Performance Regulations
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  Regulations for hospitals      
  Noise anywhere can be a nuisance, but noise in a hospital can be a positive menace.

People who are ill or recovering from operations find noise more troublesome than healthy people and can even take longer to recover if their sleep or emotional well-being is disturbed by it.

And as in any workplace, intrusive and inappropriate noise disturbs the concentration of staff and can lead to mistakes, fatigue and low morale.

As part of its vision for the future the NHS is taking steps to make hospitals, primary care facilities and other healthcare premises more pleasant environments for staff and patients alike, and part of this is a clearer focus on noise reduction.

There has been some confusion in the past as to which NHS regulations are most appropriate to consider when designing new healthcare facilities – with the two relevant documents HTM 56 and HTM 2045 focusing on different aspects of the problem in a different way.

Essentially, HTM 56 defines the acoustic standards for partitions, based on laboratory testing of construction systems and not taking into account the environment in which that partition will be asked to perform. The performance requirements contained in HTM 56 are given in Table 11. Partitions build in accordance with HTM 56 could in some circumstances fail to meet the requirements of HTM 2045 and hence be rejected as unsatisfactory.		  

HTM 2045 takes a more holistic approach. It looks at acoustic performance of walls, floors and ceilings as part of a complete environment, with compliance measured by on site testing. HTM 2045 does not set out to give instruction in design work but highlights the overall requirements and considerations that should be applied to noise control.

Current thinking is that HTM 2045 is a more appropriate approach to take. It is also strongly advised that a suitably qualified acoustician should be consulted at an early stage.

The emphasis, says NHS Estates, should be on regarding the document as a guideline rather than a specification. The intention being for the parties concerned to consider the HTM documents as guidance rather than specifications – the key consideration should be that everyone understands what is being done and why.

NHS Estates are currently working on new guidance documents that will take the acoustic requirements out of HTM 56 and incorporate them in a revised version of HTM 2045.

 
         

  The privacy factor      
  HTM 2045 takes into account the different levels of privacy that different spaces require, the impact of mechanical noise from building services and the effect of voice levels.

This is expressed in terms of a privacy factor (PF) where:

PF = Rlw - B + C

and Rlw is the site-tested weighted apparent sound reduction index,

and B is the mechanical services noise rating (NR) criterion (see Table 12),

and C is a voice effort correction factor that recognises that certain in certain areas voices may be raised above normal speaking levels (see Table 13).

Assuming normal speech levels, privacy factors over 80 mean that any conversations in an adjoining space are inaudible, and below 70 they are both audible and intelligible.		  

In general, the privacy factor approach will mean that the majority of internal partitions will have a weighted apparent sound reduction index (Rlw) in the range of 40 to 50 dB. Lower values would rarely be acceptable.

The required privacy factors for various types of space, assuming normal speech levels, are given in Table 14. Please not that these figures do not take into account the Voice Effort Correction Factor.

In addition to the factors contributing the privacy factor, HTM 2045 also sets out requirements for the level of intrusive noise from outside the building. These are given in Table 12.

  
         
 
  General principles   Healthcare premises  
  As a general principle all calculations should be based on a ‘worst case’ scenario.

HTM 2045 also points out that it is sensible to consider the location of departments that are likely to be noisy, such as kitchens and children’s wards and put them as far away as possible from areas that need low noise levels such as wards.		   As well as its application to hospitals the Primary and Social Care Premises Planning and Design Guidance given by NHS estates also makes reference to HTM 2045 – in fact it’s stated scope is quoted as ‘healthcare premises’.  
         
 
  Hospital floors   Fire performance  
  HTM 2045 gives guidance on acceptance criteria for vibration and impact sound, but in practice these are rarely an issue since most hospital floors are made of reinforced concrete which gives the required performance.   Partition walls and floors between rooms must provide appropriate levels of fire resistance as well as acoustic insulation. Fire performance requirements are given in HTM 81 which is based on Approved Document B of the Building Regulations (see Table 7 and Table 8 for minimum periods of fire resistance of elements). Please refer to HTM 81 or call the Xella technical hotline for further details.