What implications does the Building Safety bill have for the NHS?

The UK public was left in shock after the Grenfell tragedy of 2017. An investigation was launched, as well as a full independent review of building regulations and safety, commissioned by the government and led by Dame Judith Hackitt.

The review highlighted issues around the regulatory system, compliance and enforcement, with an early interim report suggesting that a universal shift in culture was needed. A year after the tragedy, more than 50 recommendations were published, followed by the Building Safety Bill in 2021.

The changes are based on more than two years of investigation and review that analysed the ways in which the building sector needed to improve safety processes to prevent future fires. The new guidance focuses primarily on residential buildings, but does acknowledge that hospitals are also high-risk, complex buildings, and that patients within them have a wide range of dependencies. 

The bill creates a more robust regulatory and accountability framework for the construction industry, as well as introducing clearer standards and guidance to create systemic change within the building industry.

Residents were put at the heart of the regulation improvements, but other public sector buildings, such as hospitals, must be mindful not to get left behind in these new fire safety processes. Health Technical Memorandas (HTMs) give comprehensive advice on the design, construction and operation of specialist building and equipment, which is crucial for NHS assets to retain high standards. But the fire safety guidance was last updated in 2015, and doesn’t reflect the newer fire safety regulations that have come into circulation. 

Trusts now have an opportunity to evaluate their fire safety protocols ahead of time, before the changes begin to impact non-residential public sector properties. The HTM guidance will need to be upgraded, and the NHS can learn lessons from the social housing sector to ensure it’s up to the necessary standards.

In light of recent events, trusts must seek external assurance that fire safety requirements can be met in the future. This will involve careful review and audit, something which the NHS will need support with from partners. 

Once trusts have established any overhauls that will be needed, they need to understand whether they have the right resource and skill within their existing teams. If the answer is no, they may wish to consider implementing new training programmes, or expanding the team to employ people who already have the necessary skills needed. Meanwhile teams need to ensure that NHS asset information is fully up to date, with all fire safety records monitored, to ensure equipment such as fire extinguishers, sprinkler systems, alarms and other safety mechanisms are in operational condition at all times. 

Robust governance of fire safety is essential, meaning that everyone across the organisation needs to have visibility and understanding of the way guidance is implemented and executed. Trust boards hold ultimate accountability, and will be responsible for the way that safety regulations are actioned throughout the entire organisation. Within the NHS, there is currently a backlog of maintenance work that needs to be actioned, something that will require significant investment as demonstrated in the latest NHS Estates returns. In addition to being granted government funding, trusts need to manage this in the right way, ensuring that any new upgrades to existing buildings prioritise patient safety. 

Fire safety considerations need to be implemented at every stage of building development and maintenance, something which must be taken into account during the planning phases. It will be vital for trust managers and the private firms they work with to understand exactly what will be required in terms of fire safety regulations, and how that might impact current guidance. A building safety manager or a building safety team needs to be responsible for setting out and managing a list of competencies within the NHS estate, to ensure accountability. For example, if a firm goes in to change the ventilation in a hospital, every stage of this journey must be carefully managed and monitored so that it remains in line with updated guidance. 

Merging existing fire safety legislation with the new guidance outlined in the Building Safety Bill might not be an easy task, but it’s necessary to protect NHS assets and continue the smooth running of services. By learning from the lessons laid out by the housing sector, trusts now have the opportunity to safeguard buildings for the future.