Legionella: HTM04-01 Training and Temperature Monitoring

HTM 04-01 is a Health Technical Memo (HTM) that provides essential guidance on water safety in healthcare facilities and social care settings. It covers the design, maintenance, and operation of hot and cold water systems to ensure effective control of waterborne pathogens, such as Legionella and Pseudomonas aeruginosa.

What is HTM 04-01?

This guidance helps prevent the spread of infections, safeguard patients and staff, and ensure compliance with legal requirements and the Approved Code of Practice (ACOP).

The HTM covers:

Managing and controlling waterborne pathogens, including Legionella bacteria.
Preventing infections in patients, staff, and visitors.
Ensuring compliance with legal requirements and approved codes of practice.

What does HTM 04-01 include?

Guidance on the design, installation, and commissioning of healthcare water systems.
Operational management advice for maintaining safe water systems.
Risk control measures for Legionella and other waterborne pathogens.
Monitoring strategies for bacteria levels, including Legionella and Pseudomonas aeruginosa.

Who is HTM 04-01 for?

New and existing healthcare facilities, including hospitals, care homes, and NHS premises.
Professionals involved in legionella control, water system management, and operational maintenance in healthcare environments.

Understanding HTM 04 01 Part B and Temperature Monitoring

HTM 04-01 outlines key guidelines for managing healthcare water systems to ensure water safety and reduce the risk of Legionella and other waterborne pathogens. A primary control measure detailed in HTM 04-01 Part B is temperature monitoring, which is essential for limiting bacterial growth within hot and cold water systems.

Temperature Monitoring Requirements

According to HTM 04-01 Part B, temperature monitoring is critical to legionella control and should be conducted at regular intervals. The document specifies:

A temperature control regime, such as the traditional method to mitigate the risk of Legionella and other waterborne pathogens (Section 7.3).
Regular monitoring frequencies, as outlined in "Table 1" of HTM 04-01.
Use of thermometric equipment and automated sensors, with continuous monitoring integrated into building management systems (BMS) (Section 7.4).
Strategic placement of sensors throughout the healthcare environment, including all critical hot and cold water systems, to provide accurate temperature readings (Section 7.5).

For further details on temperature monitoring, refer to HTM 04-01 Part B, Sections 7.3 – 7.5.

The dangers of legionella bacteria in accordance with htm 04 01

HTM Water 04-01 and Training

An important component of HTM 04-01 is the formation of a Water Safety Group (WSG) to oversee the Water Safety Plan (WSP) and ensure compliance with legal requirements for healthcare water systems.

Role of the Water Safety Group (WSG)

According to HTM 04-01 Part C, Section 6.3, the WSG is a multidisciplinary team responsible for:

Ensuring operational management of water systems.
Identifying possible issues related to Legionella control.
Overseeing training and competency assessments for all staff involved in water safety (Section 6.9).

Training Requirements in HTM 04 01

Training and Competency of Staff

HTM 04-01 mandates that all personnel involved in healthcare water systems, including those working in care homes, hospitals, and other types of healthcare premises, receive appropriate training. Key requirements include:

Adequate supervision, training, and competency assessments for all levels of staff, including housekeeping and facilities management personnel (Section 6.21).
Regular competency reviews and refresher training, with documented records (Sections 6.27 – 6.28).
Specific water hygiene training for staff responsible for:
- Outlet flushing and cleaning.
- Maintenance of valves, TMVs (thermostatic mixing valves), and other design applications.
- System disinfection and microbiological control (Sections 6.29 – 6.30).

Water Hygiene Training: Key Topics Covered

To meet the approved code of practice outlined in HTM 04-01, healthcare organisations, including NHS England and private care units, should implement structured water hygiene training. This training should cover:

Overview of Legionella and other waterborne pathogens.
Legal requirements and code of practice for healthcare water systems.
Risk of Legionella and how to mitigate it within cold water supplies and hot water systems.
Organisational governance and water safety plans.
Proper handling of pipes, valves, and TMVs to prevent contamination.
Cleaning protocols for water distribution systems and patients’ environments.
The importance of health screening to identify individuals who may be carriers of waterborne diseases.

A comprehensive water safety plan must integrate legionella control measures, ensuring all staff understand their responsibilities in maintaining safe and compliant healthcare environments.

HTM 04 01 Training

HTM 04-01 underscores that training and competency are central to ensuring safe water systems in healthcare facilities. The Health and Safety Executive (HSE) and the Department of Health require that a legionella risk assessment is conducted by competent persons with relevant qualifications. You can read more about this here.

Legionella Risk Assessment

A legionella risk assessment must:

Identify risks associated with healthcare water systems.
Define a written scheme for controlling Legionella and other pathogens.
Ensure proper training and competency evaluations for all staff handling water systems.

Legionella Risk Assessment completed because of htm 0401

How often should healthcare facilities be assessed for compliance with HTM 04-01?

Healthcare facilities should be assessed regularly for compliance with HTM 04-01 guidelines. The frequency of assessment can vary based on factors like the size of the facility and its risk level, but typically, assessments should be conducted at least annually to ensure adherence to water safety regulations.

What type of HTM 0401 Training is Available?

For large healthcare environments such as hospitals, tailored bespoke training is recommended. These tailored bespoke training sessions can address the unique challenges and requirements of such complex settings, ensuring that staff are well-equipped to handle any water hygiene issues that may arise.

Smaller premises, such as GP surgeries, care homes, and community health centres, may only require a general water hygiene course.

Commodious offers an online Legionella awareness course suitable for healthcare professionals working with water systems in healthcare settings. The course covers:

Legionnaires’ disease – causes, symptoms, and transmission.
Legionella risks and key control measures.
High-risk systems
Compliance with UK healthcare regulations, such as L8, HSG 274, HTM 04-01, and COSHH.

This course meets HSE, CHAS, SafeContractor, and other SSIP training standards. An advanced course is available for those with operational responsibility for healthcare water systems.

Final Thoughts

By following HTM 04-01 and ensuring staff competency, healthcare facilities can maintain safe water systems, comply with legal requirements, and protect patients, staff, and visitors from waterborne diseases, including Legionnaires’ disease.

HTM 04-01 Training and Temperature Monitoring