How much true understanding is there in the architectural and contractor healthcare community of specifying products correctly to meet the demands laid out in the Healthcare Building Notes? This very question was raised to me by an architect during a recent CPD presentation. The specifier wanted to know how it could specify an IPS system and ensure that the installation not only met the stringent requirements set out in HBN guidance, but also ensured an aesthetically pleasing installation with completely hidden plumbing.
For CS Medical, this was a common query. We support clients, architects, and contractors, to ensure that projects are accurately specified, well-designed, and, most importantly, are specifications that will work when installed on site. In part the problem arises in understanding the products being specified. While the term ‘IPS’ is recognised as a general description for panel systems, it actually refers to an ‘Integrated Pre-plumbed System’, which includes sanitaryware which is pre-mounted to the panel system off site. In fact, often the contractor will not purchase such a pre-plumbed system, and most will revert to the installation work being undertaken on site. This more traditional installation method means the specification cannot easily control all the works performed on site, which can result in a poorer quality install.
NBS Specification classification
The NBS Specification classification system can add to this confusion, as it divides key components into different sections. N13 Sanitary appliances and fittings defines all the materials for the sanitaryware, including the waste, trap, and other fittings, but does not cover the pre-plumbed panel systems or vanity units. Instead, these are detailed in K32 Propriety duct panels, including panels for preplumbed systems, and N10 Vanity Units including panels for preplumbed systems. This makes it more difficult to ensure that these assemblies are procured properly by the specifier, since often different trades are involved in the works and ordering materials directly. It is common for a specification to be broken at this point, and for the panels to be ordered and installed as part of the joinery package, with the plumbing installation being undertaken separately on site. Reverting to traditional on-site installation like this can result in poorer quality and design conflict, as they are not manufactured and installed together within one process
This situation is replicated on multiple projects. The key is a change in approach, and to ensure good specification management principles – specifically that all parties communicate to ensure that each finished project is supplied to the highest quality
The specification process
No matter how a project starts, the specification should be built from the initial consultation meeting and a detailed review of a client’s requirements, aligning every aspect of the work required with the contractor. Each project should have a physical on-site meeting, since seeing the rooms in situ helps to understand and interpret the clients’ needs. Special requirements can be considered, reviewing how these align to the relevant guidance documents, such as HBN 00-10.1 A site survey being undertaken for each room allows for every aspect to be considered, including how the new installation will interact and work round other equipment in the room, which may or may not appear on a drawing.
A good project example is our work with (Dorset-based building contractor) Westmade at Royal Bournemouth Hospital. At the initial consultation meeting the following points were discussed, and an agreement was made as to how to tackle the unique issues:
The waste position was further into the room than was expected, which was solved by increasing the duct depth to ensure that all services remained hidden.
There was a ceiling bulkhead restricting the predicted height of duct. This was tackled by reducing the height of the duct to suit the site conditions.
Surface pipework running horizontally into the face of the proposed duct, which was addressed by adding an infill section of panelling so as not to restrict access later.
Careful consideration was given to the location of rodding points and valves, so that they could be easily accessed through the new duct.
As a result, the client was confident that the project would be completed to its unique requirements, ensuring that both the contractor and manufacturer would work together to achieve this.
HBN stipulations
In considering sanitaryware and concealing services, HBN 00-10 Part C covers two key points in designing panel systems (commonly referred to as IPS)
Panels should be easy to clean, durable, and impervious.
Access panels should be hinged wherever possible, for ease of maintenance access. These panels should have a simple lock device to prevent unauthorised opening. In considering the first point, panels are commonly manufactured from a chipboard, plywood, or MDF panel, with HPL bonded to the face and rear. Once manufactured, this produces a panel which is easy to clean, but if the surface or edge become compromised, water damage is likely, and the panel itself can become a breeding ground for bacteria, and possible infection can result. For this reason, it surely cannot not be considered ‘durable and impervious’.
The argument, therefore, is that it is better to make any panel systems from a completely waterproof panel, such as solid/compact grade laminate, or a coextruded plastic board. Both materials are durable, easy to clean, and can have antibacterial properties added within the manufacturing process.
‘Lift-off’ or ‘Pull-off’ panels
The second statement I have highlighted in HBN 00-10 addresses the potential issue in having ‘lift off’ or ‘pull off’ panels. A panel that is removeable can easily be damaged, as it is removed and often placed on the floor. In addition, lifting a panel can also create a health and safety ‘red flag’, especially as the weight of a waterproof material like SGL is considerable. To remove these concerns, simply adding a hinge, and a suitable locking mechanism where required, will ensure that access is simple, while eliminating the lifting and damage risks.
There are multiple options in introducing a hinge to an access panel. The most common solution is an accessible panel which sits in front of the wall or infill sections. These are hinged using a cabinet hinge to the side, or a lift-up hinge. Lift-up hinges require that the panel is lifted above head height, and a challenge with this can be the variation in height of the person installing or maintaining the system; the task can often be impractical for smaller users.
Optimal solution
A side-mounted hinge – while perceived as easier for everyone to use – often requires continuous adjustment to retain the access door level. Also, if the door is out of alignment, it can damage the panel below when opened and closed. The optimum solution would be a sidemounted pivot hinge. The body of the hinge can be recessed into the SGL panel, so it is securely fixed, and will remain in perfect alignment.
The manufacturing process
One of the key drivers in HBN 00-10 is to have standardisation and pre-assembly of standard components. It is at this stage that the full value of a factory-assembled IPS system can be appreciated. Using an integrated pre-plumbed system with factory-installed sanitaryware has several key benefits over more common panel only systems. These include
Factory manufacturing conditions allow for higher quality output, with production taking place in a more controlled environment, away from other trades. It is far easier to accurately align everything on a flat bench, rather than trying to hang panels on a site-built frame.
Offsite manufacture reduces the number of deliveries to a site, which in turn reduces the negative carbon impact of the works.
Health and safety on site is improved, with fewer contractors required to install units, and as the units are built to the correct size, minimal cutting is required on site.
Pre-installed taps with fixed copper tails and shut-off valves provide a simple connection on site, and ensure that pipework is streamlined and concealed properly.
Installation times are vastly reduced.
On-site waste materials and packaging are vastly reduced.
Allen Gilbert-Stroud from Westmade explains that the company always uses the pre-plumbed system, even though it is a slightly more expensive purchase, as the quality of the product and speed of installation are more important. A squint tap or repair on site are what the client will remember, and not the good work leading up to it, and so he relies on the offsite assembly process to ensure that everything is perfect.
The installation process
When the supplier is also responsible for the installation of the materials, there is a heightened continuity and responsibility to maintain the highest standards of the pre-plumbed units. However, it is often the case that the works are installed by a third party, which has secured the package of works. To ensure that the installation is managed, it is important that a site survey is undertaken by the manufacturer in conjunction with the installer. This step is often missed, and yet is a vital process to agree all the installation requirements particular to each project.
For CS Medical the experience of working together with Westmade on multiple projects has resulted in a good understanding of both process and product for both parties. Ultimately it is good communication that results in drawings being produced accurately first time, with the approval process being simplified, as the client has been involved from day one. The installation sign-off is the final step, ensuring that the manufacturer re-visits post-installation to review the works. In this case we were able to review the installation and go over care and maintenance in person.
By taking the time to understand the project initially, introduce offsite manufacture of key components, and follow up with meetings on site throughout the project, you can ensure that all works are completed to the highest standard, meeting the client’s requirements, and exceeding their expectations.
Reference 1 Health Building Note 00-10: Part C – Sanitary assemblies. Department of Health and Social Care, 2013. https:// www.england.nhs.uk/wp-content/ uploads/2021/05/HBN_00-10_Part_C_ Final.pdf
John McKinlay
With over 15 years’ experience in the healthcare sector, John McKinlay, Brand manager at CS Medical, provides design and specification advice to clients including architects, the NHS, and contractors, on a wide range of products. With CS Medical and Cubicle Systems, he can offer advice on designing and selecting IPS pre-plumbed duct panels and sanitaryware, along with complementary furniture solutions suitable for a wide range of healthcare environments. He also provides CPD training, including on ‘Specifying healthcare assemblies and sanitaryware’.