Investigation of Gas Explosion, Bromley Hospital NHS Trust
Overview
Following a gas explosion, caused by contractor’s activities, to determine what had happened, how it had happened and importantly how the situation could be stabilised and avoided in the future.- Following a complete failure of power supplies to Bromley Hospital (no mains electricity – standby generators failure to start) to determine what had caused the failure of the incoming supplier and why the standby generator had failed to start and to hold the site load.
CPA’s Approach
- Following contact by the Trust, CPA staff was on site the following day.
- Through site inspections, interviews with staff, contractors and retained consultants the sequence of events and outcomes were determined for
- Gas explosion.
- Power – generator failure. - An interim report was prepared for the Trust Chairman / Chief Executive with recommended courses of action.
- Control procedures practised by trust staff were reviewed, modified and re-established.
- The standby generators had their control software modified to ensure that mains power failure would be sensed & covered on full load.
- Full mains failure was simulated and the stand-by generators took and held full load on two separate occasions.
- Clear protocols for the selection and control of contractors were established including Method Statements, Restricted Working Space, etc.
Findings
- The contractors appointed for cutting back the “live” gas main were not competent, experienced or suitable.
- The Trusts supervising officer had not controlled the job or determined the methods to be adapted restricted workings etc.
- The stand-by generator had sufficient capacity but the control software was programme to lock them out (in certain site conditions).
- Prior to CPA’s involvement the stand-by generator had been restricted and failed again.
Outcomes
- Reliable and proven stand-by generators were established on the Bromley Hospital Site.
- A range of selected control protocols was established for use by the Trusts technical staff.
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