‘No two projects likely to be the same’ for hospital lifts

This article was originally published in Health Estate Journal's May 2024 issue.

Within the UK lift industry, there has been a regulatory requirement to fit communication devices to new passenger lifts since the introduction of EN 81-1 and EN 81-2 in 1998. However, most lifts in a hospital environment had telephones within them long before this. While the majority of lifts installed in the UK have communication systems which dial out to the lift maintenance company, in hospital locations it is usual that lift communication systems call an emergency phone within the hospital's emergency contact centre. It's essential that lift emergency communications are operational, and that they connect to a 24/7 emergency contact centre where staff can arrange for the rescue of the trapped passengers.

Daily checks

HTM 08-02: Lifts recommends that lift communication systems are checked daily. This should form part of a Standard Operating Procedure (SOP) for the identified Lift Stewards (a defined role under the HTM). Note that the standard associated with lift communication (EN81-28) requires that lift emergency communication systems are checked at least every 72 hours. This means that Trust Estates teams will typically find that they have two different types of lift telecom systems to manage:

1. Internal telephone line connections in a hospital environment.

2. Externally connected communications which use the BT network (typically for non-hospital locations and community premises).

BT has announced that from September 2025, the existing analogue (copper) phone line system will be switched off. The plan, which has been ongoing for some years now, is that by this date existing analogue phone line customers will have been migrated onto digital IP-based phone systems. This issue will affect all lift communication systems which use the BT phone network.

From a lift communication system perspective there are going to be challenges. Most older existing auto-dialler devices will not be compatible with the switch to IP networks, and will need upgrading to new systems or to have new GSM phone lines fitted. If a change is not made, this has the potential to cause a safety issue in the event of lift breakdown and entrapment, with the lack of emergency communications causing non-compliance, and the inability of trapped passengers to contact a rescue service.

Potential solutions for lift system owners

What should those responsible for lifts do? The network change is coming, but if suitably prepared and planned it can be managed effectively. I would suggest following these four steps to make sure that your lifts are ready:

1. Know how these changes affect your lifts: The first step is to understand how your lifts are affected. Find out what communication and telecoms systems your lifts have. The key consideration is knowing which use a BT line.

2. Consider the potential solutions for your lift communications: The most likely solution will be to install a Global Service Mobile (GSM) integrated emergency auto-dialler or GSM gateway units to modify existing auto-diallers. They have many benefits, as they don't require a fixed line, data can be readily transmitted over the mobile network, and the units are battery-supported, ensuring that the associated alarm system will still work in the event of a power failure (as required by BS EN 81-28).

Note that if an existing auto-dialler system needs to be upgraded, care should be taken to ensure that any new system will provide an equivalent level of safety. Many more modern lift communication systems also include the ability for trapped engineers to use the system by providing emergency communication from the top of the lift car and the pit; these, however, have to be retained and operational as originally fitted.

3. Watch out for the GSM switch-off: Consideration also needs to be given to planned changes in the GSM infrastructure, with a planned switch-off of the older 3G (and possibly 2G) systems and migration to 5G. When upgrading or replacing lift communication equipment to address the BT 2025 switch-off, take care not to purchase an older (2G/3G) GSM gateway, which is itself likely to need replacing in a few years.

4. Know the issues: It is worth noting that a GSM communications solution does have some associated negative issues, mainly revolving around signal strength and connectivity. We've all experienced not having a mobile phone signal in certain locations, or deep inside buildings — and GSM gateways can be affected in just the same way. This obstacle can generally be addressed by using a roaming non-steered SIM which, rather than being tied to a single provider, can locate and use the strongest network available. Fixing the GSM unit in the part of the shaft or machine room that provides the strongest signal strength is also essential, Extension aerials can also help. Finally, careful consideration must also be given to the SIM card, be it on a contract or a prepaid/ top-up basis, and ensuring that it remains 'live'.

The challenge of healthcare lift project delivery

Over many projects, with different Trusts, in varying roles, I have observed several consistent challenges. The most cost and time-efficient way to upgrade, refurbish, or replace an existing lift is through a comprehensive one-time modernisation project. Some of the issues associated with this approach are discussed in greater depth below, but the main downsides tend to be cost and programme. There may be times when it's appropriate to undertake a smaller project — often termed a minor refurbishment, when only one or two of the lift's main systems are upgraded. The main system elements are:

• A control system, including the signal station.
• Drive system electric traction — a traction machine which may be geared or gearless, and should always include rope replacements.
• The drive system — a hydraulic pump and valve system, which may also include the hydraulic cylinder depending upon its condition.
• A car door operator (which can be upgraded while retaining landing door equipment and car door panels).
• A complete car and landing door system (note that only by replacing the complete system can a fire certificate be issued for the new landing doors).
• Safety gear.
• The lift car interior.

I have not included the structural elements of a lift, such as the car frame, sling, and
counterweight in this list, as their replacement would not usually be included as part of a minor refurbishment.

When undertaking a minor refurbishment it is essential to do so with a long-term view. For example, if the control system is replaced it is important both to consider what future minor refurbishments may be needed, and to ensure that the installed control system has future compatibility to ensure that if, for example, there is a future drive upgrade, the control system will not need replacing again.

The Health Technical Memorandum (HTM) documents are extremely useful in assisting Trusts with the operation and management of healthcare facilities. HTM 08-02 is the primary HTM relevant to lifts. It covers all types (e.g. traction, hydraulic, and platform), all usage types (e.g. bed lifts, passenger lifts, and refuse lifts), and guidance for lifts in newly constructed healthcare buildings, as well as modernisation of lifts in existing buildings.

As a result of this broad scope of coverage, it is not appropriate for HTM 08-02 to be quoted as if it were a specification. During the initial scoping phase of a project the applicable elements of HTMs should be identified and specified for the project, along with appropriate additional information as relevant.

Lift projects are often frustrated due to a lack of stakeholder involvement in the scoping phase. In the writer's experience this can be a result of the appropriate Estates team members not being engaged at a sufficiently early stage. However, it can equally result from the Estates team not providing the information that the Capital team needs within the timescales required — most likely due to the operational pressures they have to deal with daily, and the need to prioritise the burning issues of the day over longer-term project needs.

I recommend that the Authorising Engineer for Lifts be engaged to support the scoping phase of projects and speak on behalf of the Estates team and lift APs (Authorising Persons). The Lift AE would typically be sufficiently aware to assist the AP, and as they are external to the Trust, they are not generally involved in day-to-day operational issues.

The specific lift requirements for a project need to be defined in a lift-specific Employer's requirements or specification document. This should comprehensively convey to a contractor the results of the aforementioned points 1-3, and detail precisely what is required, inclusive of performance requirements and named suppliers or product types where appropriate. A suitable document will enable both the Trust and the contractor to agree the scope and requirements for the project without misunderstanding or misinterpretation. Projects can often become stalled, frustrated, delayed, or delivered unsatisfactorily, due to a misinterpretation of the requirements.

Hospital Estates managers and directors have a huge task on their hands when it comes to capital planning for equipment replacement. With hospital buildings needing to last much longer than the lifespan of the equipment which supports their operation, planning of proactive capital equipment replacement is essential. Capital planning for lift equipment is particularly challenging for a number of reasons, as follows:

1. Essential equipment with long downtime is problematic

The downtime of a lift for major refurbishment or replacement will differ for each lift, depending on the type of equipment, the height of building, and the scope of the works being undertaken. This is likely to range between one and three months, or more — for taller or more complex lifts.

The impact on the operation of a hospital building which is without a lift for this length of time is significant, and generally requires plans to be but in place during the lift works to divert lift users to other routes (assuming, of course, that alternative routes are available).

Buildings with a single lift will be most significantly affected, and any significant work on the lift may necessitate the building or 'area' having to be decanted for the works' duration. My top tip to approximate the likely downtime of a lift for major refurbishment or replacement is to use the following formula: The number of floors + 4 = the approximate number of weeks the lift will be unavailable.

2. Contractor procurement, and design and equipment's long lead times

• Each lift is generally different from another, meaning that a refurbishment or replacement project will need to be designed and developed specifically for that individual lift. There are a number of steps or stages in progress, through:
• Development of the works specification (due to the specialist nature of lifts this would generally be undertaken by a lift consultant on behalf of the Trust).
• Procurement of a lift contractor.
• Lift contractor's detailed design development.
• Equipment procurement (many lift components will have lead times of 3-4 months from order).

The upshot of having to navigate one's way through the aforementioned steps is that the time period from initiation to lift works starting will typically be around 9 months.

3. 'Often manual' Annual Trust budget planning and approval processes

In my experience, Trusts plan capital expenditure on an annual basis, with their budget year running from April to March. However, it not unusual for it to be June or July by the time budgets are formally approved, leaving the remaining 8-9 months to undertake the works before the end of the budget year.

4. Lifts are provided in groups

Lifts are often provided (as recommended by HTM 08-02) in groups for purposes of resilience. Additionally, these lifts should operate together as a group (there are some specific cases where groups of lifts would not be grouped, such as clean/dirty refuse lifts), as this reduces wear and energy costs due to lift users calling multiple adjacent lifts to accelerate their journey. Where lifts are grouped to operate together, placing a call on one lift also places a call on the others in the group, and the control system determines which one lift will arrive for you.

These group arrangements mean that typically when upgrading one lift in a group it will also be necessary to upgrade the others simultaneously. This will lead to an increase in capital cost (two lifts cost more to replace than one), but on the positive side the cost increase is likely to be less than 200% of the cost of one lift, and result in a capital cost saving.

When undertaking upgrades of groups of lifts, it is usual for the works to be carried out one lift at a time (e.g. lift 1 upgraded while lift 2 remains in operation; then on completion of lift 1, lift 2 is upgraded with lift 1 in operation). This has a knock-on effect of increasing the overall project installation time (if one lift takes two months to install, the overall duration of two lifts being upgraded sequentially would be four months).

The compound effect of the issues identified in (1)-(4) is that from gestation to completion a lift upgrade project will often span multiple budget years, with contractual commitments for the works being made in the first budget year, and typically circa 30-50% of the project spend made, then the remainder of the project being completed in the following year, along with the associated spend.

In my experience these multiple year projects can be challenging for Estates teams, who typically plan works around a single year budget. Trust capital projects teams are often better placed to manage multiple year projects, but due to the relatively low complexity of the lift project (compared with constructing a new A&E department), it is usual for the lift consultant engaged to develop the works specification to also be retained to manage the project, monitor the works, and act on behalf of the Trust to ensure a successful project completion.