Health & Safety – Legionella
Page Contents
CQC Essential Standards of Quality and Safety
Legionnaires Disease and Water Safety in Primary Care Routine
Introduction
Legionellosis is the collective name given to the pneumonia-like illness caused by legionella bacteria. Legionnaires’ disease is a potentially fatal form of pneumonia caused by the inhalation of small droplets of contaminated water containing Legionella.
All man-made hot and cold water systems are likely to provide an environment where Legionella can grow. Where conditions are favourable then the bacteria may multiply thus increasing the risk of exposure. It is a simple fact that the organism will colonise both large and small systems so both require risks to be managed effectively.
The Control of Substances Hazardous to Health Regulations 2002 (COSHH) provides a framework of actions to control the risk from a range of hazardous substances, including biological agents such as Legionella – to identify and assess the risk, and implement any necessary measures to control any risk.
Therefore a “suitable and sufficient” Risk Assessment should be undertaken to identify the hazards, assess the risk and to define suitable control measures to eliminate, reduce or control the risk.
As an employer or person in control of premises, you must appoint someone competent to help you comply with your health and safety duties, eg take responsibility for managing the risks. A competent person is someone with the necessary skills, knowledge and experience to manage health and safety, including the control measures.
The Health and Safety Executive have issued an Approved Code of Practice – Legionnaires’ disease. The control of legionella bacteria in water systems – L8 (Fourth edition) Published 2013 HSE L8 4th Edition (2013) which provide key guidance.
This leaflet Legionnaire’s Disease – a guide for dutyholders, produced by the HSE (Health and Safety Executive) is informative and will enable most practices to feel confident that they know enough to make a reasonable judgement and risk assessment.
As employers, practices do have to carry out a risk assessment for legionnaires disease. The HSE code of practice states “A simple risk assessment may show that the risks are low and in such case no further action will be necessary. Examples include small, domestic-type water systems where temperatures and turnover are high, or where instantaneous water heaters are used.” Guidance from the HSE makes it clearer: “If you decide that the risks are insignificant, your assessment is complete. You need take no further action other than to review the assessment periodically in case anything changes in your system.” It has been suggested that there is no legal requirement for a third party specialist to carry out an assessment, but that the assessment should be carried out by a suitably qualified/competent person – this isn’t quite what the code of practice says, it’s that the “duty holder” (i.e. the employer) has to have access to competent help and advice.
See also:
- HSE Legionnaires’ Disease Technical Guidance Legionnaires’ disease – HSE
- HSE Control of legionella bacteria in water systems Audit checklists Control of legionella bacteria in water systems – HSE
CQC Essential Standards of Quality and Safety
CQC is not asking for anything new or different from what practices should already be doing as employers. It is for the practice to assess its risk and take appropriate action.
Regulation 15 – Premises and Equipment
All premises and equipment used by the service provider must be—
- clean,
- secure,
- suitable for the purpose for which they are being used,
- properly used
- properly maintained, and
- appropriately located for the purpose for which they are being used.
- The registered person must, in relation to such premises and equipment, maintain standards of hygiene appropriate for the purposes for which they are being used.
Related guidance for Regulation 15 includes the Control of substances hazardous to health The Control of Substances Hazardous to Health Regulations 2002 in which Legionnaires Disease is referenced.
The following documents are also listed that relate to legionnaires disease:
- All currently valid Health Technical Memoranda (HTMs) published by the Department of Health
- All currently valid Health Building Notes (HBNs) published by the Department of Health. Health Building Note 00-09: Infection control in the built environment
Legionnaires Disease and Water Safety in Primary Care Routine
Information from Matthew Richardson, Specialist Nurse – Infection Prevention and Control.
Primary Care practices have a duty to ensure that their water systems do not pose a risk to the health and safety of employees and visitors from legionella bacteria.
All water systems in Primary Care practices require a risk assessment. However, not all systems will require elaborate control measures and responses and actions should be proportionate to the identified risk. A simple risk assessment may show that the risks are low and being properly managed to comply with the law. It is likely to that most practices will not require anything more than a basic local risk assessment and simple in-house control measures.
This document is a summary designed to introduce Primary Care practices to the requirements around water safety and help practices to determine whether external consultation is proportionate and necessary.
With thanks to West Hampshire ICB for this information.