The Building Safety Act (BSA),1 introduced in response to the Grenfell Tower tragedy to fundamentally reform the building safety system, is a significant legislative change that impacts new and existing hospital buildings undergoing building work during both design and construction. It strengthens the regulatory framework for building safety, ensuring greater accountability and responsibility throughout the lifecycle of buildings under the new regime. It also requires any occupied hospital buildings that contain residential accommodation (meaning key worker or student accommodation, but no patient wards or ‘on-call rooms’) to be registered and managed.
The BSA introduces new responsibilities for existing stakeholders involved with the design and construction of new and existing buildings. It also introduces new stakeholders for occupied buildings with residential accommodation (Accountable Persons and Principal Accountable Persons), and a new regulator, the Building Safety Regulator (BSR), sitting within the Health and Safety Executive, that oversees all buildings, but in particular the safety of higher-risk buildings (HRB).
A HRB is any building at or above 18 metres or seven storeys that contains two or more residential units, and for the design and construction requirements, also those buildings that are at or above 18 metres or seven storeys and are hospitals or care homes. The changes to HRBs include a new requirement to apply, with a much larger amount of information, to the Building Safety Regulator for building control approval where any building work is proposed. This is causing Trusts both additional expense, and major delays in projects, as construction cannot commence until design approval has been given, with potential impacts on patient care, safety, project funding, and capital cost.
Helping the NHS understand the BSA’s requirements
NHS England ProCure23 recognised early on that the legislation and existing guidance were difficult to apply to the complex nature of hospital sites, which often consist of multiple connected buildings with varying heights and uses. It is important that hospital Trusts develop a comprehensive understanding of the BSA’s requirements, and — if required — appoint competent advisors to support them. To help inform hospital Trusts of the new requirements, and, equally to help such organisations comply with them, NHS England has published several NHS-specific guidance documents. These include PRN01337 — NHS Estates Technical Bulletin (NETB) No. 2024/2 Building Safety Act 2022 (BSA) — application to healthcare buildings,2 a detailed guidance document on the application of the BSA to hospital trusts; updates to template contracts and construction documents, and additional supporting information in response to the BSA.
Complex sites split into small sections
Importantly, the Technical Bulletin provides an explanation and examples of the provisions that allow complex hospital sites to be split into smaller independent sections (so long as they have their own entrance / exit, and are not connected to any other sections with residential units). The test to determine whether something is a HRB (i.e. height and use) is then applied to these smaller independent sections, rather than the entire wider site. This means that some parts of sites will not be subject to the new HRB regime, so traditional (quicker) building control approval routes can be followed. It is hoped that this will assist Trusts and contractors, as well as local authorities, who in some instances wrongly categorise existing buildings as HRBs and refuse to submit or accept building control applications.
The Technical Bulletin is supported by the NHS England ProCure23 BSA Support Document (link at the end of this article). This document includes 21 different hospital-specific scenarios, flowcharts, workflows, and hospital-specific guidance to support hospital Trusts to understand the nuances of their site.
Competency is now a focus for ensuring building safety. The new Part 2A inserted into the Building Regulations 20103 introduces a new competency regime to ensure that all individuals involved in the design, construction, and management of buildings are adequately trained and competent, in terms of skills, knowledge, experience, and — importantly — behaviours for various roles. Many professional bodies within the sector are developing specific competency requirements for their members working within HRBs.
To support hospital Trusts, NHS England’s ProCure23 team has developed a simple Competency Checklist toolkit (see link at the end of this article). This checklist covers both Construction Design Management (CDM) and BSA requirements, serving as a best practice tool for all projects. It has been validated by the Royal Institute of Chartered Surveyors, who have ensured its credibility and effectiveness, and is endorsed by the Building Safety Regulator and Local Authority Building Control (LABC).
Maintaining ‘a golden thread’ of information
As with many of the existing systems used to support the safe operation of hospital buildings, information is crucial. Working with the Construction Leadership Council, NHS England ProCure23 teams have adopted the principles of the Golden Thread Advice and Summary.4 This document provides essential advice on maintaining a golden thread of information throughout the lifecycle of a building — an approach emphasised in the BSA — and is directly applicable to hospital buildings. The approach has been reflected in the latest ProCure23 workflows and Building Information Management templates. Through ongoing initiatives, the NHS England and ProCure23 teams continue to support NHS Trusts on the processes and compliance requirements within the BSA.
It is recognised that the Building Safety Act is a significant change, and the challenges for hospitals are only beginning to be understood. It is recommended that any concerned hospital Trusts seek external advice to review their site and define the extents of HRBs, independent sections, and therefore what the BSA means to them.
References
1 The Building Safety Act 2022. July 2022. https://www.gov.uk/guidance/the-building-safety-act
2 NHS Estates Technical Bulletin (NETB) No. 2024/2 Building Safety Act 2022 (BSA) — application to healthcare buildings. NHS England, 7 August 2024. https://www.england.nhs.uk/publication/netb-2024-2-building-safety-act-2022/
3 The Building Regulations etc. (Amendment) (England) Regulations 2023. https://www.legislation.gov.uk/uksi/2010/2214/contents
4 Delivering the golden thread: Guidance for dutyholders and accountable persons. Construction Leadership Council, August 2024. https://tinyurl.com/46zmtwzu
Further resources
A range of information and resources on the Building Safety Act are available from the Estates and Facilities Collaboration Hub — see https://tinyurl.com/yhyt2xwv — under the ‘Fire’ section, including:
n Competency Checklist toolkit created by NHSE ProCure23 (August 2024).
n NHS England ProCure23 BSA Supporting Document inclusive of 21 pictorial scenarios (August 2024).
n Recording of the national webinar on the Building Safety Act (February 2024).