As featured in Waterline Spring 2025

A week in the life of an NHSScotland Assure AE (Water)

Craig Morning, Authorising Engineer (Water), NHSScotland Assure

My name is Craig Morning, and I am an IHEEM registered Authorising Engineer (Water) employed within NHSScotland Assure, part of NHS National Services Scotland (NSS). In November 2022, NHSScotland Assure launched its Authorising Engineer (AE) service to meet the need for a consistent, cost-effective engineering service for health boards across Scotland. The AE service is delivered by NHSScotland Assure’s Engineering and Assurance team, which is made up of 21 subject matter experts specialising in energy, electrical services, medical gases, water and drainage, and ventilation. The NHSScotland Assure AE service supports health boards in Scotland to assess compliance in the healthcare estate and develop estate strategies. This includes planning preventative maintenance, managing plant replacement, and looking at strategies to mitigate risk.

A typical week consists of 80% planned activities and 20% allowed for short notice support, future planning, or Continual Professional Development (CPD). In February of each year, I try to pull together a list of all the planned activities such as Water Safety Group attendance, audits, annual leave, CPD and other commitments for the next financial year and add them to the diary. I extend diary invites to relevant stakeholders so that all parties have clear visibility on the collaborative works planned for the next 12-month period.

On Monday of this week, I attended a Health Board Water Safety Group. In preparation for this group meeting, I met with the two appointed Authorised Persons (Water) and the Responsible Person (Water) to review the actions from the previous meeting and to discuss progress. This pre meeting allowed us to identify any progress that had been made on the actions assigned and to allow time for suitable reports to be prepared and issued to the other Water Safety Group (WSG) members in advance. It also allowed us to identify the key points that required progress prior to the meeting taking place. In this instance, these items were around the signing of a new policy and a decision being made on training budgets for the new year which required research into the options available.

During the WSG meeting, the chair led the group through the standing agenda, allowing the relevant people to present on their areas of responsibility including:

• As part of a key governance step, under the Health Boards Water Safety policy, a record of who was in attendance was taken and measured against the meeting quorate. On this occasion the core people were all present, which meant we confirmed the meeting could go ahead and that the group could make decisions in line with their responsibilities.

• Discussions on the personnel involved in water management in the organisation and whether they are still in post, their appointments are still in date, if any training is due soon or whether evidence of competent needs to be reassessed. Typically, courses are booked six to nine months in advance of renewal to fit with operational pressures and other diary commitments.

• A review of previous actions with an update from each action owner on the current position. This allows other group members to ask about any support required and if deadlines are not going to be made. Any decision to escalate items would also be made at this stage. One of the items discussed previously was the signing of a new policy at director level, at the time of the meeting this had still not been completed.

• Evidence of Pre-Planned Maintenance completion was shared in advance, this gave our group members an opportunity to ask questions regarding any failures and how these have been managed since identification, as well as asking why some pre-planned works were not completed. The group discussed potential changes to reporting so that some higher risk items are added to an escalation list if they were ever to occur.

• The recent sample results and the associated trend analysis was then discussed. At this stage no concerns were identified but there was a discussion about the review of locations where samples are collected from as the last review was undertaken a little under 12 months ago.

• The Consultant Microbiologist was then invited to share with the group any concerns identified in the period related to patient isolates and whether there should be any amendments to the types of bacteria to be tested for in the water samples. On this occasion there were no concerns where any infections in patients could potentially be traced back to domestic water or above ground drainage systems.

• The other specialist departments, renal, hydrotherapy and dental, would then have an opportunity to share the management of their respective systems and discuss any areas of concern or where support was being requested.

• The Project Managers then lead the group through a review of the current position of the projects that involve changes to water or above ground drainage systems, indicating times when support will be requested in the future. The group was asked to approve the selection of sanitaryware for a new project, the details of which had been shared with the group in advance and were discussed during the meeting.

• To conclude the meeting, the group members were given an opportunity to raise any other concerns or information they felt would be useful.

Monday afternoon was spent producing my own notes from the morning meeting and making progress on the items I was asked to provide support with. I then prepared for an upcoming site audit, creating a common folder to hold all relevant documentation provided as evidence, reviewing the board wide policy and water safety plan to refresh myself on the potential differences between guidance and what the Health Board intends to do and what I should expect during my audit.

On Tuesday I visited an NHS territorial health board to undertake an audit of one of their community health centres. Our scope as an Authorising Engineer, as defined in the Memorandum of Understanding (MoU), includes an audit of every property in the portfolio in year one and prioritisation of audits in the following years, which will indicate a frequency of between one and three years. To start the visit, I met with the Authorised Person (Water) for the site and asked questions on the governance, risk assessments, control measures, validation, verification and supporting programs linked to the site with evidence requested to confirm the answers given. I then reviewed the written scheme, last water risk assessment, and logbook provided by the Authorised Person (Water) for the site. Any gaps in the monitoring or maintenance were highlighted to the Authorised Person (Water) as part of the end of day review.

On Wednesday, I undertook a site visit of the health centre to look at main plant items on site and any areas of concern outside the scope of the water risk assessment. This might include backflow issues, how closed systems are being managed, how dental chairs are being managed. On site records for the management of the dental chairs was reviewed along with a discussion with the staff who perform these tasks.

Thursday was spent finishing the audit from Tuesday. Under the MoU we need to issue all audits within 28 days on the audit being undertaken, the ability to have protected time in the diary is essential in ensuring that this timeline is met.

On Friday, I had a meeting with Water Management Society colleagues in my role as part of the membership committee where we review new applicants and make decisions on whether to accept them as new members, at various grades, based on their experience in the industry and training / CPD completed.

I then joined NHS territorial health board colleagues in a meeting to review a proposed scope for a replacement Cold Water Storage Tank installation. The AP reached out as he had concerns with the proposal and wanted to review the submission quickly before the contractor pressed ahead and potentially caused issues. We discussed the basic principle of the need for stored water and whether the storage capacity was simply a like for like replacement, or whether a reduced capacity would better replicate the building need. The contractor Project Manager confirmed that the same capacity was being proposed, and they had not undertaken any review into the working capacity that would be needed. Our discussions moved on to focus on the specification of the materials being proposed and whether these were acceptable and compatible with the current installation. The site has point of entry filtration, but the new tank did not include for the additional items that would be required under Scottish Healthcare Technical Memorandum (SHTM) guidance. This can include a HEPA filter on the lid vent and glass traps on the overflow and early warning overflow pipes. We asked about the proposed work team and the sequence of works they were going to follow and for evidence of the competence of the staff who would be involved in the installation and commissioning of the new Cold Water Storage Tank (CWST). To wrap up our meeting, the site AP reviewed the actions and agreed that a paper would be prepared for the Water Safety Group to consider and give their approval, once an amended proposal and supporting documentation was sent on by the contractor.

After lunch, the rest of my Friday was spent responding to emails that had been received during the week, ranging from Personal Protective Equipment orders to supporting health boards.

Rarely are two weeks ever the same and the role sees me supporting a wide range of different people across the country in a variety of different roles. I find a common misconception that the Authorising Engineer is there to support the estates and maintenance teams, when we are there to support health boards in their commitment to provide safe water to patients, staff and visitors.