GP mythbuster 27: Legionella

Page last updated: 23 December 2022
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We have had a number of queries about what we expect to see in a GP practice in relation their responsibilities to protect staff and patients from the risks of legionella bacteria.

We expect GP practices to provide assurance that they have carried out risk assessments to identify all risks associated with their premises and that they are managing these risks.

The Health and Safety Executive (HSE) has produced guidance and practical advice on how to control the risks from exposure to Legionella in man-made water systems.

Legionellosis is the collective name given to the pneumonia-like illness caused by legionella bacteria. This includes the most serious legionnaires’ disease, which is a potentially fatal form of pneumonia. Everyone is susceptible to infection. However, some people are at higher risk, including:

  • people over 45 years of age
  • smokers and heavy drinkers
  • people suffering from chronic respiratory or kidney disease
  • anyone with an impaired immune system.

Any water system that has the right environmental conditions could potentially be a source for legionella bacteria growth. The most common places where legionella can be found include purpose-built water systems, cooling towers, evaporative condensers, hot and cold water systems and spa pools. There are also a number of other systems that may pose a risk to exposure to legionella, eg humidifiers, air washers, emergency showers, indoor ornamental fountains etc.

All systems require a risk assessment, but not all systems will require elaborate control measures. Neither CQC nor HSE make any requirements about who carries out the risk assessment other than that they should be competant to carry out the task. The HSE guidance describes what a risk assessment should include. A simple risk assessment may show that the risks are low and being properly managed. In many cases the risk assessment will lead the practice to conclude that the risks are insignificant and are being properly managed to comply with the law. In these instances the assessment is complete and no further action is required.

If a risk of legionella is identified by the practice, then they will need to take steps to prevent or control the risk. HSE has provided detailed guidance, in particular on controlling risks in evaporative cooling systems and on the control of legionella bacteria in hot and cold water systems.

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