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Whenever there has been a death caused by infection or outbreak of Legionnaires Disease in a Hospital or GP surgery it will always make headline news. There are extensive control measures in place by the HSE including engagement of the Care Quality Commission to monitor and report publically its findings on each site throughout England.

It is strongly advised that specialist consultants should be advising or managing in its entirety the Legionella control program at Medical sites. Here is some very useful information for Hospitals, Doctors, Ambulance Stations & GPs:


  • The elderly and those with lowered immune systems, have a substantially increased risk of contracting Legionnaires disease.
  • Patients who are suffering from chronic diseases such as Diabetes or Heart disease, or are suffering from illness that lowers the efficiency of their immune system have an increased risk of infection from Legionella bacteria.
  • Hospitals are susceptible to bacteria infection.
  • Some water outlets maybe used infrequently and if not flushed regularly have an increased risk of bacteria proliferation.
  • Some wards/facilities may be left unoccupied for infrequent time periods possibly leading up to water stagnation.
  • Many other Health & Safety compliances required within the sector, sometimes Legionella compliance is (wrongfully) considered to be a lesser important one.


  • Legislation that protect staff & the public must be complied with by all private & public sector Hospitals & GP Surgeries. These being: Health and Safety at Work Act 1974 & Management of Health and Safety at Work Regulations 1999.
  • Hospitals and GP Surgeries must adhere to guidance supplied by the Health & Safety Executive (HSE) as laid out in the document now known as HSG274 Part 2. Previously this document was known as ACOP L8. There is also further Care sector specific information published by the Department of Health available here (HTM 04-01 PART A).
  • All Hospitals & GP Surgeries within the UK come under the Jurisdiction of the Care Quality Commission (CQC) which is the independent regulator of all health & social services in England. It is an executive non departmental public body of the Department of Health. Established in 2009, they employ over 2,000 staff. The CQC will randomly inspect all registered Nursing & Care Homes, who also must pay a subscription.
  • Employers must report any case of Legionnaires’ that may have been caught at work to the Health and Safety Executive (HSE), under the Reporting of Injuries, Diseases, and Dangerous Occurrences Regulations (RIDDOR). The duty to do this follows on from a doctor notifying the employer.

Repercussions for Failures

  • Risk of an Outbreak.
  • Risk of death.
  • Huge Fines by the CQC and/or HSE.
  • ‘Special Measures’ enforcement.
  • Expensive Court Cases.
  • Defamation and Bad Press.

Case Studies

Basildon University Hospital

A total of 13 people have contracted Legionnaires Disease since 2002 in separate incidents, three of whom have died (2002, 2007 & 2010). Chelmsford County Court imposed a fine of £350,000 in 2013 after it found the Hospital guilty of failing its patients and falling short of its responsibilities, despite the Hospital claiming that it had spent £2m battling the infection.

Royal United Hospital Bath

The Hospital pleaded guilty in Magistrates Court on December 13th 2017 of failing to discharge its general duty towards health and safety to “a person other than an employee”. In 2015 a 68 year-old man contracted the disease and died. The sentencing will take place at Bath Crown Court 17th January 2018.

Liverpool Heart & Chest NHS Hospital

After a HSE investigation in 2009, it was discovered that there was unsafe levels of Legionella bacteria in the hospitals water system. They had stopped testing for Legionella in 2002 even though the last test on record showed high levels of bacteria. The consultants appointed by the Trust had made recommendations that were ignored and no senior management was delegated for overseeing the Legionella control scheme. The court fined them £35,000 and £12,862 in costs.


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