Understanding control of infection risks arising from the building systems of a healthcare environment is rapidly becoming a necessary skill amongst infection prevention and control practitioners in the UK. Traditionally though, training for infection prevention and control doctors and nurses has only superficially covered issues like safe water management in healthcare and an understanding of safe ventilation systems far less correct interpretation of environmental microbiological data. Yet examples abound of high profile, newly opened, “sick hospitals” where after patient occupation, endemic and hard to eradicate contamination issues with water or ventilation related micro-organisms begin to manifest with adverse patient outcomes and an IPCT workforce feeling ill-equipped to advise and guide estates teams and health board management in corrective action from a position of specialist knowledge and experience. Often there is a need to balance other important agendas such as energy efficiency, cost minimisation, waste reduction and introduction of novel technologies but being able to identify factors that may compromise patient safety through risk of infection and being able to work in a team to resolve them before they cause harm are becoming sought after skills in the UK. This session seeks to share some such practical learning and experience accrued from involvement in numerous refurbishment and new build projects.