of supply.
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1 Policy, context and requirements
Debriefing
Following return to normality, a team debriefing should be held to review the emergency procedure and update
or correct any apparent weaknesses.
Review procedure
This procedure will be reviewed following any change in personnel, equipment, materials and environment or
following any change. It will be reviewed at regular intervals not exceeding 12 months.
Amendments
Plan approved and accepted by:
Board member: .....................................................................
Risk assessment
This document is linked to risk assessment no ..................... It should incorporate existing controls contained in
the risk assessment and should be modified if any changes to the risk assessment are made.
11
Gas
Fire
Lifts
water
12
failure
Paging
Boilers
systems
Medical
Heating
Asbestos
checklist
Building
Kitchens
Flooding
Drainage
Infestation
Explosions
equipment
engineering
Incinerators
Operational
Refrigerators
management
Air pollution
Domestic hot
Clinical waste
(eg heatwaves,
Other extreme
Air-conditioning
Electricity supply
cold/frozen spells)
Operating theatres
Laboratory failures
weather conditions
Operational
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Health Technical Memorandum 00 Policies and principles of healthcare engineering
14
1 Policy, context and requirements
Space requirements for engineering 1.76 The surface temperature of radiators should not
exceed 43C. Ceiling-mounted radiant panels can
plant and services
operate at higher surface temperatures as long as
1.68 The building design must incorporate adequate the surface is not easily accessible.
space to enable the full range of engineering plant
1.77 Exposed heating pipework, accessible to touch,
and services to be installed and kept operational.
should be encased and/or insulated. Further
1.69 Space for plant and services should provide: information is given in Health Guidance Note
an easy and safe means of access; Safe hot water and surface temperatures. Special
care should be taken when facilities are being
s ecure accommodation protected from provided for older, confused or mental health
unauthorised access; patients, and where children may be present.
a dequate space around the plant and services to 1.78 Care should be taken to ensure that heat emitters
permit inspection, maintenance and do not adversely affect the local temperature
replacement; and conditions of adjacent storage and preparation
f or the installation of further plant and services areas.
at a later date where this is anticipated to be 1.79 Heat emitters should be located under windows,
required. against exposed walls or in the ceiling above
1.70 Guidance on spatial requirements for engineering windows.
plant and services is contained in paragraphs 1.22 1.80 Where radiators are installed there should be space
1.47. between the top of the radiator and the windowsill
1.71 Further useful information on the provision of to prevent curtains reducing the output. There
space for plant is contained in BSRIA TN 9/92, should also be adequate space underneath to allow
and for building services distribution systems in cleaning equipment to be used.
BSRIA TN 10/92. 1.81 Ceiling-mounted radiant panels should preferably
1.72 With the exception of drainage and some heating run around the perimeter of the building. The
pipework, engineering services should not be panels should not be located over beds, patient
brought from the ceiling void of the floor below. trolley positions or in other locations where they
Service distribution to a particular area should be might radiate directly onto a patient or member of
contained within the service spaces on that floor. staff for a prolonged period.
1.73 Plant rooms, particularly for air-conditioning and 1.82 Ceiling-mounted radiant panels should be selected
ventilation, should be located as close as possible to to match the appearance of the adjacent ceiling and
the areas they serve, thus minimising the amount of should be sealed to the adjacent ceiling by means of
space necessary to accommodate large ducts. a gasket or similar device.
1.74 Care should be taken to ensure that noise and 1.83 Where appropriate, heating controls should be
structure-borne vibration cannot be transmitted provided to modulate heating circuit flow
beyond the plant room. Further guidance on temperatures to maintain the desired air
acoustics and vibration can be found in Acoustics. temperature.
1.84 Radiators or radiant panels may also be used to
Mechanical services offset building fabric heat losses in mechanically
ventilated spaces. The system should be designed to
Heating ensure that the heating and ventilation systems
1.75 General space heating requirements may be met by operate in a coordinated manner and do not cause
a variety of systems including under-floor the space to overheat.
pipework, radiators or ceiling-mounted radiant
Ventilation and cooling
panels, or by an air conditioning system. Designers
should ensure that the most appropriate method is 1.85 Ventilation systems should be designed in
employed with regard to the healthcare accordance with the requirements of Health
environment being provided. Technical Memorandum 03-01 Specialised
ventilation for healthcare premises.
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Health Technical Memorandum 00 Policies and principles of healthcare engineering
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1 Policy, context and requirements
17
Health Technical Memorandum 00 Policies and principles of healthcare engineering
Socket-outlets for cleaning equipment 1.123 Fluorescent lighting in areas where clinical
procedures are carried out and/or medicines are
1.116 Sufficient socket-outlets (RCBO-protected) should
handled, including stores, must be derived from
be provided to enable the use of cleaning
lamps having suitable colour-rendering
equipment without the need to use extension
characteristics.
leads. Most floor scrubbers and polishers have 9
m-long power cables. 1.124 Light switches should be provided in easily
accessible positions and at appropriate locations in
Lighting systems corridors and general circulation areas. In areas
with multiple luminaires, switches should permit
General the selection of luminaires appropriate to the area
requiring illumination.
1.117 To achieve energy efficiency, lighting systems
should be designed to: 1.125 Ceiling-mounted fixed luminaires should not be
sited immediately above positions where people lie
maximise use of natural daylight; on a bed, couch or trolley to avoid glare. This
avoid unnecessarily high levels of illumination; applies to all spaces where people are consulted,
examined and treated.
i ncorporate efficient luminaires, control gear
and lamps; 1.126 Adjustable task lighting should be provided at the
bedhead for patients who wish to read.
incorporate effective controls.
1.127 Good lighting should be provided in all sanitary
1.118 Low energy or ultra-low energy lighting should be
spaces and there should be no reflective glare (see
considered as the primary lighting source.
BS 8300 and Approved Document M for details).
1.119 Where local circumstances permit, the use of time
1.128 Lighting services, including lighting controls,
switches or occupancy controls using infrared,
should comply with the following CIBSE
acoustic or ultrasonic detectors should be
guidance: Code for Lighting, Lighting Guide 2
encouraged. In corridors and general circulation
Hospitals and health care buildings and Guide
areas, lighting levels should be automatically
F Energy efficiency in buildings.
controlled to allow reduced levels of lighting (e.g.
with only up to 50% of luminaires switched on) 1.129 In areas where VDUs are in use, lighting should be
when the space is not occupied during normal designed to comply with CIBSE Lighting Guide 7
opening hours. Office lighting.
1.120 Lighting in sanitary spaces is generally assumed to 1.130 Lighting is important in enabling the effective
operate from passive infrared (PIR) sensors and cleaning of corners and edges that can harbour
therefore no light switches have been indicated on dust.
the example room layouts of sanitary spaces on
this website. Where light switches are required, Emergency lighting
reference should be made to Approved Document 1.131 Emergency lighting, incorporating escape lighting
M and BS 8300 for recommended location and standby lighting, should be provided in
heights. accordance with BS 5266 and building control
1.121 Lighting and the appearance of luminaires should and fire officer requirements.
be coordinated with architectural design. In 1.132 Escape lighting should also be provided in
particular, decorative finishes should be compatible accordance with Health Technical Memorandum
with the colourrendering properties of lamps and 06-01, Health Technical Memorandum 05-02
spectral distribution of the light source. See Fire safety in the NHS: Guidance in support of
Lighting and colour for hospital design. functional provision for healthcare services and
1.122 Where artificial lighting is provided in spaces CIBSE Lighting Guide 2.
where patients are examined or treated, it should
enable changes in skin tone and colour to be External lighting
clearly defined and easily identified. The quality of 1.133 The issue of light pollution should be taken into
lighting will need to be considered if video consideration when planning external lighting.
consultation is likely to take place.
18
1 Policy, context and requirements
Where possible, external lighting should not shine external entrances, car parking and pedestrian
excessively into adjacent properties. walkways may be at particular risk at night.
1.134 The following steps should be taken:
External services
Avoid excessive lighting.
1.144 Where premises do not operate over a 24-hour
Use sensor-activated luminaires. period, external engineering plant and equipment,
particularly security cameras and engineering
Ensure luminaires are correctly orientated.
service supplies, should be positioned and suitably
protected to minimise the risk of damage or
Patient/staff and staff emergency call interference when the premises are closed.
systems
1.135 Patient/staff and staff emergency call systems Car park barriers
should comply with Health Technical 1.145 To improve site security, and control unauthorised
Memorandum 08-03 Bedhead services. parking, it may be necessary to install car park
1.136 Patient/staff call points should be provided in all barriers. Where barriers are required, all electrical
spaces where a patient/attendee may be left alone services to them should be installed using external
temporarily, for example clinical rooms and WCs. cable runs routed below ground level as far as is
practical.
1.137 Staff emergency call points are for a member of
staff to call for assistance from another member of Door access control systems
staff. They should be provided in all spaces where
1.146 Health and community care buildings will
staff consult, examine and treat attendees/patients.
generally require controlled access to the building
1.138 Consideration should be given to the use of at the staff entrance and, internally, to staff areas.
modern technology and location of staff
1.147 Where door access control systems are required,
emergency call points to ensure that the risk of
these should consist of an electronic keypad, fob or
accidental operation is minimal and that, where
other approved door entry system installed in
necessary, they can act as a deterrent to potential
conjunction with a separate door entry intercom
aggressors in addition to enabling a response to an
system.
incident.
1.148 External door entry systems should be compatible
1.139 Patient/staff and staff emergency call systems may
with insurance requirements. They should be
be hard-wired or may form part of a multiplexed
weatherproof and vandal-resistant. Internal systems
data or radio system.
should be vandal-resistant.
1.140 Dedicated call points for summoning the crash
team may be provided. These are not standard Entertainment systems
installation and need to be specified for individual
rooms where patients are at a high risk of suffering 1.149 Entertainment facilities, such as television and
a cardiac arrest radio/music systems, may be provided in waiting
areas to mask sound transfer for confidentiality
1.141 A visual and audible indication of the operation of purposes or in staff rest areas to create a relaxing
each system should be provided at a suitable staff atmosphere.
base to identify the nature and origin of the call.
1.150 The entertainment services should comply with
1.142 Over-door indicator lamps and corridor indicator Health Technical Memorandum 08-03 Bedhead
lamps should be appropriately located to guide services.
staff quickly to the origin of the call.
IT and wiring systems
Security
General
CCTV installation
1.151 Where possible, a structured wiring system should
1.143 CCTV systems should be installed to monitor be provided. This will permit a unified approach
internal and external areas where there is a risk of to the provision of cabling for:
attack or vandalism. Areas such as receptions,
19
Health Technical Memorandum 00 Policies and principles of healthcare engineering
IT systems
Sustainability and energy efficiency
1.157 The IT system should include the installation,
1.166 Engineering services should use renewable and
termination, testing and commissioning of all
natural energy sources, wherever feasible. The
switches, routers, hubs, distribution cabling
energy consumption of engineering services should
complete with cable containment system, and
be further minimised through the use of low/zero
required RJ45 terminal outlets.
energy solutions and/or energy-saving devices.
Pneumatic tube systems 1.167 Account should be taken of the recommendations
in the following documents:
1.158 If a new pneumatic tube system is to be installed,
significant investigation needs to be undertaken to C
urrent editions of Building Regulations and
ensure that the system will meet required needs. Approved Codes of Practice.
For further guidance on the design of pneumatic
20
1 Policy, context and requirements
E
nergy Efficiency Office and Carbon Trust best consumption of incoming electrical supplies as
practice guidance. well as carbon emissions.
Sustainable development in the NHS U
se of thermostatic controls to limit
temperature increases and heat wastage.
Environmental strategy for the NHS
I ncreased pipe insulation to limit temperature
H
ealth Technical Memorandum 07-02
losses.
Encode making energy work in healthcare
1.168 Consideration should be given to using the
Sustainable health and social care buildings
thermal properties of the building when the
B
uilding Services Research and Information facility is not in use, for example at night or
Association (BSRIA) publications. weekends, where circumstances permit.
C
hartered Institution of Building Services 1.169 Engineering plant and equipment should be
Engineers (CIBSE) publications design recycled, wherever practical. Ideally any disposal of
guides, energy codes, technical memoranda, plant and equipment should not require a special
lighting guides, climate change levy. licence. Where a licence for disposal is necessary,
1.167 The following factors should be considered in these should be acquired as prescribed by statute.
order to minimise energy consumption: 1.170 Specific guidance can be found in Health
U
se of natural lighting and ventilation, Technical Memorandum 07-01 Safe
wherever feasible. management of healthcare waste, Health Technical
Memorandum 07-05 The treatment, recovery,
U
se of passive solar design, including the use of recycling and safe disposal of waste electrical and
solar heating panels, the use of reflective glass electronic equipment and Health Technical
and/or blinds to minimise solar gain, where Memorandum 07-06 Disposal of
appropriate, and locating heat-sensitive pharmaceutical waste in community pharmacies.
accommodation away from south facing fascias.
U
se of energy efficient equipment, including Validation and handover of engineering
high efficiency condensing boilers and motors, installations
and energy efficient luminaries.
1.171 It is important that, on completion of an
U
se of electronic inverter speed control devices installation and prior to hand-over, the
on air handling equipment instead of performance of the installation is fully tested and
alternatives such as belt pulleys or pole validated.
changing motors.
1.172 The final acceptable performance details should be
Power factor correction to major plant. recorded and, together with full manufacturers
U
se of presence detection, photocell and multi- operating and servicing details, test results,
circuit systems to control lighting. certificates, as-fitted drawings, manuals etc, made
available to users and the maintenance
U
se of a BMS system to provide automatic organisation before the installation is handed over.
time control switching (to shut down plant
1.173 Once the installation is fully operational, its
when not required) and performance
monitoring (to ensure plant is operating at performance should again be tested. This will
optimum levels) check that it is operating to the designed criteria.
1.174 Any risk management plans, operational
I mplementation of heat recovery, particularly
for ventilation systems. procedures and contingency plans should be fully
evaluated and tested with staff. Opportunities
Use of ground source heat pumps. should also be taken as soon as practical after
U
se of sensory taps, urinal controls, low volume physical completion of the facilities to familiarise
toilet cisterns and grey water (i.e. rain water and train staff in the use of all relevant equipment
harvesting or recycled water) to reduce water and services and to practice any procedures to
usage. ensure staff members understand what is required
of them.
U
se of combined heat and power plant
(including micro CHP plant) to reduce
21
Health Technical Memorandum 00 Policies and principles of healthcare engineering
2.1 There are numerous statutory and legal duties that Code of Practice, they will need to show that they
owners and occupiers of premises must adhere to. have complied with the law in some other way, or a
These are continually changing in the light of new court will find them at fault.
evidence and experience. Reference should be made
2.8 Standards (British or European), institutional
to these documents at the time of application.
guides and industry best practice play a large part
in how things should be done. They have no direct
Health and safety legal status (unless specified by regulations).
2.2 Current health and safety philosophy was However, should there be an accident, the applied
developed following the Report of the Robens safety practices at the place of work would be
Committee 1972, which resulted in the Health and examined against existing British or European
Safety at Work etc Act 1974. Standards. It would be difficult to argue in favour
of an organisation where safety was not to the
2.3 The standards of health and safety in the UK are described level.
delivered through a flexible enabling system
introduced in 1974 by the Health and Safety at 2.9 Guidance is issued in some cases to indicate the
Work etc Act 1974 and are typified by the best way to comply with regulations. But the
Management of Health and Safety at Work guidance has no legal enforcement status.
Regulations 1999.
2.4 The Health and Safety at Work etc Act 1974 leaves
Other commonly cited legislation
employers freedom to decide how to control the 2.10 There are numerous statutory and legal duties that
risks that they identify that is, to look at what the owners and occupiers of premises must adhere to.
risks are and to take sensible measures to tackle These are continually changing in the light of new
them. The Act is part of criminal law, and evidence and experience. Reference should be made
enforcement is by the Health & Safety Executive. to these documents at the time of application.
Successful prosecution can result in fines or
2.11 Some of the commonly cited legislation can be
imprisonment.
viewed in the list below. The list is not exhaustive,
but is intended to demonstrate the range of issues
Regulations, Approved Codes of Practice,
that should be considered. All references to
Standards and guidance
guidance/legislation/standards should be compared
2.5 Regulations are law, approved by Parliament. These to those current at the time of application. Latest
are usually made under the Health and Safety at published guidance always takes precedence.
Work etc Act following proposals from the Health
2.12 Only the primary Acts and main regulations are
& Safety Commission. Regulations identify certain
cited here. Most of these Acts and regulations have
risks and set out specific actions that must be taken.
been subjected to amendment subsequent to the
2.6 Approved Codes of Practice give advice on how to date of first becoming law. These amending Acts or
comply with the law by offering practical examples regulations are not included in this list.
of best practice. If employers follow the advice,
Health and Safety at Work etc Act 1974
they will be doing enough to comply with the law.
Factories Act 1961 (as amended)
2.7 Approved Codes of Practice have a special legal
status. If employers are prosecuted for a breach of The NHS and Community Care Act 1990
health and safety law, and it is proved that they did
Consumer Protection Act 1987
not follow the relevant provisions of an Approved
22
2 Statutory and legislative requirements
23
Health Technical Memorandum 00 Policies and principles of healthcare engineering
24
2 Statutory and legislative requirements
Probability Rating
Certain 5 5 10 15 20 25
Likely 4 4 8 12 16 20
Possible 3 3 6 9 12 15
Unlikely 2 2 4 6 8 10
Rare 1 1 2 3 4 5
Rating 1 2 3 4 5
Effect Insignificant Minor Moderate Major Catastrophic
25
Health Technical Memorandum 00 Policies and principles of healthcare engineering
3 Professional support
3.1 Managers of healthcare property and services need appointed person should have access to a robust
technical and professional support across a range of structure that delivers governance, assurance and
specialist services. This support should be embraced compliance through a formal reporting mechanism.
into the structure and responsibility framework of
the organisation to ensure an adequate approach Management structure
for each of the areas covered by the healthcare-
specific technical engineering guidance. 3.5 To engage and deliver the duties required, a
healthcare organisation may consider the structure
3.2 Within this building engineering guidance, a range shown below. In following this structure, healthcare
of measures are discussed to meet the needs of each organisations may consider that the necessary
service. This section considers the principles, professional and technical resilience is available to
standards and common features that will be provide a robust service.
applicable as a core approach.
Professional structure
Management and responsibility
3.6 While a chief executive and the board carry
3.3 Healthcare organisations have a duty of care to ultimate responsibility for a safe and secure
patients, their workforce and the general public. healthcare environment, it can be assigned or
This is to ensure a safe and appropriate delegated to other senior executives.
environment for healthcare. This requirement is
identified in a wide range of legislation. 3.7 However, it may not be generally possible to
maintain a senior executive with specialist
3.4 At the most senior level within an organisation, this knowledge for all professional services; external
responsibility does not need to include technical, support may therefore be required.
professional or operational duties, but the
Appointed qualified
technical staff
26
3 Professional support
3.8 An independent adviser for audit purposes, 3.14 The DP will work closely with the Senior
assessment and operational advice may also be Operational Manager to ensure that provision is
required. made to adequately support the specialist service.
3.9 The structure shown below represents a
Trust Senior Operational Manager (SOM)
professional approach to delivery of a specialist
service. 3.15 The SOM may have operational and professional
responsibility for a wide range of specialist services.
3.10 Within a specific service, other support staff for
It is important that the SOM has access to robust,
safety, quality and process purposes may be
service-specific professional support which can
required.
promote and maintain the role of the informed
3.11 Within certain healthcare organisations, some client within the healthcare organisation. This will
elements of specialist services are not present (high embrace both the maintenance and development of
voltage electrical, decontamination, medical gas service-specific improvements, support the
pipelines etc). In this case, an appropriate level of provision of the intelligent customer role and give
professional support should be considered. assurance of service quality.
3.12 It is possible for several organisations to share the
Authorising Engineer (AE)
same professional staff either individually or
collectively; however, it is usual for the Authorising 3.16 The AE will act as an independent professional
Engineer role to remain independent of the adviser to the healthcare organisation. The AE
organisation, with particular regard to the critical should be appointed by the organisation with a
audit process. brief to provide services in accordance with this
guidance. This may vary in accordance with the
Roles and responsibilities specialist service being supported.
3.17 The AE will act as assessor and make
Designated Person (DP) recommendations for the appointment of
3.13 This person provides the essential senior Authorised Persons, monitor the performance of
management link between the organisation and the service, and provide an annual audit to the DP.
professional support, which also provides To effectively carry out this role, particularly with
independence of the audit-reporting process. The regard to audit, it is preferable that the AE remains
DP will also provide an informed position at board independent of the operational structure of the
level. trust.
Designated Person
Appointed senior executive
(board level) with assigned
responsibility for service
Authorised Person
Appointed qualified
technical engineer (specific to
service)
Competent Person
Assessed and qualified
craftsperson
(specific to service)
27
Health Technical Memorandum 00 Policies and principles of healthcare engineering
28
4 Operational policy
4.1 The healthcare organisations management board is 4.10 The Authorised Person responsible for engineering
responsible for setting overall operational policy, services should take a lead in explaining to users the
and it is the Designated Person as the senior function of the system, and organise adequate
executive who has responsibility for information and training about the system.
implementation.
4.11 Maintenance and safety are two closely related
4.2 The building services engineering guidance on this subjects. General safety is largely dependent on
site should enable an organisation to be aware of good standards of maintenance being attained and
the issues relative to a particular service and support staff safety disciplines being mutually exercised.
any operational policy that has to be prepared.
4.3 It is acknowledged that some organisations have Records/drawings
separate procedures that are referenced within the 4.12 The organisation should have accurate and up-to-
operational policy under the control of other date records and/or drawings. These should be
specific departments. readily available on site, in an appropriate format,
4.4 Where the operation of engineering services is vital for use by any Authorised Person responsible for
to the continued functioning of the healthcare engineering services.
premises, operation and maintenance may require 4.13 A unique reference number should identify the
special consideration; therefore, improving equipment. This should correspond to that shown
resilience within the critical engineering systems on the records/drawings.
should be considered.
4.14 The records/drawings should indicate the type and
make of the equipment.
Operational considerations
4.15 Database systems could be used to link plant
4.5 The operational policy should ensure that users are
reference numbers to locations on drawings and
aware of the capacity of the specific system and any
detailed records of the plant and its maintenance.
particular limitations.
4.16 A schematic diagram of the installation should also
4.6 A maintenance policy that pursues and expects the
be available and displayed in each plantroom or
good upkeep of plant and equipment by regular
service area, scheduling key components.
inspection and maintenance is evidence of best
practice. 4.17 When additions or alterations are to be made to
existing installations, the Authorised Person
4.7 All safety aspects of operation associated with
responsible for engineering services should ensure
particular plant or equipment should be clearly
that the current as-fitted information is available in
understood by operational staff.
an acceptable format. On completion of the work,
4.8 Nursing, medical and other staff should be aware of the records/drawings should be updated and the
the purpose of any alarm systems and of the course service alterations noted and dated.
of action to be taken in the event of an emergency
occurring. Security
4.9 Staff responsible for engineering plant operation 4.18 All means of service isolation, regulation and
should be aware of the activities necessary to ensure control (except those in plantrooms) should be
the continued safe operation of the system and secured in such a way that they can be fixed in the
what action should be taken in an emergency. normal position.
29
Health Technical Memorandum 00 Policies and principles of healthcare engineering
4.19 In the case of those components that may have to 4.26 Work should only be carried out by suitably
be operated in an emergency, the fixing method qualified contractors within the range of design,
should be capable of being overridden. installation, commissioning or maintenance of
services as appropriate. Evidence of current
4.20 All plantrooms should be kept locked, suitably
registration should be by sight of the correct
signed and under access control.
certificate of registration.
4.21 A procedure in the operational policy for
4.27 The operational policy should set out the
controlling access, including in the event of an
responsibilities for monitoring the work of
emergency, should be established.
contractors. The Authorised Person responsible for
4.22 Adequate means of engineering plant isolation and the specific engineering services would normally
safe working areas should be provided for all coordinate this. The call-out procedures for a
operational and maintenance contingencies to contractor, particularly in the event of a fault or an
allow temporary plant where required and safe emergency, should be set out in the operational
working around equipment. policy.
Contractors
4.25 All contractors should comply with the
organisations safety procedures. This should be
clearly stated in the operational policy.
30
5 Emergency preparedness and resilience
a n environmental incident (floods, transport 5.14 Essential-service contingency plans should not be
incident, storm damage, overheating, or other confused with major incident plans (although the
extreme weather event). two should be consistent):
31
Health Technical Memorandum 00 Policies and principles of healthcare engineering
organisations response to a public incident for 5.18 From an understanding of the area and the
which an immediate high level of healthcare is healthcare activity that takes place, all the estates
required; services and facilities that exist in the range of
buildings on-site should be considered.
c ontingency planning is generally inward-
looking and deals with actions needed to 5.20 The table below gives a broad list of suggested
maintain a healthcare facility in a safe and topics for consideration. It is not a comprehensive
operational status under adverse conditions. list and may not be applicable to all sites, but it
should act as a prompt to establish the services
5.15 It is possible that some features from both plans
list.
may be needed for a complex incident, but lines of
responsibility should be clearly defined and
understood at all times. System resilience, planning and design
5.21 Resilience of the various systems and services (for
Creating an emergency plan example water and fuel) is ideally provided at the
design stage of a healthcare facility. This could
5.16 All plans should be documented and supported by
include:
as much information as possible. This should be
kept up-to-date and under constant review. p
riority allocation of the site by local utility
suppliers which provide alternative routes for
5.17 It is important to define the area to which the plan
site supply, should parts of the external
will apply. This will usually be by site rather than
infrastructure be damaged or contaminated;
individual buildings to avoid repetition of
procedures and to embrace the wider service issues.
Table 1 Suggested systems and services for consideration when creating an emergency plan
Suggested systems and services for consideration when creating an emergency plan
32
5 Emergency preparedness
r esilient internal infrastructure systems which laundry, waste disposal, transport etc need to be
provide flexibility in services supplies to confirmed, and all lines of communication and
buildings; supply chains regularly tested.
p
rovision of alternative fuel sources, with 5.29 It is also necessary to discuss and establish the
appropriate storage capacity on-site (for priorities of clinical services within the plan. These
example, fuel oil as back-up to natural gas for will move from life-critical functions (operating
boiler plant); theatres, critical care areas, neonatal intensive care
units, emergency care) through diagnostic services
e nhanced levels of on-site standby capacity for
(imaging, laboratories) and on to clinical support
electricity supplies by the use of CHP systems,
(blood, sterile services, pharmaceutical supplies,
the sizing of standby generator plant, and
medical gases etc).
flexible electrical distribution systems;
5.30 Prioritised but flexible, estate and facilities services
a ppropriate monitoring and storage capacity for,
which underpin clinical priorities will provide a
for example, water supplies.
good platform for the organisation to cope with the
5.22 Planning and designing for resilience whenever the impact of emergencies and speed up recovery to
opportunity arises that is, when new sites/ provide normal business continuity.
buildings or departments are being considered and
when major refurbishments are taking place is a External impact
key responsibility of the management board.
5.31 External influences are perhaps the most difficult
5.23 This will require a clear understanding of the element of contingency planning due to the wide
critical operational service requirements and the range of scenarios that could be presented.
type and level of ongoing service needs in the event Consequently, scenario planning for every
of an emergency/incident. eventuality is very unlikely.
5.24 Prerequisite information should be provided at the 5.32 However, some of the most likely scenarios and the
planning and design stage to enable an appropriate key issues arising should be examined, evaluated
level of resilience to be built in. For this purpose, and, where possible, tested to ensure that some
close liaison should take place between the form of response is in place for that eventuality (for
organisations emergency planning officer and the example loss of major utility, external
estates and facilities professionals at the earliest communication links etc).
possible stages.
5.25 Of particular importance in times of emergency are Security
all forms of communication systems. Email, mobile 5.33 Areas of clinical concern (for example radiology,
phones, advanced telephone/telemedicine and pathology) may require enhanced access control,
patient data systems may all require a detailed and staff and contractor screening, in accordance
analysis of the effect of failure loss. with the NHS Security Management Manual.
5.26 Proposed changes to any communication system 5.34 Adverse incidents may present exceptional
should ensure that consideration is given to the requirements to control security, access, patient and
requirements of emergency plans and staff safety etc. Planning should ensure that
communication-service resilience before decisions measures are available and understood which may
are taken. include additional staff resources (drawn from non-
5.27 These considerations should also include home/ critical roles) for entry/exit control, increased
mobile communication systems for key staff who awareness and communications, defined
will be required in the event of an emergency or management responsibility etc.
adverse incident.
Responsibility
Services and priorities 5.35 If the issue or incident remains predominantly an
5.28 Maintaining services is an essential function of estates or facilities issue, action should be
business continuity and must be a priority within a coordinated through the estates and facilities
contingency plan. Alternative sources of catering, management (EFM) structure. However, if the
33
Health Technical Memorandum 00 Policies and principles of healthcare engineering
34
6 Training, information and communications
35
Health Technical Memorandum 00 Policies and principles of healthcare engineering
6.8 From this type of assessment, it should be possible 6.14 The cost of training and the cost of apprenticeships
to determine the service shortfalls relative to loss of can be difficult to secure. When presented as part
staff for whom a natural replacement is not readily of an overall assessment with, at least, a medium-
available, and the skill shortages of existing staff term plan, it can deliver cost-efficient provision of
and the skill shortage for equipment or systems services meeting the future need of the
installed etc. organisation.
6.9 The resulting analysis may give rise to either a 6.15 Training and the quality of service are inter-linked.
training need for existing staff or a need for a staff/ Taking full advantage of multiskilling and flexible
structure review with possible training implications. working practices will begin to deliver the cost and
It may also identify a service which may be more performance efficiencies required from the services.
cost-effectively provided by an outsourced contract.
6.10 While it is important to address the staff profile by Criteria for operation
trade or service, it may be useful for an organisation 6.16 Maintenance staff should be trained in all
to link the outcome with other service profiles. maintenance procedures.
This may indicate some common issues, economies
6.17 The depth of training will depend on the level of
of scale for training needs, useful feeder groups and
required maintenance, but it should at least draw
a better general overview of the service, which can
attention to any risks and safety hazards arising due
be used to inform a priority assessment.
to maintenance activities.
Improving the workforce profile 6.18 Other personnel who monitor plant or who carry
out routine plant maintenance should be trained
6.11 Many of the traditional training routes no longer
in:
provide the level of opportunity relevant to the
healthcare sector; at the same time, skills and a. understanding the visual displays;
competences needed are becoming more and more b. acknowledging and cancelling alarms;
specific to the healthcare sector.
c. taking required actions following alarm
6.12 One challenge is to encourage more young people messages;
to enter the services sector of healthcare
organisations under specific programmes such as d. obtaining the best use of the system.
the modern apprenticeship scheme where skills can 6.19 Training (including refresher training) will need to
be delivered to meet a specific need. Another is to be repeated periodically in order to cater for
develop a multi-skilled approach to service delivery. changes in staff or the systems.
In each case, training and development will be an
important factor in the solution. 6.20 Records of the training provided should be kept
up-to-date.
6.13 With an understanding of the existing workforce
profile, a training plan may be established to meet 6.21 On completion of training, employees should be
the short-, medium- and long-term requirements assessed by an Authorised Person to ensure that the
that are needed to satisfy the organisations training programme has been understood and that
requirements. they are competent to undertake the work required.
36
7 Maintenance
7.6 The initial frequency of maintenance will depend 7.12 Records of service reports and attendance dates
on the manufacturers recommendations and the (both scheduled and achieved) should always be
circumstances of application. available.
37
Health Technical Memorandum 00 Policies and principles of healthcare engineering
38
7 Maintenance
39
Health Technical Memorandum 00 Policies and principles of healthcare engineering
8 References
Health Technical Memorandum 02-01 Medical gas CIBSE Code for Lighting, Guide F Energy efficiency
pipeline systems. in buildings.
nes for healthcare projects. CIBSE Lighting Guide 7 Office lighting.
Control of Asbestos Regulations 2006. Lighting and colour for hospital design. DH, 2004.
Health Building Note 00-07 Resilience planning for Health Technical Memorandum 05-02 Fire safety in
the healthcare estate. the NHS: Guidance in support of functional provision
for healthcare services.
Health Technical Memorandum 06-01 Electrical
services supply and distribution. Health Technical Memorandum 08-03 Bedhead
services.
Health Technical Memorandum 03-01 Specialised
ventilation for healthcare premises. Health Technical Memorandum 2009 Pneumatic air
tube transport systems.
Health Technical Memorandum 08-01 Acoustics.
Health Technical Memorandum 08-02 Lifts.
TN 9/92 Space and weight allowances for building
services plant inception stage design. Health Technical Memorandum 07-06 Sustainable
health and social care buildings: Planning, design,
TN 10-92 Space allowances for building services
construction and refurbishment.
distribution systems.
Building Regulations.
Health Guidance Note Safe hot water and surface
temperatures. Carbon Trust.
Health and Safety Executive Guidance Note EH 40. Sustainable development in the NHS. DH, 2001.
Control of Substances Hazardous to Health (COSHH) Sustainable development: Environmental strategy for the
Regulations. National Health Service. DH, 2005.
Health Technical Memorandum 04-01 The control of NHS Sustainable Development Unit.
Legionella, hygiene, safe hot water, cold water and
Building Services Research and Information Association.
drinking water systems.
Chartered Institution of Building Services Engineers.
Health Technical Memorandum 2005 Building
management systems. Health Technical Memorandum 07-01 Safe
management of healthcare waste.
Firecode.
Health Technical Memorandum 07-05 The treatment,
Health Technical Memorandum 05-03 Part B Fire
recovery, recycling and safe disposal of waste electrical
detection and alarm systems.
and electronic equipment.
Institute of Engineering and Technology Guidance Note
Health Technical Memorandum 07-06 Disposal of
7 Special Locations.
pharmaceutical waste in community pharmacies.
MEIGaN Medical Electrical Installation Guidance.
Management of Health and Safety at Work Regulations
Medicines and Healthcare products Regulatory Agency.
1999.
CIBSE Code for Lighting.
NHS and Community Care Act 1990.
CIBSE Code for Lighting, Lighting Guide 2 Hospitals
Disability Discrimination Act 1995 (DDA).
and health care buildings.
40
8 References
Management of Health and Safety at Work Regulations Pressure Systems Safety Regulations 2000.
1999.
Pressure Equipment Regulations 1999.
Workplace (Health, Safety and Welfare) Regulations
Simple Pressure Vessels (Safety) Regulations 1991.
1992.
Construction (Design and Management) Regulations
Provision and Use of Work Equipment Regulations 1998.
1994.
Manual Handling Operations Regulations 1992.
Construction (Health, Safety and Welfare) Regulations
Personal Protective Equipment at Work Regulations 1996.
1992.
Building Regulations 2000.
Confined Spaces Regulations 1997.
Environmental Protection Act 1990.
Reporting of Injuries, Diseases and Dangerous
Control of Pollution (Amendment) Act 1989.
Occurrences Regulations 1995 (RIDDOR 95).
Waste Management Licensing Regulations 1994.
Working Time Regulations 1998.
Environmental Protection (Duty of Care) Regulations
Control of Substances Hazardous to Health Regulations
1991.
(COSHH) 2002.
Controlled Waste (Registration of Carriers and Seizure of
Health and Safety (Consultation with Employees)
Vehicles) Regulations 1991.
Regulations 1996.
Hazardous Waste (England and Wales) Regulations 2005.
Health and Safety Information for Employees
Regulations 1989. List of Wastes (England) Regulations 2005.
Health and Safety (Safety Signs and Signals) Regulations Pollution Prevention and Control (England and Wales)
1996. Regulations 2000.
Employers Liability (Compulsory Insurance) Regulations Clean Air Act 1993.
1998. Environmental Protection (Prescribed Processes)
Health and Safety (Training For Employment) Regulations 1991.
Regulations 1990. Trade Effluent (Prescribed Processes and Substances)
Control of Asbestos at Work Regulations 2002. Regulations 1989.
Electricity Act 1989. Controlled Waste Regulations 1992.
Electricity Safety, Quality and Continuity Regulations Environment Act 1995.
2002. Packaging (Essential Requirements) Regulations 2003.
Electricity at Work Regulations 1989. Control of Pollution (Oil Storage) (England) Regulations
Electrical Equipment (Safety) Regulations 1994. 2001.
Plugs and Sockets etc (Safety) Regulations 1994. Landfill Tax Regulations 1996.
Radio Equipment and Telecommunications Terminal Chemicals (Hazard Information and Packaging for
Equipment Regulations 2000. Supply) Regulations 2002.
Electromagnetic Compatibility Regulations 1992. Town and Country Planning Act 1990.
Supply of Machinery (Safety) Regulations 1992. Producer Responsibility Obligations (Packaging Waste)
Regulations 2005.
Lifting Operations and Lifting Equipment Regulations
1998. Waste Electrical and Electronic Equipment Directive
2002.
Gas Appliances (Safety) Regulations 1995.
Water Industry Act 1991.
Gas Safety (Installation and Use) Regulations 1998.
Water Supply (Water Quality) Regulations 2000.
Lifts Regulations 1997.
Water Resources Act 1991.
Noise at Work Regulations 1989.
41
Health Technical Memorandum 00 Policies and principles of healthcare engineering
Water Supply (Water Fittings) Regulations 1999. Food Safety Act 1990.
Control of Lead at Work Regulations 2002. Food Safety (General Food Hygiene) Regulations 1995.
Noise & Statutory Nuisance Act 1993. Food Safety (Temperature Control) Regulations 1995.
Ionising Radiations Regulations 1999. Public Health (Infectious Diseases) Regulations 1988.
Radioactive Substances Act 1993. A risk-based methodology for establishing and managing
backlog. DH, 2005.
Ionising Radiation (Medical Exposure) Regulations 2000.
Health Building Note 11-01 Supplement A Resilience
Radioactive Materials (Road Transport) Regulations
and emergency planning in primary and community
2002.
care.
(The) Regulatory Reform (Fire Safety) Order 2005.
NHS Emergency Planning Guidance 2005.
Furniture and Furnishings (Fire) (Safety) Regulations
1988.
Dangerous Substances and Explosive Atmospheres
Regulations (DSEAR) 2002.
42