Estates & Facilities Alerts Phil Ashcroft Principal Engineer NHS Improvement (England)

Estates and Facilities Alerts –

Cooperation across the Devolved Nations

Philip Ashcroft Principal Engineer - Senior Policy and Strategy Lead (Hard FM)

3 May 2018

DH to NHS Improvement

• The Department of Health underwent a major reorganisation (DH2020) during 2016/17

• Approximately 1/3rd reduction of staff in DH.

• The NHS Estates function was transferred from DH to NHS Improvement as part of the DH2020 process on 1st February 2017. It lost 75% of the existing staff in this reorganisation & transfer.

• As Principal Engineer I was transferred over under TUPE as part of this process.

• The monitoring of Defects & Failures and issuing of Estates and Facilities Alerts comes under my remit.

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NHS Improvement is the operational name for the organisation that brings together:

Who makes up the NHS Improvement

family?

Reporting of Defects and Failures in

England

• In England reporting of estates related incidents affecting the safety of patients and the continuity of services is part of the statutory responsibilities on NHS healthcare providers established by the Care Quality Commission (Registration) Regulations 2009: Regulation 18 http://www.cqc.org.uk/content/regulation-18-notification-other-incidents

• This is over and above safety incident reporting as part of Health Safety at Work Act regulatory requirements

Reporting of Defects and Failures in

England

To help ensure estates related safety and business continuity incidents are investigated NHS healthcare providers, Commissioners, Dental practices and GP surgeries area also asked to report defects and failures (D&F) involving engineering plant, infrastructure and non-medical devices

Reporting of Defects and Failures in

England

• Organisations that need to report an incident do so through the efm Defects & Failures* web portal hosted by NHS Digital on behalf of NHS Improvement.

• These can vary from faulty manufacture of plugs to incorrect connection of bus bars in CHP centres (compounded by incorrect commissioning of fuel solenoids!)

* Scotland, Wales and Northern Ireland have their own reporting systems

Issuing of Estates and Facilities Alerts by

the Devolved Nations

Issuing of Estates and Facilities Alerts by

the Devolved Nations

When do we issue Estates & Facilities Alerts?

There are varied reasons, for example. – Recommendations from Coroner’s reports

(e.g. window restrictors)

– Requests from HSE (e.g. asbestos gaskets)

Issuing of Estates and Facilities Alerts by

the Devolved Nations

– An incident reported by an NHS organisation that requires broad dissemination (e.g. batteries, UCV theatre canopy filters, automatic fire doors)

– Manufacturer safety/recall/remedial action notices (e.g. Miniature circuit breakers, shower thermostatic mixer valve)

– Changes in regulations/standards (e.g. window blind cords)

Issuing of Estates and Facilities Alerts by

the Devolved Nations

Why do we issue Estates & Facilities Alerts?

Again there are varied reasons. – Prevention of future deaths, with respect to acting on Coroner’s

reports

– Ensuring safety of patients, staff and visitors

– Sharing learning across the NHS Estates and Facilities teams; and their PFI, capital and contract partners

– Removing potentially dangerous equipment from use within the NHS

– Helping to ensure remedial actions can be undertaken to rectify potential faults in plant and equipment

Issuing of Estates and Facilities Alerts by

the Devolved Nations – the process

• Whichever nation is made aware of the incident or formal request is responsible for making the other three aware of the need for a potential Alert and undertaking any intelligence gathering

• Discussion takes place between the four nations on whether the potential Alert meets the criteria for being issued.

• Once consensus is arrived at the instigator produces a Draft Alert for circulation and comment. Each nation is expected to consult with their relevant policy leads and professionals.

Issuing of Estates and Facilities Alerts by

the Devolved Nations – the process

• Received comments are considered and generally taken into account to produce a Final Draft. Once completed this is again circulated for final consensus.

• An agreed date and time for issuing is determined and the Alert issued simultaneously across the 4 nations.

When would issuing an Estates and

Facilities Alert UK wide not take place?

• There are certain circumstances when an Alert may not be issued UK wide. This decision is still undertaken in conjunction with the other nations. For example: – It is agreed that it would be more

appropriate to revise a Health Building Note or Health Technical Memorandum (e.g. the issuing of the Pseudomonas aeruginosa addendum to HTM 04-01)

– Local policy differences (e.g. issuing of the additional guidance in England for electronic cigarette chargers)

What else happens to the information

from Defects & Failures reporting?

• The information submitted, whether it is used to assist in developing an Alert or not is still important. It may help, for example: – Identify trends. 1 incident with an item or type of equipment may not

result in an Alert but 2, 3 or more incidents may well do.

– To instigate revisions to HBNs and HTMs or be of use during planned revisions.

– Information relating to low voltage and high voltage distribution equipment/switchgear may be used to issue safety reports by the Energy Networks Association

– To inform the HSE of potential hazards affecting patients/staff that may assist their development of guidance

– To inform manufacturers of problems with the manufacture or safe operation relating to their products