Limitations with HTMs need addressing

Having recently started a new job, by way of some sort of initiation I was tasked with writing an article for Health Estate Journal. While searching through the archives of the magazine seeking inspiration, I came across an article titled 'The Missing Health Technical Memoranda', first published on 3 November 2006. This article centred on the argument that there were significant gaps in the current suite of Health Technical Memoranda (commonly referred to as 'the HTM's'), and that more could be done to control the highest-risk activities within health estates. This piqued my interest, because 18 years later the issues raised in the article remain extant, and are in fact the same issues that I (and a lot of others) still face today. I endeavoured to find out why.

To understand why there are limitations with the HTMs, and why they only cover specific activities, in a specific way, perhaps we need first to understand the motivation behind writing them in the first instance. In other words, where did they come from?

It is often thought that the HTMs were originally written to be Safe Systems of Work, as required by the Health and Safety at Work etc Act (HSWA) 1974, and inferred by the Management of Health and Safety at Work Regulations 1999. It would seem, however, that they were not. Instead, they are a series of documents written so that healthcare estates could comply with the requirements of the Care Quality Commission and the Health and Social Care Act. This line of thinking can be demonstrated by the flow chart diagram on page 5 of HTM 00: Policies and Principles of Healthcare Engineering (see Figure 1). You may notice a lack of health and safety legislation being cited.