Refurbishing a healthcare building is not like refurbishing an office. Patients may be elderly, unwell or immunocompromised. Clinical areas need to stay safe and open, and a small lapse in dust control or water hygiene can have serious consequences.
Whether you manage a GP surgery, dental practice, clinic, care home or hospital department, this guide explains the infection control and compliance basics for a healthcare facility refurbishment, and what to look for in a contractor.
Why Healthcare Refurbishment Is Different
Healthcare projects have their own design, compliance and operational demands. A good contractor works around:
- Vulnerable people who are more at risk from dust, mould and contaminated water
- Live operations, where clinics, wards or treatment rooms often cannot simply close
- Strict standards for surfaces, ventilation, water systems and layout
- Regulatory scrutiny from bodies such as the Care Quality Commission (CQC) in England
1. Start with an Infection Control Risk Assessment (ICRA)
Before work starts, an Infection Control Risk Assessment looks at what the works involve, which patients and areas are affected and what controls are needed. It is typically a joint exercise involving the facility’s infection prevention and control team, estates or facilities managers and the contractor.
The ICRA shapes how the project is planned, from where hoarding goes to how waste leaves the building. It should be reviewed whenever the scope or programme changes.
2. Control Dust and Airborne Contamination
Construction dust can carry fungal spores and other contaminants. Typical controls include:
- Solid hoarding with sealed joints around the work area
- Negative air pressure or air filtration units with HEPA filters where the risk requires it
- Sticky mats or dust-control floor protection at entrances and exits
- Dust extraction on cutting and sanding tools
- Wet cleaning rather than dry sweeping
- Dedicated routes for workers, materials and waste, away from patients
Good contractors check these controls daily, not just at the start.
3. Ventilation and Water Safety
Ventilation and water systems are central to infection prevention. In the UK, guidance for healthcare estates includes the Health Technical Memoranda (HTMs), such as HTM 03-01 for ventilation and HTM 04-01 for water systems. Poorly managed water systems can encourage bacteria such as Legionella. If you want more background, read our article on Legionella and water hygiene compliance for commercial landlords, which covers principles that also matter in healthcare settings.
Refurbishments often disturb or alter water systems. That means flushing, testing, avoiding dead legs in pipework and keeping records. Contractors should also take care when commissioning ventilation after works.
4. Choose Healthcare-Appropriate Finishes
Surfaces in clinical areas must be easy to clean and durable. Typical choices include:
- Seamless, coved flooring that resists moisture
- Smooth, wipeable wall finishes with minimal joints
- Sealed joints and junctions where bacteria could collect
- Clinical handwash basins in the right locations
- Cabinetry and worktops that can withstand repeated disinfection
Early design input from infection control teams avoids expensive rework later.
5. Plan Around Live Operations
Few healthcare buildings can shut down completely. Phasing breaks the project into stages so that services keep running. Out-of-hours and weekend working can reduce
disruption, and temporary clinical spaces may be needed. Planning also covers fire safety, emergency access and the movement of patients through the building.
6. Documentation and Compliance
Evidence matters. Expect to keep records such as:
- The ICRA and any method statements
- Permits for hot works and other risk activities
- Test and commissioning certificates for water, ventilation and electrical systems
- Cleaning and handover records
- Health and safety files
In England, CQC inspections look at whether premises are clean, safe and suitable for their purpose, so well-organised documentation supports your compliance. Always confirm the current requirements for your service type and nation with the relevant regulator.
7. Keeping It Compliant After Handover
Compliance does not end when the contractor leaves. Planned maintenance of ventilation, water systems and electrical equipment protects both patients and your investment. See our guide to PPM vs reactive maintenance for how to build the right balance, and learn how our FM and MEP services support buildings after completion.
What to Look for in a Healthcare Refurbishment Contractor
- Proven experience in live clinical environments
- A clear approach to ICRAs, dust control and phasing
- Recognised accreditations and a strong health and safety record
- Good communication with clinical and estates teams
- In-house capability across building and MEP, so one team is accountable
Mobius Group is a main contractor specialising in construction, fit-out, refurbishment and facilities management, with accreditations including UKAS, Alcumus, Constructionline Gold, SSIP and NICEIC. Explore our general building works and recent projects, or get in touch to discuss your healthcare refurbishment. For more advice from our team, visit Mobius News.
FAQs
What is an ICRA in construction?
An Infection Control Risk Assessment identifies the infection risks of a building project and sets out controls to protect patients and staff.
Can a healthcare facility stay open during refurbishment?
Often yes, with phasing, hoarding, dust control and careful planning with the clinical team.
What standards apply to healthcare refurbishments in the UK?
Relevant guidance includes the Health Technical Memoranda and Health Building Notes, plus regulatory expectations such as those of the CQC in England. Requirements vary by service and location.
Why is water hygiene important during a refurbishment?
Changes to pipework can create conditions where bacteria such as Legionella grow, so flushing, testing and good records are essential.
Who is responsible for infection control during the works?
It is shared. The facility’s infection control team, the duty holder and the contractor all play a role, and responsibilities should be agreed at the start.