Risk Management Services

Seeing the risks you face and developing solutions

BOC Healthcare can provide an impartial and pragmatic view of risk in your systems, using our experience with supplying medical gases to the NHS since 1948. We apply tried and tested risk analysis methodology to ensure we provide the hospital with a solid foundation upon which to build.

BOC Healthcare will make a detailed assessment of how medical gases are managed in your hospital. This involves surveying equipment and conducting interviews with your staff, covering all of the areas referred to in HTM 02-01 as well as BS EN ISO 7396-1:2007+A2:2010, BOC standard operating procedures and best practice.

The audit will include identification of potential risks and shortcomings in the following areas:

• Plant capacity and condition
• Distribution systems
• Emergency preparedness
• Manual handling
• Management systems and documentation
• Preventative maintenance effectiveness
• Training needs analysis
• Signage
• Level of patient risk
• Provision of equipment and emergency back-up.

BOC Healthcare can assist you in identifying the risks associated with medical gas management. Having provided you with a documented risk assessment, the risks can be prioritised and incorporated in your risk register. This enables you to manage and mitigate them effectively.

Potential risks identified by comparison to HTM 02-01 and best practice could include:

• Inadequate product/prohibition/warning signage and emergency notices
• Medical gas drawings incomplete/out of date
• Operational policy incomplete/out of date
• No knowledge of standards/compliance shortfall
• No designated storage points at ward level
• Authorising engineer not in place.

Identifying the risks in your hospital is not enough, the next step is to start reducing the level of risk to as low as is reasonably practical. BOC Healthcare can provide you with expert, impartial and qualified guidance to do just that.

Developing Solutions with You in Managing Risks

At least 60% of patients are administered medial gases during their stay in hospital. Your staff will handle and administer medical gases everyday - frequently. That means everyone needs to understand and carry out their responsibilities to avoid potential danger.

A moment of carelessness, an overlooked precaution or simple mistake can lead to an accident, injury and loss. Unless your hospital has the procedures, regular training and facilities in place to manage medical gases safely, the safety of patients, staff and visitors could be at risk.

How can you assess the level of risk against HTM 02-01 unless a compliance audit has been carried out, the risk identified and quantified? Even if the non-compliance is minor, you should still prepare a plan to bring the MGPS up to standard.

Compliance with HTM 02-01 is your responsibility - but where can you find the expertise, time and resources to ensure you meet the demands of guidance and best practice? At BOC we have the solutions to help you with compliance.

The distribution and management of medical gases within a healthcare facility should be controlled in accordance with HTM 02-01. A part of this policy document states that each healthcare facility must have an operational policy which advises the relevant stakeholders of their duties and responsibilities.

The policy should be detailed enough to enable the extraction of best practice procedures and information.

BOC Healthcare offers a service where we develop a bespoke operational policy for you to support you in your compliance with HTM 02-01.

Elements would include but not be limited to:

• System description overview and operation
• Management responsibilities
• Stakeholder’s defined and accepted responsibilities
• Training requirements
• Operation of the permit to work system
• Normal and emergency operational procedures
• Specifications (where available)
• Plant and manifold log-sheets.

Maintenance Specification

Medical gas systems are subject to PPM usually carried out by specialist contractors in accordance with recommendations of HTM 02-01. This requires that a specification is developed specific to the hospital in question advising the contractor of their duties and responsibilities.

The PPM specification should be detailed enough to enable all chosen contractors to price and carryout the maintenance required for your system ensuring best practice and procedures.

Elements would include but not limited to:

• MGPS installed plant
• Product specification
• General work procedures
• Schedule of maintenance services required
• In depth contractor questionnaire to ensure compliance with the various standards and benchmarking.

Medical gas cylinders should be stored in accordance with the recommendations of HTM 02-01. This requires that a specification is developed specific to the hospital in question advising the contractor of the store requirements for the safe storage of medical gas cylinders.

This could involve carrying out a site survey to determine optimum stock levels and designing the available spare with the correct racking and storage systems.

An Authorised Person - Medical Gas Pipeline System (MGPS) is required by HTM 02-01 to provide functional and technical management of the medical gas systems where the gases are carried and distributed within a pipeline system.

The provision of an AP (MGPS) therefore needs to be by someone fully experienced and qualified to undertake duties that are required.

Depending on your requirements BOC Healthcare can provide you with Authorised Person support in the following ways:

Where you need assistance on site, or where your site isn’t large enough to warrant a qualified engineer of your own, we can provide an AP (MGPS) on your behalf. Some of the duties would include:

• Managing interruptions to service requiring high hazard level permits to work
• Advising local staff on all aspects of medical gas management
• Training your staff to act as Responsible Persons in order to deal with contractors and low hazard permits to work
• Attending medical gas committee meetings
• Selection and management of medical gas contractors working on your site.

Even where you have the operational staff required to manage your existing systems, you may not have the experience necessary to adequately manage a large MGPS installation project. Here we can provide technical assistance to enable you to ensure that the installation contractors working on your project are carrying out the work competently and that the completed works are tested and commissioned to the required design parameters. This can be divided into the following elements:

• Design validation, to ensure that the systems have been designed to cater for your demands
• Contractor evaluation, to ensure that the specialist installers have the correct training and qualifications to complete the work safely
• Installation testing, to ensure that all functional and safety tests are carried out at the correct times and to the correct standards
• Commissioning, after all the works have been completed the systems needs to be commissioned to ensure the design parameters have been adhered to. This also ensures that the system performs to design, and it is safe for patient connection.

This service is designed to allow the BOC Authorising Engineer to ensure that you can demonstrate your familiarity with the MGPS. During the survey you will show the BOC Authorising Engineer around:

• All primary plant and emergency reserves
• Main distribution and primary valving
• Alarm Systems
• Emergency inlet points and back up cylinder stock
• Representative selection of wards, theatres, ITU etc.

In this element, the BOC Authorising Engineer will be looking to review evidence of adequate and up to date training together with correct management systems, including relevant documentation:

• CV's, certificates and training records of yours and those of your staff
• Your operational policy
• Hard/Electronic copy of your as fitted drawings
• Permit to work, book with any supporting documentation (Risk assessments and method statements, hot permits etc.)
• Current copy of HTM 02-01 and C11
• Maintenance and installation specifications for MGPS
• Plant/equipment history sheets and maintenance record sheets
• Written scheme of examination and competent person inspections (PSSR)
• Tools, equipment and test gear.

All BOC Authorising Engineers will set a typical occurrence within a hospital environment. They will review the pre visit work you have prepared and the manner in which the paperwork has been completed, they will also look at:

• Notification to users
• Specification preparation, risk assessments and method statement
• Instructions to contractors
• Permit to work
• Agreements with other stakeholders.

Our Partnership approach to this service not only achieves your sign off requirement by the Chief Executive but also creates the foundations for you and your APs to confirm your medical gas pipeline systems are managed in accordance with the standard.