Whitepaper: Power Demand & COVID-19: Impact on the Health Sector
The healthcare sector in the UK relies heavily on electrically-powered systems, making power a fundamental factor in supporting the work of doctors and nurses. Hospitals, care homes, nursing homes, dialysis centres and hospice homes, as well as radiology centers and rehabilitation centres depend on electricity for a range of functions – from operating theatres, kidney dialysis and respiratory machines through to incubators, ward lighting and other critical power equipment. Moreover, the administrative side of things – such as patient record keeping and support services – require electrical power to operate. Because suitable healthcare can be the difference between life and death, electrical power planning is of the utmost importance, as is finding power sources such as hospital generators and healthcare UPS systems that can meet the demands of the 800+ healthcare buildings across the UK. With COVID-19 also contributing to power demands, in this industry whitepaper, we aim to show the importance of electrical power planning within the healthcare industry, and how legislation and other external factors have helped to shape this. Active within the healthcare sector ourselves – supplying industry compliant power supply equipment and services to healthcare sites and facilities – we’ve seen the importance of power supply to healthcare services.
The Importance of Power In The Health Sector
Critical power supply is quite literally a matter of life and death for the healthcare sector. Healthcare facilities rely on their IT and medical equipment for strong patient care, and equipment relies on the availability of electrical power to function effectively. To reinforce their emergency power systems, hospitals and other healthcare facilities are adding UPS systems and generators to their power infrastructure for continued operation. Therefore, the aims of today’s healthcare providers are:
To provide the best and safest level of patient care.
To ensure reliable infrastructure performance at the best possible cost.
The need for 24/7 power availability within a healthcare facility is apparent; patient care links directly to power dependency. Even a small power failure can have serious consequences for patients. As a basic necessity for all hospital processes, critical power comprises of two basic categories within healthcare:
Critical Medical Processes: Including operating theatres, intensive care units and emergency rooms. These areas carry the highest risk in terms of a power outage as they rely on both commercial loads and industrial loads, which require continuous power.
Critical Non Medical Processes: Includes patient data management systems. This technology requires critical power for backups and archiving, as well as the data centres that support the records system, white space infrastructure, rack system, security and IT management software.
Data In The Healthcare Sector
Hospitals deal with large amounts of patient data every day. From test results and registrations through to health records and medical imagery, data is the foundation of correct diagnosis. Hospital Episode Statistics (HES) is a database containing details of all admissions, A and E attendances and outpatient appointments at NHS hospitals in England.
Each HES record contains a variety of information on patients admitted to an NHS hospital, including:
Clinical information related to diagnoses and operations.
Patient information, including age group, gender and ethnicity.
Administrative information, such as dates and processes of admission and discharge.
Geographical information such as where patients are treated and the area in which they live.
With some estimates claiming that, “30% of global data centre space will be used for health-related data in the coming years”, managing a healthcare facility’s data stream is becoming increasingly significant. Inaccurate or incomplete medical records can unfortunately mislead diagnosis, impacting the correct treatment of patients. Power continuity through hospital generators and healthcare UPS systems can ensure that more accurate and accessible medical records inform the correct medical decisions, with scalable data centres helping to address their growing data needs while improving system reliability and optimising energy efficiency.
Hospital Data Security
As well as dealing with data, healthcare facilities have a duty to protect patients’ confidential information. As stated in University Hospital Southampton’s, ‘Data Protection and Confidentiality Policy’: ‘’The NHS cannot operate effectively if the patients we need to treat do not trust us to provide confidential and effective care. Part of this trust is being able to provide confidential information to clinicians and other staff and be confident that it will remain confidential and only be shared when necessary.’’ Further laws related to confidentiality include:
If healthcare facilities integrate their power distribution with building and security systems, the positive outcome is doubled. This means savings can be made which can in turn, improve financial performance, whilst patients are more accurately treated and robustly protected.
Hospitals must be compliant with strict safety standards and power regulations involving electrical applications and data management. In the next section, we take a look at the UK’s health sector, and the impact of COVID-19.
An Introduction to the UK’s Health Sector & The Impact of COVID-19
In the UK, the whole population is covered by the National Health System (NHS), which is financed through general taxation and run by the Department of Health. According to Health Estate Journal, one million people are treated by the NHS every 36 hours, and most of the time, patients will receive their care free of charge, much to the envy of countries where insurance-based systems are commonplace. However, until recently, responsibility for purchasing these health care services – the equipment, the premises and the dedicated staff – rested at the constituent country level: Primary Care Trusts in England, Health Boards in Scotland, local health groups in Wales and Primary Care Partnerships in Northern Ireland. Beyond this, there is an increasing trend towards private care, with 10% of the population contracting additional private health insurance.
Throughout the UK, there is a coexistence of public hospitals, private non-profit hospitals and private for-profit hospitals. While hospitals are typically publicly-owned and independently-operated, they are organised as hospital trusts with three hierarchical levels: community hospitals, district hospitals, and regional or inter-regional hospitals, as well as a number of specialised hospitals offering advanced treatment. Primary care services are usually provided by General Practitioners (GPs), who also act as first line defence in providing access to secondary care. As of March 2019, there were 112,031 doctors, 311,380 qualified nursing staff (including midwives and health visitors) and 34,556 managers in the NHS out of a total workforce of 1,093,638. These numbers rose with the advent of COVID-19, with volunteers and retired staff coming back into the workforce to help out with the pandemic.
Struggles With Healthcare – Prior To COVID-19
The NHS, and the healthcare sector in general, has dealt with many challenges during the past 15 years that have hindered the medical guidance, support and provision that they’d ideally like to be giving. From declining funds and out of date IT systems through to energy resilience and the rise in greener healthcare, there’s been much to combat, navigate, and make allowances for:
Declining Funds In The Healthcare Sector: Capital budget used in long term investments – such as IT, buildings and equipment, has declined in real terms over the past 8 years, leaving Trusts with a 21% reduction to their funding. Most of this money has been transferred by the Department of Health and Social Care to cover the daily costs of running the NHS. Temporary power hire – for example – can ease operational pressure and create efficiencies without eating too much into capital budget. This can also aid energy consumption, reduce energy costs and put hospitals on a better track to low-carbon output, without the financial risk that comes with a full-on purchase.
Creating Space: Never more prevalent than during the start of the pandemic in the UK was the lack of space in hospitals and health care facilities. Reports showed queues of ambulances waiting outside hospitals, and people lying in corridors waiting to be checked over. Temporary power has been a big help with this issue – easing pressures on hospitals that have been put under unusual strain. Leisure centres, schools and Nightingale hospitals set up incorporated generators to help meet demand, with temporary medical theatres to help treat those in critical conditions.
Energy Resilience: Critical power equipment such as incubators, kidney dialysis and operating theatre equipment requires constant electrical supply, while hospital wards and hallways need to be lit day and night to give patients and staff safe access to all parts of the healthcare facility. Considering the fatal consequences that come with a power outage or complete power failure, hospitals are required under Health Technical Memorandum (HTM) 06-01 to plan and mitigate the risks of serious interruption to power supply. The importance of power supply however, is not limited to critical situations such as surgery. Extended power failure would also have a major impact on the NHS’s continuity of service. As Health Estate Journal, states: ‘’Blood and plasma stocks, for example, would spoil if the temperature inside chillers became too high, while unexpected outages to servers and IT equipment could corrupt patient files that are essentially day-to-day function.’’
Struggles With Healthcare – During & Post COVID-19
As mentioned above, the strain has been so great that retired medical professionals have been coming out of retirement to help cope with the increasing demands on the healthcare sector. But more than this, these people are risking their own safety and working in demanding conditions that require their focus, commitment and reliance on a constant supply of power. As the British Medical Association (BMA) states: ‘’New activity data for May and June 2020 lay bare the disruptive impact of the COVID-19 pandemic on NHS care. With services already under severe strain the first three months of 2020, unprecedented steps were needed to ensure the NHS would be able to cope with a large influx of COVID-19 patients from late March onwards.’’ Capacity was created by:
Cancelling planned operations.
Large numbers of patients being discharged back into the community.
Non-COVID patients and staff had to be protected by conducting GP consultations remotely.
As the BMA continues: ‘’These changes meant that intensive care did not have to be rationed to COVID patients. Though, the new data indicates that the shutdown of most non-COVID services, combined with drastic changes in patient behaviour, mean the NHS is now facing a large backlog of non-COVID care, storing up greater problems for the future. Infection control measures and the ongoing diversion of healthcare resources towards COVID-related services mean that this backlog of care will take even longer than usual to work through.’’
Critical power equipment such as hospital generators and UPS healthcare systems will therefore be needed now more than ever and hospital emergency power requirements should be at the forefront of these decisions.
In the next section, we take a look at the importance of electrical power planning in the healthcare industry.
Electrical Power Planning In The Healthcare Sector
With potentially fatal consequences should there be a loss of power, hospitals are required under the, ‘Health Technical Memorandum 06-01’ to plan for and account for the risks related to power supply. As stated within, the guidance given within this memorandum has been written, ‘’to promote good practice for those responsible for the design, installation, commissioning, operation and maintenance of electrical services in healthcare premises.’’
The memorandum sets out grades of patient risk with regard to loss of supply, with guidance given on how to mitigate risk for all of them. The grades range from grade E to grade A:
Risk grade E: typically – support services and circulation: As examples, these areas may include waiting rooms, offices and non-patient care areas such as pharmacies or finance departments. Loss of power supply does not have an impact on the clinical treatment or safety of patients (but it’s important to remember the requirements of escape lighting and fire alarm systems – that may be provided from a local tertiary power source).
Risk grade D: typically – ambulant care: As the memorandum states: ”As examples, these areas may include patients in consultation (excluding examination) or general out-patient areas. Loss of supply may cause disruption, and inconvenience but would not directly compromise clinical treatment and safety. The loss of electrical power to other engineering services (for example, ventilation) will not cause concern for the immediate safety of the patient or staff. There may be a business continuity risk if these areas are not connected to the SPS (standby power supply) for failures that last for several hours (notwithstanding the requirements of escape lighting, fire alarm systems, etc. that may be provided from a local tertiary power source).”
Risk grade C: typically – general patient care: In these situations, patients will usually not be connected to ME equipment over 24-hour periods. That being said, medical monitoring or medical test equipment may be used and connected externally to a patient’s body for a short or intermittent time – such as an electrocardiogram. Clinical treatment and patient safety will not be immediately compromised by an interruption to power supply. However, the interruption of electrical power should not exceed 15 seconds together with other engineering services used in the support of the clinical treatment such as medical gases, hot and cold water, heating, ventilation and air-conditioning (HVAC), and communications.
Risk grade B: typically – complex treatment and diagnostics: As examples, these areas may include LDRP (labour, delivery, recovery, post-partum) areas (maternity), accident & emergency general/minors, haemodialysis areas, radiography diagnostic, magnetic resonance imaging (MRI), and therapy rooms. Patients may have ME equipment, medical monitoring or medical test equipment connected externally to their body for a prolonged period of time. Clinical treatment and patient safety may be compromised (but not put in danger) by any minor interruption of electrical supply. Any interruption of the electrical supply to medical equipment must not exceed 15 seconds however.
Risk grade A: typically – life support or complex surgery: These areas may include operating theatre suites, critical care areas, cardiac wards, MRI, and interventional angiographic rooms. Where the disconnection of the supply represents a threat to life, an alternative source of power must be available within 0.5 s or as a nobreak supply if critical ME equipment to be used will not continue to function without a reset after a 0.5 break.
As you can tell, much relies on sustainable and continuous supply of power in the healthcare sector. Health Technical Memorandum 06-01 also provides guidance on resilience measures healthcare businesses, sites and facilities should put in place to ensure a continuous power supply to all critical power equipment. These include:
”4.36: The resilience required to maintain essential supply in the event of not only primary failures but also secondary failures should be considered. A suitable assessment of the likelihood of concurrent failures occurring within a foreseeable period should be made, and therefore the operation and interrelationship of the system and its component parts should be fully understood.”
”4.37: Incoming electrical supplies may be constrained by what the DNO is able to provide or what has been assessed as cost effective for the type of healthcare facility. The distribution strategy should maintain the required resilience level to support the internal electrical system.”
”4.38: An iterative design process will help stakeholders and the Electrical Safety Group to assess the distribution strategy. The process may be used to determine the location of the first single point of failure in addition to the method used to mitigate the risks on the distribution downstream of that point. The provision of tertiary supplies (UPS) on final distribution boards or the ability to manually reconfigure the distribution may be suitable risk mitigation.”
”4.39: The effects of electrical power failures due to faults at any level can be designed out by the robustness of the network. The distribution strategy should include adequate resilience and access space so that routine testing and maintenance can be carried out safely, without placing patients, staff and users at unnecessary risk. Such strategies may call for a redundancy in certain electrical equipment, for example generators, UPS systems and Medical IT. The provision of resilience to support maintenance is considered best practice.”
All of this leads into the design considerations, the demand side response network, the assessment of current electrical systems and the power quality required. In the next section, we take a look at maintenance specifications in the health sector.
Health Sector Specifications – Maintenance
There are various British standards, codes of practice and guidance documents which provide direction on operational management and maintenance of electrical switchgear in relation to the health sector, as well as other industries. For example:
The Health & Safety Executive’s HSG230 – ‘Keeping electrical switchgear safe’.
BS EN 6626 – ‘Maintenance of electrical switchgear and control gear for voltages above 1 kV and up to and including 36 kV’.
BS 6423 – ‘Code of practice for maintenance of low-voltage switchgear and control gear’.
BS EN 60422 – ‘Mineral insulating oils in electrical equipment. Supervision and maintenance guidance’.
It is also a legal requirement of the Electricity at Work Regulations that all electrical equipment is maintained. The responsibility for safety, delivery of function and the role of maintenance to electrical services should be embedded in the structure and responsibility framework of the healthcare organisation. This should be supported by the “Professional support and operational policy” outlined in Health Technical Memorandum 00 – ‘Policies and principles of healthcare engineering’, which includes:
”3.26 Where the operation of engineering services is vital to the continued functioning of the healthcare premises, operation and maintenance may require special consideration; therefore, improving resilience within the critical engineering systems should be considered.”
”3.27 Operational requirements should ensure that users are aware of the capacity of the specific system and any particular limitations.”
”3.32 Maintenance and safety are two closely related subjects. General safety is largely dependent on good standards of maintenance being attained and staff safety disciplines being exercised.”
In the next section, we discuss suitable hospital generators and healthcare UPS systems for the healthcare sector.
Healthcare UPS Systems & Hospital Generators That Meet Emergency Power Requirements
Two greatest assets to healthcare facilities are uninterruptible power supplies (UPS) and generators. Whereas healthcare UPS systems offer emergency power to a load when the input power source or mains power cuts out, a generator converts mechanical or chemical energy into electrical energy to provide electricity when this is unavailable from the power grid. When an electrical current has been created, it is directed toward machinery and critical power equipment such as defibrillators, ECGs and anaesthesia machines.
Generators – for example – offer total power solutions that can meet healthcare regulations and distinct specifications. Guaranteeing a 100% load response time in just 10 seconds, generators can also meet hospital generator soundproofing requirements, ensuring minimum noise emissions for each and every health facility in which they are installed. For hospitals, nursing homes, dialysis centres and rehabilitation centres, we suggest choosing a generator from the heavy range, industrial range or medium voltage range, and we can discuss the best choice for you based on your unique needs.
The Heavy Range: This critical power equipment can be used to supply power continuously, for peak shaving or as emergency power in the industrial, commercial and residential sectors. Includes the HTW (Powered by MITSUBISHI. 670 – 2.555 kVA) and HMW (Powered by MTU. 745 – 1.377 kVA) series.
The Industrial Range: Great for the needs of care homes and radiology centres, the industrial range of diesel generators, natural gas generators and LPG generators offers something for every need, and includes the HYW (Powered by YANMAR. 8 – 51 kVA), HFW (Powered by FPT IVECO. 44 – 625 kVA) and HZA (Powered by HATZ. 4 – 42 kVA) series.
Medium Voltage Range: Designed to cover medium voltage electricity needs, such as those of temporary hospitals. The medium voltage range diesel series includes the HMW (Powered by MTU. 1.014 – 1.369 kVA) and HTW (Powered by MITSUBISHI. 1.069 – 2.536 kVA) series.
Not only can we install, supply, maintain and manage Himoinsa generators, but we also provide a great range of UPS systems in our UPS healthcare line, which includes the Dale E600 series or the Dale E700 series. The Dale E600 UPS power supply range promises flexibility and dependability with configurable modular redundancy. The level of redundancy can be altered to meet the demands of the protected load and hot swappable modules allow servicing and repairs to be made whilst the UPS supports the load – for continued service. The Dale E700 series provides internal sealed, maintenance free VRLA batteries for extended autonomy in the event of a mains failure (up to 40kVA), and if needed, external batteries can also be installed for extended autonomy.
From the Dale E61150 (50kVA Single Phase modular UPS), Dale E633200 (200kVA 3 Phase power modular UPS) and the Dale E633800/4050 (800kVA 3 Phase modular UPS) through to the Dale E73320 (20kVA 3 Phase UPS), Dale E733120 (120kVA 3 Phase UPS) and the Dale E733160 (160kVA 3 Phase UPS), we have a vast range in our UPS product line, and are always happy to advise and guide based on your power requirements.
Case Study – The Health Sector & Dale Power Solutions
With the spread of Covid-19 came the need for the NHS to increase the number of daily tests for the virus, and the need to ensure that tests could be processed rapidly and without power interruption.
The healthcare industry has been under much pressure in recent years, having to contend with budget cuts, energy resilience practices and strict regulations, not to mention COVID-19. Electrical power planning is a key first step when it comes to understanding the importance of reliable power supply in the healthcare sector, helping dedicated doctors and nurses carry out their duties with complete confidence in their critical power equipment, which saves the lives of so many people, every single day. The needs of care homes may differ greatly from the needs of hospitals, but what unites them is a reliance on dependable power sources. But more than this, COVID-19 will likely change the way in which healthcare functions in the future – better preparedness, ample space and increased funding to ensure that as many lives as possible are saved. That’s why specialist systems, maintenance and servicing are required. They can mitigate risks, work unhindered for extensive periods of time, and ensure power supply is always available.