Pest management is an important consideration for any facilities or estates manager in the health service. Pests pose an unnecessary public health risk and have the potential to spread disease. Today’s pest control industry can offer a wide range of products and services to the health service.
Hospitals are complex buildings which are threaded with ducting to carry various utilities. They have fairly constant temperatures and also provide ample harbourage and food sources - an ideal environment for pest species to thrive in.
Martin Hart, senior partner of Nottingham-based consulting engineers DH Squire, has been working for the health service at a number of hospitals in the Midlands for 30 years. “The profile of the risks of disease in the NHS has heightened and people have become more aware of the problems that pests bring to hospitals,” explains Mr Hart. “The age and construction of hospital buildings certainly does create problems as far as pest infestations are concerned. Old hospitals are often served by a central boiler plant with underground links for the heating pipes and ducts to the various blocks. Entry points offer good access for vermin. The more modern hospitals have decentralised boiler plants which does reduce this problem considerably.”
Food hygiene law
Until 1986 NHS hospitals had immunity from prosecution relating to contraventions of the food hygiene law. However, with increasing concerns about the standards of hygiene in hospital kitchens, and fuelled by a serious food poisoning outbreak at Stanley Royd Hospital in the mid 1980s when 19 people died and over 400 patients and staff became ill, Crown Immunity was lifted from hospital sites in 1986. At this time measures were introduced by the Department of Health, along with the preparation of a Model Contract for Pest Control, to help improve the management of pests in our hospitals. Local Authorities now have the responsibility to enforce food hygiene law. However, even after the removal of Crown Immunity, there are still concerns about the acceptable level and quality of work carried out by some pest control contractors.
In the 1990s the NHS set out guidelines for ‘Pest control management for the health service’ to ensure that hospitals met their legal obligations in respect of pest prevention in the hospital, including food preparation areas. It also advised on the appointment of nominated officers who would co-ordinate pest control activities including contract service and specifications. Today, a mix of Local Authority pest control services and private pest control companies provide a pest control service for the country’s hospitals with a small minority of hospitals handling their own pest control.
“It is possible to eradicate pests from hospitals, with a good pest control contract, a good contractor and someone in the Health Service Trust who is managing the pest control contract effectively,” insists Clive Boase of the Cambridgeshire-based Pest Management Consultancy. “The objective in hospitals and healthcare establishments should always be eradication of the key pests that could come into contact with the patients e.g. cockroaches, rodents, Pharaoh’s ants and bedbugs, and this should not be compromised. Since the Model Contract was introduced in 1986 some hospitals that have had long term pest problems, have put training in place, monitored contractors and are now free of pests.”
“Under NHS policy there will be a specification of what the Health Trust wants done. They will approach four or five pest control companies to tender for the work and unless there are compelling reasons the lowest tender price, of those tenders that meet the specification, is normally accepted,” explains Mr David Oldbury, Group Manager, Manchester City Council.
The British Pest Control Association (BPCA), located in Derby, has estimated that less than one fifth of one per cent of hospital budgets are spent on pest control - less than the budget for window cleaning! But which poses the greater threat to public health? Should hospitals be spending their money on a dirty window or controlling a pathogen carrying pest?
“The BPCA has drawn up guidelines for selecting a pest control contractor and what a contract specification should cover,” advises Oliver Madge, Chief Executive Officer, BPCA. “Contractors need to be trained and qualified and should belong to the BASIS PROMPT scheme, which means that they hold a recognised industry qualification and must keep their knowledge up to date. They should also have adequate liability insurance and, by being members of the BPCA, they will abide by the Association’s Code of Practice and will be regularly audited. They should be able to fully survey the premises, provide a quotation and detail the pests found, outline the treatments to be carried out and the frequency of visits. If you want a good pest control job to be done, when it comes to contractors, cheap is not always best.”
Watch out, there are pests about
Within a hospital environment reducing the risk of infection is of paramount importance. Many insect pests such as cockroaches, Pharaoh’s ants and house flies are all well known carriers of a range of pathogens and there have been clear links between their presence and outbreaks of Salmonella and food poisoning in hospitals. Research reveals no evidence that biting insects such as fleas and mosquitoes currently transmit diseases in the UK. They are no more than a severe nuisance, although bedbug infestations can create problems for people suffering with haemophilia. Rodents are recognised carriers of a number of diseases including Weil’s disease and birds are capable of transmitting Listeria and E.coli.
Trends in pest infestations in hospitals do change as advances are made in pest control technology and building design and construction change. “Feedback from recent NHS Nominated Officer training courses, which we run specifically for training NHS staff, suggests that infestations of the Oriental cockroach (Blatta orientalis) are still too common, and that rats and bedbugs are on the increase across hospitals in the UK. We are also seeing entirely new pests such as ghost ants becoming increasingly widespread in our hospitals,” warns Clive Boase of The Pest Management Consultancy.
Building design and different areas of a hospital will present varying degrees of risk from pest infestation, with ducting and voids being identified as the most likely features to perpetuate pest problems.
As Mr Hart explains: “We have experienced a lot of problems with birds and rodents when site surveying and this can be a big issue and has associated health risks. Cabling can get gnawed by rodents and birds can be a particular nuisance. Pigeons are often a problem in roof spaces in older premises and in the past we have found dead birds and insects contaminating water storage tanks. However, with the introduction of the Water Byelaw 30, (now replaced by the Water Supply (Water Fittings) Regulations 1999), this problem has pretty much disappeared. The regulations now demand water tanks to have fitted lids and filtered vents to prevent the ingress of insects, birds and vermin to reduce the risk of water contamination. With modern hospital buildings, the bird and rodent problems have now moved to the service voids between the floors which they can access via the ventilation grilles - vermin proof external netting resolves this and should be fitted to all external grilles.”
“What is needed is an integrated approach to pest management. It is therefore important that the trained nominated officers, pest control contractors, construction and engineering teams all work together on this. It is not just about treating a pest problem but also about how hospital buildings can be designed to prevent a pest infestation occurring in the first place,” advises Mr Hart.
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