Authorising Engineer’s ‘pivotal role’ explained

To gain an understanding of the Authorising Engineer role, we should perhaps look back to the early days of piped medical gases. The Authorising Engineer (MGPS) role was introduced in Scotland over 30 years ago, based on a decision to investigate the problems being experienced by the five Regional Boards making up the NHS in Scotland prior to the introduction of a national code of practice. With the advent of the IHEEM voluntary register for Authorising Engineers (MGPS), and the relatively recent introduction of Authorising Engineers throughout the UK, there has been a current train of thought that the focus of the AE role is perhaps restricted to the audit process. While recognising the importance of thorough and regular audit of an organisation’s MGPS (medical gas pipeline systems) operational management arrangements, it is also important to realise the full extent of the demands and scope of work that can be placed on the AE when under contract to provide the NHS board/healthcare organisation with a specialist MGPS advisory service. Background Following a fatal accident enquiry in the 1960s, the Scottish Home and Health Department at that time issued Scottish Hospital Memorandum No. 67/1966, which laid down the conditions and procedures to govern the future acceptance of medical gas installations. From this Memorandum came the first code of practice, which was issued by the then Western Regional Hospital Board. This Memorandum placed the responsibility for the inspection and testing of new installations before signed acceptance with the Regional Engineer and, where appropriate, the appointment of the Hospital Engineer as the Responsible Officer. Considering the absence of guidance, training, and specification, in the 1960s and early 1970s, the control of piped medical gas projects tended to sit exclusively with the liquid or gas suppliers, who imposed their design philosophy and installation methodology on the health service which, without strict controls in place, was to the service’s detriment. The absence of training for the Responsible Officer (later designated as the Authorised Person), particularly in relation to the management and commissioning of systems as part of new build projects, or the refurbishment of existing buildings, resulted in the contractor effectively determining the overall quality of the medical gases installation.

First national code of practice

The introduction of the first national code of practice, HTM 22, in 1972, allowed the NHS to apply some pressure for an improvement in both the MGPS design and installation aspects, with the Regional Engineer’s department leading the way with respect to the validation and verification of the medical gas projects. This was followed by the issue of the Permit to Work System, with the recommendation that the appointment of the Authorised Person would be carried out by a Chartered Engineer within the health service, who had specialised knowledge and training in medical gas pipeline systems. The professional status requirement would ensure that a level of integrity and professionalism was recognised in the event of any court action arising through the negligence of the individual. When dealing in a restricted market with the absence of credible competitors, a monopoly situation existed, giving a master/pupil relationship which tended to restrict quality improvement. This resulted, in many instances, in a delay in acceptance of hospitals. Without the acceptance of the piped medical gas systems, a hospital would be deemed “not fit for the purpose”. During that period, it was the only means of achieving the aim of improved patient safety, and for gaining tighter control on the design and installation aspects. HTM22, as possibly expected of the first published code of practice, gave rise to various interpretations and anomalies within the code of the standards required that, only in time, would ensure a common purpose.