Guy’s and St Thomas’ NHS Foundation Trust

The Royal Brompton has more than 1,600 staff, five operating theatres and four catheter laboratories. We have 295 beds, including 48 for surgery, 93 for respiratory patients, 48 for cardiology, 34 pediatric, 20 for intensive care and 12 for pediatric intensive care.

A total of 790 Assets varying between Manufacturers Horne, Armitage Shanks and Twyford across this area required servicing. A Scheduled program of 3 Months staring 1st January for servicing was set; a further one month for any revisits on hard to access areas (e.g. ICU) and appropriate remedial work such as cartridge and Inlet changes.

The challenges we found during our works Involved.

• Access – issues regarding COVID-19 or ‘RED’ areas, with various areas being non accessible for periods of time due to isolation or serious treatment and/or only accessible through additional PPE being required at certain times of the day.

• Footfall – The Level of use of areas or indeed or Privatized areas of the building. Each area is managed by a head nurse, sister, matron; or privately managed, Working with their specific needs particularly footfall.

• Poor circulation and or pressure – The Hospital was opened between 1844 & 1852 – Since that period it has expanded, and the services have been modernized. This is still an ongoing process, and it impacts quality of water and heating services.

The solutions we implemented during our works involved.

• Access – We did not delay and moved through the project focusing on areas without issue during which we assigned specific engineers who were trained and inducted into each ‘hard to access’ area by the estates manager and our internal compliance manager. Management collaborated and we liaised directly with ward representatives, understood their concerns, and built first term basis relationships; creating programs which were communicated clearly and allowed the delivery of services.

• Footfall – We conducted weekly project meetings where information gathered from the on-site team allowed us to understand levels of footfall – Our relationships also with ward managers helped us data collect and produce strategies and areas of focus. Going into high footfall areas we carried out recces to identify any associated issues with assets requiring service; this allowed for preparation and faster execution of servicing and remedials when windows of low footfall presented themselves.

• Poor Temp, circulation and or pressure – We adapted by setting up a rig to allow the ‘proving’ of assets in the correct conditions. We also provided the estates team with a comprehensive asset list Monthly which showed the level of completion of servicing for each asset, any remedials associated including a schedule of rates and highlighted notes on each asset/outlet that failed to meet temperature and reports on the areas and reasons as to why so that it can be addressed by the on-site teams.

The Impact we have had on the site has allowed them a fundamental understanding of the condition of the system at present; a detailed, updated list of assets and their condition.

Our engineers have intrinsic understanding of the site and its protocol as a NHS setting.

These Assets which contribute to the proliferation of the growth of legionella in the system now comply, which has positively impacted sample results across the site.