HTM Derogations and Clarifications

Introduction The purpose of this document is to outline derogations and clarifications with respect to the current applicable HTM and HBN guidance. This document should be read in conjunction with all Design Notes. In general the principles contained within the HTM and HBN guidance documentation will be used to establish design guidelines for the building services. It is noted however that these documents offer guidance on the provision of healthcare facilities; therefore, where considered appropriate by the designers, other design solutions may be considered better suited to the building. In the event that discrepancies are identified between the requirements of different HTM and/or HBN guidance; agreements with the Trust has been sought as to the most appropriate design solution

The design for the project/s is at stage 0 in the process and further design development will be required with respect to the engineering to confirm the final list of derogations. The list reflects that new build will largely be derogation free except the anomalies with the HTM's but refurbishment will contain a number of issues some of which are yet to be developed.

Overview of Healthcare Guidance related to Engineering Services: 1. Health Technical Memorandum 00: Best Practice Guidance for Healthcare Engineering

2. Health Technical Memorandum 01: Decontamination (replaces Health Technical Memoranda 2010, 2030 and 2031) 3. Health Technical Memorandum 01-01: The decontamination of reusable medical devices 4. Health Technical Memorandum 02: Medical gases (replaces Health Technical Memorandum 2022) 5. Health Technical Memorandum 02-01: Medical gas pipeline systems

6. Health Technical Memorandum 03: Heating and ventilation systems (replaces Health Technical Memorandum 2025). Ventilation, design, installation, testing and validation (Part A). Operational management and verification (Part B) 7. Health Technical Memorandum 04: Water systems (replaces Health Technical Memoranda 2027 and 2040) 8. Health Technical Memorandum 04-01: The control of Legionella , hygiene, safe hot water, cold water and drinking water systems

9. Health Technical Memorandum 05: Firecode fire safety in the NHS (replaces the previous Firecode suite of documents) 10. Health Technical Memorandum 05-01: Managing healthcare fire safety (published July 2006) (replaces Policy and principles) 11. Health Technical Memorandum 05-02: Guidance to support functional provisions for healthcare premises (replaces Health Technical Memoranda 81 and 85) 12. Health Technical Memorandum 05-03: Operational provisions 13. Health Technical Memorandum 06: Electrical services (replaces Health Technical Memoranda 2007, 2011, 2014, 2020 and 2021) 14. Health Technical Memorandum 06-01: Electrical services supply and distribution 15. Health Technical Memorandum 06-02: Electrical safety guidance for low voltage Systems 16. Health Technical Memorandum 06-03: Electrical safety guidance for high voltage systems 17. Health Technical Memorandum 07: Environment and sustainability (replaces Health Facilities Note 21, Health Technical Memoranda 2065 and 2075) 18. Health Technical Memorandum 07-01: Safe management of healthcare waste

19. Health Technical Memorandum 07-02: EnCO2de making energy work in healthcare (published February 2006) 20. Health Technical Memorandum 07-03: Transport management and car parking: best practice guidance for NHS trusts in England (published February 2006) 21. Health Technical Memorandum 08-01: Specialist services - Acoustics 22. Health Technical Memorandum 08-03: Specialist services - Bedhead services 23. Health Technical Memorandum 08-06: Specialist services - pathology laboratory gas systems 24. Health Technical Memorandum 2055 Telecommunications: Design Considerations 1994 25. Health Technical Memorandum 2023: Access and Accommodation for Engineering Services 26. Health Technical Memorandum 2009: Pneumatic air tube transport systems. Design considerations and good practice guide 27. Health Technical Memorandum 2030: Washer-disinfectors 28. Health Technical Memorandum 2005: Building management systems 29. Health Technical Memorandum 68: Duct and panel assemblies

Capita Symonds Telford & RSH Hospitals Preliminary Mechanical and Electrical Derogations
Location Clause Item
Health Technical Memorandum 00: Best Practice Guidance for Healthcare Engineering Health Technical Memorandum 01: Decontamination (replaces Health Technical Memoranda 2010, 2030 and 2031) Health Technical Memorandum 01-01: The decontamination of reusable medical devices Health Technical Memorandum 02: Medical gases (replaces Health Technical Memorandum 2022) Health Technical Memorandum 02-01: Medical gas pipeline systems

Comment

HBN 02-01 Medical gas pipeline systems (2006) - Provision of medical gas outlets (oxygen, medical air, nitrous oxide, vacuum and anaesthetic gas scavenging) will be provided in accordance with user requirements as defined in the RDS and not as detailed within the HTM.
Health Technical Memorandum 03: Heating and ventilation systems (replaces Health Technical Memorandum 2025). Ventilation, design, installation, testing and validation (Part A). Operational management and verification HTM 03-01: Mechanical ventilation (tempered fresh air) added to rooms where natural ventilation is not feasible due to Specialised Ventilation overheating, internal room configurations and/or acoustic requirement. In addition, DX split cooling units may be for Healthcare used in rooms where cooling cannot be achieved by this method. Premises HTM 03-01Specialised These rooms are to be naturally ventilated using the existing opening windows/trickle ventilators and ventilation for healthcare premises as such it is likely that the internal temperature will rise above 28 for more than 50 hours per C (2007) Clauses 2.15 annum. and 3.24 HTM03-01 Section 1, Figure 1 HTM03-01 Clause 2.48 HTM03-01 Clause 2.51 HTM03-01 Clause 2.54 HTM03-01 Clause 3.22 HTM03-01 Clause 3.23 HTM03-01 Clause 3.43 HTM03-01 Clause 3.54 The volume control damper can be duct mounted or part of the air handling unit. A fresh air make-up will not be provided to split comfort air conditioners where natural ventilation is provided, or where the space is unoccupied.

HTM 03-01 Specialised ventilation for healthcare premises (2007) Clause 2.51 - DX Split heat pump units will be used in these rooms to control internal temperatures.
Low level extract will not be provided. Building pressure tests will not be used to calculate infiltration rates. Proprietary software (IES) will be used for determining summertime temperatures. The maximum coil face velocity of 2.0m/s only applies to AHUs cooling coils. For those not provided with cooling coils the limit is 2.5m/s. Direct expansion coils will be allowable, if part of a multistage of inverter driven system.

HTM03-01 Clause 4.5 Access to both sides of Air Handling Units may not be provided. HTM03-01 Clause 4.6 Areas around Air Handling Unit will not be tanked, plant rooms are provided with floor gullies. HTM03-01 Clause 4.9 CO4 will not be applied to Air Handling Units serving kitchen type areas. HTM03-01 Clause 4.27/4.46 HTM03-01 Clause 4.29 HTM03-01 Clause 4.146 HTM03-01 Clause 4.48 HTM03-01 Clause 4.52 HTM03-01 Clause 4.61 Only specialised systems will be arranged for items under positive pressure. Energy recovery will not apply to the kitchen ventilation system. Energy recovery will only be provided where deemed viable. Where outlet ducts are not gradual/followed by straight duct sections equivalent to 3 duct diameters, splitters/diffuses/blast plates will be used if necessary. Diffusers/ blast plates will be fitted where necessary.

HTM 03-01 Ventilation (Clause 4.61) Provision of a standby motor for every AHU fan may not be provided if a single standby motor that is suitable for several similar sized AHU fans. This will achieve saving on storage space for multiple spare motors and save on unnecessary cost. HTM 03-01 Specialised ventilation for healthcare premises (2007) Clause 4.73 - Where possible LTHW zone reheat batteries will be located above corridors but it may be necessary to locate some over patient areas due to spacial constraints within the ceiling voids.
Air handling units, fans, split units and fan coil units may be installed in the ceiling above an occupied space. Filter maximum face, velocity to be 2.5m/s. Clause limits the face velocity to 2.0m/s. Main distribution ductwork may be routed over sleeping areas. Additional acoustic insulation will be applied if required. Grilles and louvres will be fitted with acoustically treated external inlet and outlet louvres where required. In circular ducts iris dampers may or may not be used. Smoke sensors will not be fitted in main supply ducts unless required by the fire strategy. Ventilation systems may not be controlled by movement detectors. Ventilation systems may not be controlled via a link to the lighting.

HTM03-01 Clause 4.73 HTM03-01 Clause 4.74/4.87 HTM03-01 Clause 4.130 HTM03-01 Clause 5.4 HTM03-01 Clause 5.45 HTM03-01 Clause 5.49 HTM03-01 Clause 6.21 HTM03-01 Clause 6.26 HTM03-01 Clause 6.27

Appendix 2

HTM 03-01Specialised ventilation for healthcare premises (2007) Appendix 2 Recommended air change rates - The ventilation systems will have a 'night set back' facility whereby if required, the supply and extract air volumes can be reduced to 50% (of the normal daily rates) in order to reduce noise from the ventilation system. This will mean that the minimum air change rates will not be met in areas served by the respective ventilation systems when in 'night set back' mode. HTM 03-01Specialised ventilation for healthcare premises (2007) Appendix 2 Recommended air change rates - There are no recommended internal temperature criteria for these spaces however DX split heat pumps will be installed to provide comfort cooling in accordance with requirements of the users.
Health Technical Memorandum 04-01: The control of Legionella , hygiene, safe hot water, cold water and drinking water systems

Appendix 2

No derogations sought
Health Technical Memorandum 05: Firecode fire safety in the NHS (replaces the previous Firecode suite of documents) Health Technical Memorandum 05-01: Managing healthcare fire safety (published July 2006) (replaces Policy and principles) Health Technical Memorandum 05-02: Guidance to support functional provisions for healthcare premises (replaces Health Technical Memoranda 81 and 85) Health Technical Memorandum 05-03: Operational provisions Clause states detectors need not be installed in bath / shower rooms, however in Clause 4.7 it states that detectors should always be installed in areas of patient access and patient hotels. Clause 4.4/4.5 and BS 5839 will be followed i.e. no detectors will be installed in wet areas. HTM 05-02 Clause 3.6 to 3.13 HTM 05-03 Clause 5.1 to 5.10 HTM 05-03 Clause 4.35 / 4.36 Fire control strategy agreed with the Trust and Fire Officer to be as existing site philosophy. Key operated manual call points would be provided in lieu of break glass units within the MSU as per clause 5.10. No override would be provided to access control or fire escape door. This is to be managed manually on site by the security staff as part of the controlled evacuation strategy.

HTM 05-03 Clause 4.4/4.5

4.35 / 4.36

the security staff as part of the controlled evacuation strategy. Health Technical Memorandum 06: Electrical services (replaces Health Technical Memoranda 2007, 2011, 2014, 2020 and 2021) Health Technical Memorandum 06-02: Electrical safety guidance for low voltage Systems Health Technical Memorandum 06-03: Electrical safety guidance for high voltage systems

HTM06-01 Clause 8.84

HTM06-01 Clause 8.84 asks for 200 hours of fuel storage for standby generation. Existing fuel storage to be utilised, capacity / duration as existing, this may not comply. HTM 06-01: Alteration of existing electrical services may not meet the latest emergency back up provision requirements. Ie The existing generator capacity will remain as is.
Health Technical Memorandum 07: Environment and sustainability (replaces Health Facilities Note 21, Health Technical Memoranda 2065 and 2075) Health Technical Memorandum 07-01: Safe management of healthcare waste Health Technical Memorandum 07-02: EnCO2de making energy work in healthcare (published February 2006)

HTM 07-02 Encode (Clause 5.152) Recommended minimum daylight factor of 2% may not be achieved where existing windows are provided.
Health Technical Memorandum 07-03: Transport management and car parking: best practice guidance for NHS Trusts in England (published February 2006) No derogations sought Health Technical Memorandum 07-07: Environment and sustainability Sustainable health and social care buildings

HTM 07-07 Sustainable Health (Clause 2.18) The requirements for renewable energy may not be met. Health Technical Memorandum 08-01: Specialist services - Acoustics HBN 08-01Acoustics (2008) and HBN 03-01(2007) - Noise from the new ventilation systems may exceed the noise rating criteria as set out in the above documentation. Levels of around NR45 may be experienced.
HTM08-01 Section 2.14 HTM08-01 Section 2.19 Intrusive noise level criteria may be exceeded at some times in naturally ventilated spaces. Indoor ambient noise level during heavy rainfall cannot be predicted. However design provisions are in place to ensure rain noise does not result in undue disturbance in internal spaces as required in Section 2.18

Health Technical Memorandum 08-03: Specialist services - Bedhead services

HTM 08-03 Nurse call systems will be provided without the following options: two way speech at the bed head, nurse presence detection, intruder alarm, attack alarm at the bed head, cardiac alarm systems, and pocket pagers as specified within. HTM 08-03 Entertainment Facilities at the bed head assumed to be provided by Specialist eg Patient line
Health Technical Memorandum 08-06: Specialist services - pathology laboratory gas systems Not applicable to scheme - No derogations sought Health Technical Memorandum 2055 Telecommunications: Design Considerations 1994 HTM 2055 Telecommunications: Designed to current standards and regulations. Design Considerations 1994

Health Technical Memorandum 2023: Access and Accommodation for Engineering Services HTM 2023: Access and Accommodation for Engineering Services Space provision for services plantrooms, voids and risers have been designed for adequate and safe maintenance in accordance with best practice and CDM requirements. These may dimensionally differ from the data provided in HTM 2023.

HTM 2023 Access and Accommodation for Engineering Services: Good Practice Guide (2023) - The routing of services may not be in accordance with this document due to the physical constraints of the existing building.
Health Technical Memorandum 2009: Pneumatic air tube transport systems. Design considerations and good practice guide Health Technical Memorandum 2030: Washer-disinfectors Not applicable to scheme - No derogations sought Health Technical Memorandum 2005: Building management systems No derogations sought Health Technical Memorandum 68: Duct and panel assemblies No derogations sought

Other HTM/ HBM (Not current) and Standards. HTM 2015 Section 11 Nurse call systems will be provided without the option of two way speech. NHS Model Specification section C44 clause 05.05 BS 5839 Fire Alarm and Detection No bypass switch will be provided, our proposal is to provide main failure changeover system utilising MCCB circuit breakers Fire alarm system will be designed in accordance with HTM-05 fire code.

New Build & Refurbishment Refurbishment / light touch Refurbishment / light touch

HTM 12 supplement 3 Audiology booths and associated controls assumed to be provided by Specialist within a shell. Where existing lighting is to be reused it is felt they may not meet standards set within CIBSE Lighting Guide 2 or latest Building Regulation efficiency requirements. IET Wiring Regulations: Through altering existing circuits to suit new layouts, conductor colours maybe mixed, and may not meet the latest requirements of the regulations. HBN 57 Facilities for Critical Care (2003) Clause 8.35 - Selectable temperature range to be between 21 and 24 in the single bedrooms and not between 16 and 27 C C C C. HBN 57 Facilities for Critical Care (2003) Clause 8.55 - Temperature within the single bedrooms will be centrally controlled (BMS) between 21 and 24 (averaged temperature) and not locally C C adjustable. HBN 4 Supplement 1:Isolation facilities in acute settings (2005) Clause 4.8 - Gas tight shut-off dampers will be provided to enable pairs of single bedrooms to be shut down for deep cleaning and not individual single bedrooms, due to spacial constraints in the ceiling void on the supply and extract ductwork arrangements. HBN 4 Supplement 1:Isolation facilities in acute settings (2005) Clause 4.11 - Low level extract will not be provided to single bedrooms. CIBSE Guide A Environmental Design (2006) - Non-clinical spaces that are to be naturally ventilated using the existing opening windows/trickle ventilators may be subject to summer time over heating when measured against the above document which recommends that internal dry resultant temperatures in office type spaces should not exceed 28 for more than 1% of occupied hours C during the year.