Health and safety with a capital H

Ifor Sheldon, Contract Manager, Bellrock at the West Berkshire Community Hospital

Compliance in any environment is a serious consideration for the FM and senior management team. For those working in healthcare environments, it is at the heart of every activity. From a facilities perspective, each element of maintenance and day to day service provision has an impact on patient care that can be positive or negative. In order to set the necessary high standard, a guidance document, based on standard health and safety legislation, but with more robust criteria was created. Those already working in healthcare, whether in the NHS or the private sector, will be familiar with the health technical memorandum (HTMs). It is the one truth as far as compliance is concerned. Some of these examples help those unfamiliar with the requirements to understand the more stringent criteria additional to the standard health and safety legislation. The L8 details a suite of criteria for the prevention of legionella, requiring out of use standing water environments to be flushed every week whilst for healthcare environments this is increased to twice a week. Lift maintenance frequency is determined at every three months for buildings such as hotels, but this is increased to every month for healthcare environments. The role of the facilities manager in healthcare is to ensure that the HTMs are applied to their specific facility and integrated into to the management plan.

The HTMs are at the heart of a compliance regime for healthcare but there are other aspects that make the healthcare landscape still more complex when it comes to health and safety. The changing codes of practices around infection management have not only to be closely followed but also anticipated. It is not only healthcare professionals who are tasked with keeping pace with the battle against new and mutating bugs; the cleaning regimes for the sterilisation of certain areas and general cleaning in less sensitive areas are evolving constantly. Generally, cleaning standards are initially self-monitored on a monthly basis using a system based on the NHS model. The infection control team then monitors the main clinical areas on a monthly basis in conjunction with the NHS Trust’s PFI monitoring officer. The two sets of results are compared to ensure they are comparable. The relationship between the person responsible for facilities management compliance and maintenance and the senior management team therefore has to be collaborative. A common goal to not just guaranteeing compliance, but ensuring the safety of patients and visitors alike.

Not only is the maintenance and cleaning regimes required to be more robust in healthcare environments, but compliance with the HTMs is also audited by an independent expert from the Care Quality Commission (CQC). The audit or inspection is carried out by experts in the field reviewing five critical criteria, the first of which is the safety of the environment. To demonstrate compliance it is essential that record keeping and data management is exemplary. In advance of the audit a suite of evidence is given to the NHS Trust that is used by the CQC as the basis of their
inspection in that area.

Using a powerful software tool to capture and store data is often the best way of not only demonstrating compliance in a transparent way but also managing workflow. Alerts and reminders can help schedule compliance requirements, whilst a dashboard can provide an instant overview of corrective actions and compliance status. These are essential tools for streamlining processes and driving efficiencies, as well as providing an audit trail and accurate data when it comes to demonstrating compliance. In fact in some instances, it is possible to marry up the compliance requirements with the PPM schedule which in turn saves valuable time and resources, something very welcome in the healthcare sector.

When it comes to compliance and meeting the health and safety requirements for patients, visitors and healthcare professionals it is essential for FM practitioners to understand these more demanding standards. These more demanding standards are not the only aspect that differentiates the healthcare sector. The independent audit process ensures that monitoring is central to compliance regime, ensuring FMs adopt a robust forward schedule of works and reporting mechanisms.

See page 18 of PFM Premises & Facilities Management: The complete fire and safety solution: Bellrock – Health and safety with a capital H