Despite it being almost eight years since the issuing of the Hackitt report, its key recommendations remain largely unimplemented. This is particularly true in healthcare settings, where meaningful progress has been limited. As a result, legislation may now be needed to enforce change. In this article, Dr Manjula Meda, Dr Michael Weinbren, and health engineer George McCracken provide real life illustrations of why projects go wrong, and how simple solutions such as identifying risks at the inception of a project would make future hospitals radically safer, as well as saving significant sums of money.
The primary goal of constructing a replacement healthcare facility is to ensure that it is safer for its intended occupants. Safety has many dimensions; however, for the purposes of this article, the focus will primarily be on the risk of infection arising from the built environment.
England is about to undertake one of the most ambitious hospital construction programmes in the world. This comes at a time when the design, construction, installation, and commissioning industry has been described as in a 'race to the bottom'. At the same time, antimicrobial resistance (AMR) in healthcare settings is presenting an increasingly serious challenge.
Patients in English hospitals are already dying because of AMR, and unfortunately the worst may still be ahead. AMR is projected to become a leading cause of death.1 Many advances in modern medicine depend on effective antimicrobial agents to protect patients when they are vulnerable. Without such protection, these procedures will either carry significantly higher mortality rates or may no longer be practised because they will offer no advantage in patient outcomes.
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