HDD-VEAT-21-02 Ceri Ward Ventilation works GGH

NHS Wales Shared Services Partnership on behalf on Hywel dda University Local Health Board wish to inform the market that they have awarded a contract to improve the ventilation at Ceri Ward – Glangwili General Hospital to assist with the health board's treatment target. During the current pandemic, escalation of care in the form of NIV (non-invasive ventilation) and CPAP (continuous positive airway pressure) has delivered on Padarn Ward on a previous surgical ward template located Ward Block 2, third floor. This is a 23 bedded area and the aim is to eventually return this ward area to its former function as a surgical ward.

In addition, Glangwili only has 10 isolation bays situated on CDU and any infections disease requiring isolation other than COVID are managed here. In order to support the Winter demand, it is proposed to undergo works to allow a ventilation system installed to 1st Floor, Block 4 (Picton Ward) to enable the delivery of a safe area to provide ventilator support to respiratory patients. This area is deemed as the most appropriate as situated in the medical block and on the ground floor. The current Preseli template is not an appropriate template especially given fire safety reports that in the event of a fire bariatric patients can not physically be evacuated from the ward. In addition, surgery need this template back as it is linked to Preseli theatre which is used to operate on surgical and cancer patients.

Ventilation units have already been installed on Padarn Ward and have proved to be successful in allowing CPAP and NIV to be delivered safely with the necessary air changes. However, with Winter approaching there will be an increased demand of respiratory illnesses.

The optimum option for GGH is to provide an individual ventilation unit for each room (4 x 4 bedded bays and 3 x side rooms). Hence, 7 units complete with supply and extract fans, filters, high efficiency recuperator (heat exchanger) and heater arranged one per room. These are intended to be started and stopped manually by medical staff as and when that room becomes occupied.

The units are to be sized to provide 12 air changes per hour with the supply and extract air flows adjusted to result in a slight negative pressure in the room. It is this intermittent usage, which suggests for this application, individual units are preferable to providing a large AHU sized to serve all of the rooms.

The units will be sited externally on a concrete plinth protected by a grp housing. Internal ductwork will be located in the ceiling void entering and leaving via the top ‘opaque’ panels of the windows. Supply air will be drawn from the courtyard between the buildings. Extracted air to discharge into a common large diameter horizontal external duct mounted above the ground floor windows but below the first-floor ones. The duct is fitted with an interlinked fan that draws air through the duct and thus the extract air from the rooms with the combined but diluted discharge arranged at a suitable location.

As per WHO guidance where patients (Covid-19) are receiving high levels of oxygen there needs to be effective ventilation in place to avoid the significant risk if a fire. Oxygen monitors have been in place on covid-19 wards and have regularly alarmed due to infective ventilation resulting in high ambient levels of oxygen. This places other patients and staff at high risk in the instance this could cause a fire.

A 3rd wave in the pandemic has been predicted and the need have a safe environment in which to manage these patients in a cohorted location. Avoiding having patients treated in multiple locations and increasing the risk of nosocomial transmission. Post pandemic these areas can be used to manage patients needing isolation and use of oxygen eg influenza.