Preventing Legionnaires’ Disease in Private Healthcare Facilities
In this healthcare review the water safety specialists at Legionella Control International consider the key actions required to control or prevent Legionnaires’ disease in private healthcare facilities.
The article explains what Legionnaires’ disease is and where it comes from, what guidance is available to help those responsible for water safety manage these risks; and why the risk assessment process and development of a water safety plan are fundamental early stage steps required to create a solid safety management process that will keep staff, patients and visitors safe.
A version of this story about the prevention of Legionnaires’ disease in private healthcare first appeared in Legionella Control International’s newsletter. To get it in your inbox, sign up for free here.
Preventing outbreaks of disease in private healthcare
While many people who require healthcare in the UK seek it out from the NHS, others go to private medical providers. There are many private hospitals and services throughout the UK, providing support, treatment, and other healthcare services for various conditions.
Of course, while there are many differences between the services offered on the NHS and by private healthcare services, there are also many similarities. For example, all such services and venues have a responsibility to prevent outbreaks of diseases that could easily be prevented. One of the best examples of this is Legionnaires’ disease.
What is Legionnaires’ disease?
Legionnaires’ disease is a potentially serious form of pneumonia, a lung disease that anyone can catch, but some are at greater risk of than others. The elderly and those with compromised immune systems or lung conditions are typical examples.
The disease is caused by Legionella bacteria which spreads when it gains a foothold in a hot or cold water system. If the water system is properly managed, monitored and maintained, there should be no reason for an outbreak of Legionnaires’ disease to occur. Indeed, it is often referred to as a preventable disease.
However, there have been outbreaks of Legionnaires’ in several healthcare settings in the UK. These can be avoided if the proper approach is taken to removing and/or minimising the risk factors inherent in the water systems present in a healthcare setting. In this article, we shall explore how to prevent outbreaks of Legionnaires’ disease in private healthcare facilities.
What guidance is available for the control of Legionnaires’ disease?
Making sure the various water systems inside a healthcare facility, whether that is a private hospital, clinic, or other facility, can be a daunting task. Fortunately, the UK’s Health and Safety Executive (HSE) and Department of Health issue guidance covering the control of legionella and water safety issues that those responsible can follow. There is also an important Code of Practice available (ACoP L8) that provides further support, and makes for essential reading.
Every private healthcare facility (i.e., every individual site) will have its own hot and cold water systems to assess. However, certain aspects of the process of approaching water safety will remain the same across all sites and services.
For example, many sites will likely require more than one person to manage and maintain the safety of the on-site water system. In some cases, there may be one or more individuals who already have extensive experience of such a role. However, in every case, those involved with managing the water system must be properly trained and responsible enough to carry out their roles.
In some cases, there may be someone who has already had training in the water safety arena. This could make them the ideal choice as the Responsible Person, taking on day to day responsibility for the situation and safety processes. However, there are likely to be others involved too, in which case a proper and clear plan should be developed and adopted. This Water Safety Plan will then make sure everyone is aware of the individuals responsible for each aspect of the water safety plan.
Water safety risk assessments, risk prevention, and control
The first step in making sure any healthcare setting is safe from the risk of a Legionnaires’ outbreak is to carry out a full legionella risk assessment for the individual site. The Responsible Person may do this if they are competent to do so, or they may choose to hire a competent expert from outside your company, such as Legionella Control International to complete the task.
The water safety risk assessment should identify any areas that may pose a risk from Legionella bacteria, or sometimes pseudomonas. This could mean highlighting poor management procedures, incorrect water temperatures, infrequently used taps and other outlets, such as shower heads, or a run of pipework that is no longer in use.
Developing a Water Safety Plan for managing hospital water systems
From the information identified in the risk assessment, it is then possible to begin to create a water safety plan that removes risk where possible and proportionate and reduces it in other cases. For instance, a dead run of pipework could be removed, thereby removing the potential risk as well. In the case of infrequently used taps and shower heads, a programme of regular flushing of those outlets would be better employed. This prevents build-up of scale and sludge and keeps the water flowing, thereby reducing the risk of Legionella bacteria colonising that part of the water system.
Whatever steps are taken to maintain the water safety plan, they should all be noted and kept as evidence of a proper approach to safety. If the Care Quality Commission (CQC) or HSE decides to inspect the private healthcare facility, there would be a record of all steps undertaken to make sure it is “water” safe in this respect. Indeed, the law states that businesses with five or more employees must keep records. This is likely to include almost all private healthcare facilities. Those records can also be useful to help create a record of steps taken, results gained, and to identify any potential problem areas.
Keeping patients and visitors safe from Legionnaires’ disease
All private healthcare providers have a duty of care to make sure all those using their premises are safe. Since Legionella bacteria can spread through mist and aerosolised water, it’s possible that a contaminated water system could also potentially infect those who do not directly use the system.
Given the potential for patients to be elderly or perhaps immunocompromised in some way, there are elevated risk factors present in healthcare settings that are not always present in other buildings.
We can see how important it is for all those involved in water safety and the control of legionella in a private healthcare setting to have proper training to be able to perform their roles effectively. Once a proper hierarchy, clear management plan and practical control measures have been set up, it should be more straightforward to maintain a safe approach in all buildings offering private healthcare services.
Private healthcare water safety specialists
Our healthcare water safety specialists support those responsible for the control of waterborne pathogens including legionella and pseudomonas in hospitals and healthcare environments, helping them to protect people and so meet their health and safety obligations in this specialist area.
We are experienced in the role of Authorising Engineer (Water) and can assist in the development of comprehensive Water Safety Plans to support the Water Safety Group. We also deliver professional water safety risk assessments for legionella, pseudomonas and other waterborne pathogens. We offer water quality testing, independent compliance auditing, City & Guilds training and other risk management services that help keep staff and others safe.
If you would like to speak with one of our healthcare specialists about managing your water safety risks call us today on 0330 223 36 86 or contact us here …
