Health Technical Memorandum 64 (HTM64) is a Department of Health publication that provides guidelines specifically for the health care sector. The HTM 64 guidelines need to be adhered to in all relevant new build projects and whenever existing facilities are refurbished. Here we take a look at what’s involved.
What is a sanitary assembly?
HTM 64 refers specifically to the design of sanitary assemblies. The technical document regards a sanitary assembly as ‘comprising a soil or waste appliance and appropriate supply and waste fittings. So this basically covers your toilets, urinals, sinks, taps and showers. However, in healthcare environments, this will also include hand-wash basins and plaster sinks, which may not be in the washroom but in consultation and practice rooms, as well as wards and bedrooms.
These sanitary assemblies are further divided into two categories. General Pattern and Hospital Pattern.
General Pattern refers to non-clinical sanitary ware used by patients, visitors, and staff, while Hospital Pattern refers to sanitary assemblies used by staff in connection with clinical procedures.
Washbasins are a great way of understanding the difference between the two types of patterns. A General Pattern basin is designed to allow handwashing in a reservoir of water, and a plug is specified to allow this, much like a common washbasin in the home bathroom. Meanwhile, a Hospital Pattern washbasin allows hand washing only under a constant stream of running water and has a water outlet on the back wall of the basin, without a plug.
Complying with HTM 64 in clinical environments
One of the main areas of HTM 64 is water supply and basins in the clinical environment. These may be plaster sinks or disposal sinks in operating theatres, treatment and consultation rooms. As with all good design, a large part of HTM 64 is to significantly reduce the risk of contamination and bacterial spread. Naturally, this means reduced surface areas and no nooks or crannies where bacteria can hide. This also means closely monitoring your mains water supply to mitigate the risk of contamination. Below, we look at some of the main ways this can be done.
Medical Basins
Vitreous china medical washbasins need to be designed to a hospital pattern, which means the drainage outlet is situated horizontally at the back of the basin. The basin cannot have any additional holes for taps, overflow or chains. This leaves you with a smooth, easy-to-clean sink with no areas where bacteria can linger or build up.
Medical Taps
You’ll need medical taps that are sensor, or lever operated. This stops contamination and the spread of bacteria as they are either operated by clean elbows or automatically. The tap will also need to have an open nozzle and a flow straightener. Water cannot flow directly into the drain outlet, which the hospital's pattern basin helps prevent.
If you would like further advice on which taps or basins to choose, please get in touch.
Water Safety Plans (WSPs)
Healthcare providers should develop a water safety plan for their facilities. This risk management approach is needed to keep a close eye on the water supply and should include temperature regulation and regular checks to prevent bacterial contamination. A recorded schedule of Legionella and P. Aeruginosa checks will be needed in environments where HTM 64 is relevant, as will be the use of TMV3 thermostatic valves.
Legionella checks
Legionella checks ensure your water supply does not contain Legionella bacteria, which can cause Legionnaires’ Disease, a lung infection similar to pneumonia. Legionella checks involve a series of procedures carried out weekly, monthly, quarterly, semiannually, and annually. This can be outsourced or carried out by site managers.
If you would like to read more on Legionella checks, read our feature – Legionella Checks: Reducing The Risks
P. Aeruginosa Risk Assessments
Pseudomonas Aeruginosa is a bacterium associated with disease in humans and thrives in moist, wet environments. P. Aeruginosa can be found in the last two metres of the water supply before the outlet and is an opportunistic bacterium that needs very few nutrients to survive. Given the wide range of environments in which this bacterium can be found and the diverse ways it can be contracted, rigorous risk assessments are needed. The bacteria can be contracted by washing, consuming or bathing in contaminated water as well as breathing air in areas where it may be present. Checks and risk assessments need to be carried out at regular intervals on the storage of your water supply and on events that occur during its delivery.
For further advice or information on P. Aeruginosa risk assessments, please get in touch.
TMV3 mixer valves
For the hot water supply, ensure TMV3 D08-approved thermostatic mixer valves are fitted. This accurately controls the water temperature and prevents scalding.
Other suggestions
There are other steps you can take to reduce the risk of bacterial contamination within sanitary assemblies, too. For instance, the rim of a toilet is a common spot for bacteria to accumulate and a tricky area to clean effectively. However, rimless toilets are available, which remove this problem. The same functionality applies to some urinals that benefit from concealed flush pipes and drainage, as well as no overhanging rim.
Do I need to adhere to HTM 64?
Health Technical Memorandum 64 (HTM64) applies to new build projects or to the refurbishment of existing facilities. The guidelines on sanitary assemblies apply in surgical, clinical and wider healthcare environments, including care homes, day centres, hospitals, general practice surgeries and drop-in clinics.
As always, our team are at the end of the telephone for all your queries and questions and have a wealth of knowledge they’re happy to share with you. If you need some guidance or would like to talk through your options, you can give them a call on 01202 650900.
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