As the NHS feels the financial squeeze, it has been reported that many hospitals are reducing their cleaning staff and practices to cut costs. Darren Ling explains the importance of cleaning ventilation ductwork to save money and help save lives.
The Government has announced that £20 billion of efficiency savings are required across the NHS by 2013. In February, the News of the World reported that these financial cuts to the NHS were forcing 'cash-strapped hospitals' to reduce their cleaning practices and staff, leading to fears of an increase in deadly 'superbugs' such as MRSA and Clostridium Difficile.

The concern shared by the Health Facilities Consortium (HFC), which exposed the cleaning cuts after an audit of NHS Trusts, and MRSA Action UK is that reducing cleaning practices will result in an epidemic of Healthcare Associated Infections (HCAIs), costing lives and £billions.

Derek Butler, chair of MRSA Action UK, later commented: 'Cuts to frontline services are not the answer to making savings, errors cost not only lives but are a financial burden. Healthcare associated infections are estimated as costing £7.3 billion a year.'

In a hospital environment, airborne contaminants can pose a significant threat to the welfare of patients and staff. Surface dust and dirt in ventilation systems can form harmful micro-organisms and become airborne, increasing the risk of life-threatening HCAIs.

Breeding ground

In fact, ventilation systems provide the perfect breeding ground for potentially harmful bacteria. The Department of Health clearly states: 'Increased health risks to patients will occur if ventilation systems do not achieve and maintain the required standards. The link between surgical site infection and theatre air quality has been well established.'

It is vitally important to keep heating ventilation and air-conditioning (HVAC) ductwork systems clean to avoid the accumulation of dust, dirt and other potentially harmful bacteria. If left, a build up of these components can cause serious safety hazards in the workplace, including a fire outbreak.

Harmful deposits can accumulate in a number of areas within an air supply system, including the air handling unit (AHU), volume control dampers and turning vanes. In addition to the threat posed to staff and visitors, these deposits can impair the system's performance, leading to uncomfortable humidity levels and expensive running costs.

Regular inspections

Without regular inspections and following readily available guidance and advice, businesses risk compromising the health of building occupants and facing civil litigation from injured parties due to failure to comply with Health and Safety regulations. These costs can mount.


Hospitals have a duty of care to prevent the spread of infections in line with the requirements laid down in the Health Technical Memorandum 03-01. This focuses on the operational management and performance verification of specialised ventilation systems in healthcare premises, advising on best practice and maintenance procedures.

Regulation 5 of The Workplace (Health, Safety and Welfare) Regulations 1992 says that mechanical ventilation systems, including air conditioning, are regularly cleaned, tested and maintained to ensure that they are kept clean and free from contaminants.

The Heating & Ventilating Contractors' Association's (HVCA) Guide to Good Practice TR/19 Internal Cleanliness of Ventilation Systems offers professional ventilation hygiene providers comprehensive advice on how ventilation systems should be cleaned and maintained. This includes guidelines to ensure new ductwork systems remain protected during the installation period and prior to commissioning.

When commissioning maintenance work, building and facilities managers must employ highly trained, competent maintenance contractors who are able to give evidence of their skills and prove that they can carry out work to TR/19 standards.

The Health and Safety at Work Act 1974, section 2, requires that employers provide and maintain a working environment that is, so far as is reasonably practicable, safe and without risk to health. Those in breach of this act can face prosecution and lost productivity for the business.

In addition, building ventilation systems can also provide a fire hazard if fire dampers are not properly maintained. Regular safety checks are essential to ensure they are in good working order and building and facilities managers have a legal obligation under the Fire and Safety Order (2005) to minimise the risk of fire within the buildings they manage.

Regularly cleaning ventilation ductwork is essential for hospitals to maintain their standards. A drop in standards now will cost more money and lives.

• Darren Ling is director of System Hygienics