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Safe water in healthcare premises (HTM 04-01)

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Safe water in healthcare premises (HTM 04-01)

This current review (2016) and update of HTM 04-01 is intended to move users of the document towards a holistic management of water systems via Water Safety Groups (WSGs), Water Safety Plans (WSPs) and other initiatives.

This version draws together and updates the previous guidance and includes recommendations for the safe management of water systems, via the integration of the principle of WSGs and WSPs (first introduced in the HTM 04-01 Pseudomonas aeruginosa addendum – published in March 2013), and how to manage and minimise the risks to health from various aspects, ranging from clinical risks, microbial and chemical contamination, changes to the water system, resilience of the water supply etc. It also introduces a stronger emphasis on staff competencies and the implementation of water hygiene awareness training.

These Guides discuss the design, installation, commissioning, testing, monitoring and operation of water supply systems in healthcare premises.

This Health Technical Memorandum (HTM) gives guidance on the legal requirements, design applications, maintenance and operation of hot and cold water supply, storage and distribution systems in all types of healthcare premises.

The guidance is for:

  • healthcare management
  • water safety groups
  • design engineers
  • estate managers
  • operations managers
  • contractors
  • supply chain businesses

It also provides advice and guidance on the control and management of the risk posed by Legionella, Pseudomonas aeruginosa and other water borne pathogens within a healthcare setting.(2016)


It should be read in conjunction with the HSE’s Approved Code of Practice (L8) and HSG274 Part 2. It is equally applicable to both new and existing sites.


Contains public sector information licensed under the Open Government Licence v3.0.

HTM 04-01, Part C: Pseudomonas aeruginosa – advice for augmented care units


HTM 04-01: Supplement Performance specification D 08: thermostatic mixing valves (healthcare premises)


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