Engineering & Facilities Seminars

Following a number of high profile and costly faults in construction projects both within and outwith the health service, Eddie McLaughlan will discuss developments in NHS Scotland designed to ensure that future projects and the existing estate have much less risk of significant problems.  Mainly concentrating on engineering services and their implications for patients, staff and visitors, including Healthcare Associated Infection, Eddie will discuss how to balance the competing priorities of Time, Cost and Quality.  The development of NHS Scotland Assure will be described, including its evolution and purpose and efforts to implement its philosophy in live construction projects.  The importance of competence of staff and appropriate use of specialist expertise, including Authorising Engineers, and the work within IHEEM to develop and promote Authorising Engineers will be covered.

Dr Matt Shepherd present how dated, siloed digital solutions can be inefficient and affect the patient and staff experience.

Due to task overload, it has been recognised that a fully digital end-to-end communication and collaboration solution was required that integrates the process, the people and technology to close the information gaps and provide a complete digital solution to assist the patient's pathway.

Ascom was commissioned to deploy a scalable healthcare platform to include critical alarm management, secure clinical messaging, clinical information software and an integrated mobility solution using a healthcare-specific smartphone.

Therefore, the hospital is advancing its digital status and Dr Shepherd (I) will share the Trust's excitement with the go-ahead of a revolutionary, fully digital exemplar ward, which is due to be opened in early 2023. This digital exemplar ward will include the expansion of the Ascom Healthcare Platform to include its advanced nurse call system, Telligence, and clinical information software platform, Digistat, to provide a patient response nurse call system, which will include workflow task management, EPR integration, medical device integration and collaboration from the side of the bed or whilst mobile. The aim is to improve clinical workflow efficiencies and the overall patient experience.

The Trust's long-term ambition is to be fully paperless and digital as per the NHS directive. The digital exemplar ward, utilising the Ascom Healthcare Platform, is a major contribution towards achieving the hospital's digital transformation programme.

Dr Matt Shepherd, Clinical Lead for IT and Deputy Chief Operating Officer, Harrogate & District NHS Foundation Trust

Section 710 (medical locations) of BS 7671 has been developed over the past 10 years to incorporate internationally agreed standards. The IHEEM Electrical Technical Platform (ETP) have worked tirelessly to improve resilience and in turn the maintainability of electrical systems to all hospital infrastructure including emergency and critical systems.

This presentation focusses on the ETP led interpretation of the electrical standards and guidance which have been produced to improve the resilience and maintainability of electrical systems. The presentation will use anonymised examples to demostrate the changes and reasoning for those changes to Section 710.

The presenters will discuss guidance and interpretation of the wiring regulations including application of Section 710 in other parts of the standard including but not limited to Chapter 56 Safety Services.

The presenters will demonstrate the requirements of BS 7671 and associated guidance where used in conjunction with current HTM documentation so as to bring about compliant resilient designs focussed on maintainability, inspection and testing of the intallation which is able to rise to the challenge of supply availability.

Within the Estates Department at the Royal Victoria Infirmary, a major trauma centre in the Northeast of England, the COVID-19 pandemic placed great pressure upon engineering services; exposing the need to maintain and improve the resilience and reliability of engineering services in the post-Covid era. This talk will present a case study, focusing on the Estate Department's initiative, the first in the UK, to improve medical air plant resilience and reliability using post-Covid innovation. At RVI, we conducted a risk-based backlog maintenance assessment on our medical and industrial air plant. The assessment revealed a need to replace the plant and identified key risks and areas of improvement when installing a new plant: reliability, critical spares availability, air quality and plant downtime. In line with Newcastle Hospitals' target of delivering a net zero NHS by 2030, we also looked for a plant that would address issues of energy inefficiency and carbon emission reduction. Following a tendering process, the RVI partnered with SHJ Medical Gas Specialists due to our shared vision on post-COVID resilience and innovation. The new system is built combining medical and industrial air plants as a whole to achieve maximum efficiency, where variable speed technology is employed to maintain a system base load with the option to call on selected fixed-speed compressors that adapt to different outputs and site demands. Further, the use of dewpoint temperature control, in the process of drying air, reduces energy wastage. The new plant uses a controllable global valve on the wet side of the system to give optimised control and resilience. In addition, an AI-based SHJ remote monitoring system will be implemented to collect data to further optimise the performance of the system, conduct predictive maintenance, and to estimate and quantity the net impact of the system. RVI's Sustainability Team is also collecting data from the system to quantify its impact. All the data will be collected and presented.

The construction process and project delivery ecosystem is evolving, as factors such as digtisation, whole life carbon cost and agile space emphasise the need for a step away from the conventional supply chain towards an structure that involves key value chain players throughout the whole project life cycle. From early engagement at the design phase, right through to the use, operation and maintenance of a building.

Our ability to retrieve data from our buildings, spaces and infrastructure is developing rapidly. With the right connected technology and software, we can understand and manage buildings in a different way than previously. For example, we have visibility into the condition of hospital assets and infrastructure, and we can apply condition-based maintenance to prevent the failure of critical assets. We can measure the energy used within a building or across an entire estate, and we can use the information we collect to improve the energy efficiency of buildings. We can collect data to understand how spaces are being used, to decide how we may repurpose space to optimise its use.

It is vital that action is taken because of the data we retrieve. We discuss the need for development and adaptation of facilities and operational staff in order benefit from the connected technologies. We conclude with the ideal 'digital hospital' scenario, where data streams and system information can be collated in one place, on a single pane of glass.

The discussion on healthcare environments in the last 20 years shifts between what is known as evidence-based design and salutogenic environments. These concepts have even been used interchangeably and both come from the broader health sciences field. The former derives from evidence-based medicine concepts and the latter from the theory of salutogenesis from medical sociology, both outside the built environment (BE) discipline and therefore unable to capture the intricacies of space and place. So, once those have been introduced to the built environment the concept has changed from the original theories and they sometimes end up being buzzwords.
Thus, we propose therapeutic architecture as a paradigm that stems from both health and the BE. Under that paradigm, we argue that both tangible/physiological/objective and intangible/perceptual/subjective should be accounted for. For the tangible, we investigate physiological conditions because of illness or disease and how the BE needs to accommodate those, for instance through infection control and thermal comfort. For the intangible, which is not clearly defined in the literature so far, we need to consider aspects of social, hedonic, or aesthetic value. The therapeutic paradigm we offer caters not only to pathological and salutogenic but also to the inspirational, beautiful and artistic potential of the built environment. Those could be opportunities provided by the built environment.
To explore how this concept translates in practice and can be implemented in policy, we will test our theory on three landmark case studies, defining the discussion of the era they were introduced chosen deliberately for their differences: Maggie's centers, the Evelina hospital and Chinese Covid-19 hospital placed on a matrix that explores different tangible and intangible qualities that these places offer or don't offer.

Based on real life experiences of medical storage not being planned for adequately and when staff move in they are disappointed.
Key learning points:
- Modular storage design vs Conventional storage design, HTM63 vs HTM71
- The common pitfalls in storage design and how to avoid them
- Compliance and how to provide adequate and correct storage to meet current standards and requirements
- Standardisation and Future proofing

The presentation will include slides showing examples of the difference between HTM63 and HTM71:-

HTM71 provides dense storage and better accessibility

Real life case studies and examples

Infection prevention features and points, upgrading clinical rooms to modern, efficient and pleasant places to work in:-

SUMMARY:-
Often new medical facilities open without adequate thought going into the design of storage requirements. We see time and time again, flaws in the design of specialist clinical spaces, and both traditional and new design methods not picking up the requirements and best practice of today's clinicians working on the front line.

With the NHS facing financial challenges while being required to consistently improve patient safety and care, it needs to take action at all levels to maintain its estates and facilities to a standard required by law and expected by regulatory bodies and the general public.

The NHS estate is vast complex and varied, conditions range from world-class, state of-of-the-art facilities to old Victorian hospitals that are no longer fit for purpose. The backlog of maintenance costs are increasing year on year almost equalling the operating costs of nearly £10bn.

Much of the estate requires significant and costly refurbishment or reconfiguration to remain safe and suitable for modern patient care.

Phil Bishop, Healthcare Property Director at Capita will explore how the NHS can overcome these challenges focusing on the following key learning points in his presentation:

• The opportunities for NHS Trusts not captured within the New Hospital Programme.
• The untapped potential for increased occupation of NHS sites from both health services and other uses such as housing, which can be unlocked to build healthier communities.
• Strategic asset optimisation and identifying innovative opportunities to increase the value of the assets the NHS own and manage and reimagining sites to help the NHS get the most from its estate - clinically, financially and socially.
• Using asset portfolios linked to how to work collaboratively across the public sector to match needs with opportunities and unlock solutions through a social infrastructure bond .
• How to maximum value, generated from the sale and development of NHS land, delivering new healthcare environments for excellent patient care and generating income to reinvest in clinical care or into the wider estate.