The New Balfour Hospital opened in 2019, and is an award-winning pioneer for what is to be the standard for new hospitals in the NHS. Although admirable, the net zero decision for us had some far-reaching IPC implications, which need to be acknowledged and considered more fully.  

One of the challenges we have faced has been the natural ventilation strategy of the majority of our 49-bedded hospital. The SARS-CoV-2 pandemic played a significant role in highlighting this, and though the scale of the pandemic was unprecedented, needing to account for infectious diseases spread by the respiratory route in the design of settings where patients require healthcare is not new. 

The pandemic created commonplace discussions around aerosol generating procedures and the use of FFP3 respirators. It generated guidance that created a requirement for healthcare workers to become familiar with air changes per hour (ACH) so they could calculate fallow time. For us in Scotland, this meant that in naturally ventilated rooms we had to assume only 1-2 ACH. This equates to significant fallow time and resultant PPE use. 

Sustainability cannot be viewed in isolation, and instead requires an assessment of resultant risk across the system, including IPC. It creates an additional layer of complexity and challenge to those IPC already face.