How has thinking adapted since COVID-19?

 The fact that the Government needed to tell us how to wash our hands properly during the pandemic highlighted that there is a huge gap in infection control knowledge among the vast majority of the general population. COVID-19 led to a dramatic turning point in the general awareness of infection prevention and control (IPC) as a discipline, thereby casting a light on its importance in hospitals and other healthcare facilities – perhaps one of the few positive interventions that can greatly improve the overall outcome. In this, the first of three articles covering IPC in healthcare design, we ask ourselves: ‘Four years on from COVID-19, how has our healthcare IPC design adapted?’

At the Healthcare Infection Society (HIS) conference 2023, HLM were the only architects in the room, yet as lead designers, architects are often front and centre in informing the successful outcomes of good infection control. The conference highlighted that lack of knowledge and early collaboration across IPC considerations within design and construction teams can hamper the successful delivery of projects, specifically delaying from design through to handover and commissioning. As is the case with many other specialist skills areas, this could be resolved through the involvement of IPC consultants and teams from the outset of a project, as specified in the guidance. However, in reality, there are barriers to achieving this; namely time constraints and gaps in knowledge. HIS acknowledges that this process could also be improved by the upskilling of design teams, particularly at the early stages, where key strategic decisions are made which do not necessarily need detailed knowledge of IPC best practice, but can really help make the difference between a barely compliant project, and one that has outstanding infection control features, with the collective goal of improving patient safety for the life of the building.

Operationally, the thoughtful planning and careful consideration of clinical spaces is key, and should not be seen just as a ‘tick box’ exercise, or simply a key element in complying with NHS requirements for gateway approvals. How many of us fully understand how space standards can help to reduce the potential for transmission of airborne infection through the spread of respiratory particles in a space, and that the standards are not just about the physical movement of the patients and staff? How many designers fully appreciate just how ‘unclean’ a basin or sink can potentially become through misuse or poor installation?