The recent nontuberculous mycobacteria (NTM) outbreak in a healthcare facility has highlighted the critical importance of water safety in NHS settings. As an Estates Manager, Head of Estates, or Authorised Person within an NHS Trust, you’re likely reassessing your water safety protocols. This post aims to clarify key issues and offer practical steps for improving your approach to water safety.
Understanding the Challenge with Water Safety
Managing water safety in healthcare facilities involves addressing complex risks that could impact patient safety. Here are the key questions you may be facing:
- What are the main risk factors for NTM and other waterborne pathogens in healthcare?
- How can we assess our current water systems for vulnerabilities?
- What are the latest best practices for infection prevention in hospital water systems?
- How do we balance safety improvements with budgetary and operational constraints?
Key Waterborne Risks in Healthcare
- Waterborne Pathogens: Even water that meets regulatory standards may harbour dangerous bacteria like Legionella, Pseudomonas aeruginosa, and NTM, which pose serious risks, especially to immunocompromised patients.
- Transmission Routes: Pathogens can be transmitted through ingestion, inhalation, aspiration, or direct/indirect contact with contaminated water or aerosols.
- Knowledge Gaps: Understanding of NTM infections, including their transmission pathways and control methods, remains limited.
- Complex Systems: Hospital water systems, including distribution networks and wastewater, can become breeding grounds for pathogens if poorly designed or managed.
What Estates Managers Need to Know About Water Safety
- Board-Level Responsibility: Governance for water safety ultimately rests with the board, which must ensure the safety of all building users.
- Project Water Safety Group (PWSG): Appoint a dedicated PWSG for each project, led by a Senior Responsible Owner (SRO) or Executive Director.
- Risk Assessments: Carry out comprehensive risk assessments from the project’s conception through to handover and beyond.
- Specialised Design: Water systems must be designed to minimise microbial contamination risk, with input from mechanical and electrical (M&E) experts.
- Commissioning: The filling and commissioning of water systems are high-risk processes that require precise execution.
- Continuous Monitoring: Routine monitoring and maintenance are crucial for long-term safety.
Key Focus Areas for Estates Managers
To ensure water safety in healthcare settings, focus on these core areas:
- Comprehensive Risk Assessment
Evaluate your water system from source to point-of-use, identifying stagnation areas, temperature issues, and materials that could harbour pathogens. - Water Management Plan
Update your water management plan to address the specific risks of NTM and other opportunistic pathogens. Include regular monitoring, clear response protocols, and preventative maintenance strategies. - Staff Training
Ensure that all relevant staff – from facilities management to clinical personnel – understand their roles in maintaining safety and are trained on updated protocols. - System Upgrades and Maintenance
Consider whether your water systems need upgrades, such as point-of-use filters or more rigorous flushing routines for infrequently used outlets. - Documentation and Compliance
Keep detailed records of safety measures, testing, and maintenance activities. Proper documentation is crucial for both regulatory compliance and identifying trends over time. - Expert Collaboration
Collaborate with specialists to receive tailored guidance and support for your specific facility. Their expertise can enhance your risk management strategies and improve patient safety.
How PSA Can Help: Your Water Safety Partners
At PSA, we offer comprehensive support to help NHS trusts manage risks. Here’s how we can assist:
- Clear Communication: We can provide clarity on complex regulations and assist in producing action plans for your trust to ensure a logical path to compliance.
- Risk Assessments: Our experts can review your current Risk Assessments and assist you with an action plan to rectify non-conformancies.
- Design Reviews: We ensure your water system designs align with safety guidnace and budget constraints.
- Procurement Guidance: We help you choose materials and equipment that prioritise safety and efficiency.
- Commissioning Support: We ensure compliance and best practices throughout the commissioning process.
- Staff Training: Our team can advise on training requirements for your team to ensure they are up to date on the latest knowledge.
- Ongoing Collaboration: We offer continuous support to maintain high standards in your facility.
Next Steps for Estates Managers
As you move forward in improving water safety, consider these actions:
- Conduct a risk-assessment of your current water safety measures.
- Review and update your water management plan in light of new or emerging risks.
- Engage key stakeholders to coordinate a comprehensive approach to water safety.
- Reach out to water safety specialists for expert advice on crafting or enhancing your strategy.
Ensuring water safety in NHS facilities is a continuous, proactive process that requires expert knowledge and a commitment to improvement. Taking the right steps now will protect your patients, staff, and institution from the risks posed by waterborne pathogens.
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