The key to security is a balancing act

Hospitals are busy places; as well as patients and staff moving around, large groups of transient visitors are also in and out all day long, and the activity continues on a 24/7 basis. Controlling the movement of people within hospital buildings to create a safe and secure environment represents a significant challenge for estates and facilities managers. Unless a hospital is brand new, it is likely to have grown organically over a number of years. Hospital Trusts change and add to their buildings on an ad hoc basis, and, as a result, a hospital can end up as a sprawling complex. For the estates or facilities manager, looking after the operation and maintenance of the various buildings is a task similar to managing an estate the size of a small village. Hospitals have many hazardous and vulnerable areas, housing very expensive equipment or materials that can be dangerous in the wrong hands. Access control acts as a red light, and deters unauthorised entry in areas that need to be kept “off limits” to the public. Often estates and facilities managers will add a range of access control solutions to keep certain areas safe. But how do they balance the need for access control in such a complex environment, and with so many different determining factors, without turning the hospital into a prison? Also, how can this be achieved on a tight budget, with limited resources, as is so often the case in the NHS?

Determine ‘at risk’ areas

When new hospitals are commissioned, it is likely that all of the elements of access control are installed to work together in the most effective way. Where hospitals have grown over time, however, access control is often added on subsequently, and, in some cases, can be very out of date and costly to maintain. Whatever the circumstances, estates managers should consider access control as part of the overall security plan, and carry out risk assessments regularly. The main entrance and exit doors on the outer perimeter of the buildings will have open access during the day. Once inside the buildings, there will be a mix of both high and low risk areas that need access control. Research laboratories and operating theatres, for example, will need more stringent restrictions than will apply to access to generic consultation rooms, and children’s wards will have a higher priority for security than cleaning or linen cupboards. The continuing threat of theft has put greater emphasis on the need to secure access to drugs, medication, and chemicals in recent years. Restricting access to areas containing IT systems is important to protect patient confidentiality, while of course staff and patients need somewhere safe for their personal belongings while they are working, or when they are staying in a hospital or other healthcare facility overnight. There are many different areas to consider, and part of the role of the estates and facilities estates manager is to assess them all and prioritise accordingly. This might be achieved with the help of a building control officer, who can also advise on regulations concerning fire doors and escape routes. With areas considered to be “lower priority”, cost is often the biggest consideration, and, of course, what works in one area or hospital will not necessarily work in others. Selecting a range of access control solutions, and using them in combination, will help achieve the best results.