Hidden risks in hospital electrical systems

The call comes in just after two in the morning. Theatre 3 lost power mid-procedure. The emergency generator played its part, but the patient still had to be moved. The investigation reveals a fault that has been developing for weeks, invisible to monthly manual checks. In the morning, the team will face questions about system reliability, patient safety and why a preventable electrical failure compromised a six-figure procedure.

This scenario plays out across the NHS with alarming regularity. Behind every emergency callout, every unplanned shutdown, every compromised procedure lies the same fundamental issue — healthcare estates are hampered by limited visibility to developing electrical faults. The scale of this hidden crisis becomes clear when we examine the numbers.

Shocking statistics

With 11.2 billion kWh consumed in 2022/23 and costs hitting £12.4 bn, a 12 per cent year-on-year increase, the Building Engineering Services Association calculates £400 m could be saved through smarter energy management. Much of this waste stems from the very electrical faults that remain hidden in current monitoring approaches — inefficient systems, power quality issues, and equipment operating below optimal performance. Yet many facilities still depend on monthly manual checks and reactive maintenance, allowing faults to develop undetected until systems fail.

Regulatory pressure is intensifying for those carrying compliance burdens, as well as those estate directors who are balancing Net Zero commitments against strained budgets, knowing that Green Plans required board approval back in July. SECR (Streamlined Energy and Carbon Reporting) and ERIC (The Estates Return Information Collection) reporting must be evidenced, not just completed compliance tick-boxes.

Therefore, the question has progressed from whether proactive monitoring pays for itself to whether decision-makers can afford to sit on their hands any longer.

Walk through any hospital today and you’ll encounter an underlying conflict. These institutions are at the forefront of medical technology, where split-second decisions save lives and precision is critical. Yet, beneath this perception of clinical excellence, the electrical infrastructure that powers everything from life-support equipment to theatre lighting requires ‘healthcare’ of its own.

Traditional monitoring approaches leave critical vulnerabilities exposed. Monthly manual checks and reactive maintenance schedules create dangerous knowledge gaps where developing faults can mask serious issues until they become emergency callouts. Real faults often hide behind legacy systems, analogue checks or reactive inspections that provide only snapshot views of complex electrical networks.

This is a high-stakes situation. When electrical systems fail in healthcare environments, the consequences extend far beyond inconvenience. Equipment failures can compromise patient safety, disrupt critical procedures and trigger costly emergency repairs that strain already pressured budgets. This reactive firefighting maintenance model is a worrying reality and is further compounded by the regulatory situation facing healthcare trusts. SECR applies to large healthcare organisations and requires annual reporting of energy usage, emissions and efficiency actions. ERIC, a mandatory reporting system, collects energy consumption, cost, carbon emissions and estate efficiency data. Building Regulations Part L mandates sub-metering in non-domestic premises with floor areas greater than 500m², while automatic meter reading is required in premises exceeding 1,000m².

Firefighting vs. foresight

Rather than waiting for systems to fail, proactive condition monitoring enables estates teams to identify developing issues before they become critical failures.

This is now a reality following advances in monitoring technology that can detect the early warning signs of electrical faults. Residual current monitoring and earth fault detection systems can identify developing problems that, from our experience, account for over 80% of all electrical failures. Combined with comprehensive power quality monitoring, these systems provide visibility into the health of critical electrical infrastructure.

Energy monitoring provides the data needed for strategic decision-making. With healthcare organisations committed to reaching Net Zero for direct emissions by 2040, and every organisation now required to have a Board-approved Green Plan including energy monitoring and reduction actions, having accurate, real-time energy consumption data becomes essential for compliance and strategic planning. The data collected through comprehensive monitoring systems forms the foundation for evidence-based energy reduction strategies and supports the journey toward Net Zero targets.

Proving compliance without disruption

One of the most significant advantages of modern condition monitoring solutions is the ability to maintain compliance without disrupting operations. Traditional BS7671 testing often requires disconnecting essential loads — an increasingly impractical approach in healthcare environments where continuity of service is no longer an option.

Smart monitoring systems can generate the reports needed for regulatory compliance without shutting down systems for testing. This improves the compliance process from a disruptive obligation to a seamless background process that enhances rather than hinders it.

Integrating multiple monitoring functions such as residual current monitoring, insulation monitoring, power quality analysis and energy measurement, creates a broader view of electrical infrastructure health. This holistic approach enables maintenance teams to move away from calendar-based preventive maintenance to condition-based predictive maintenance, which benefits costing and reliability.

For those healthcare estates teams dealing with ageing infrastructure and tight budgets, this is an improvement in operational efficiency. Resources can be allocated based on actual need rather than arbitrary schedules, while the risk of unexpected failures is dramatically reduced through early detection of developing problems.

Real world validation

The practical benefits of proactive condition monitoring were demonstrated at a private healthcare estate, where a Bender Pulse trail delivered results across multiple critical areas.

The system deployment included 8 ATICS-ISO devices, 12 EDS units, 12 PEM devices and residual current monitoring across 142 circuits spanning two essential distribution boards (72 circuits on DB01-ESS01 and 70 circuits on DB01-ESS02).

Pulse began detecting issues that the traditional monitoring approach had missed. A recurring 10kΩ fault was detected in circuits feeding operating theatre sockets, ultimately traced to a ‘Theatre in Use’ sign with low resistance to earth. While not immediately dangerous, this type of fault could mask more serious issues if left unaddressed, precisely the kind of hidden vulnerability that comprehensive monitoring is designed to reveal.

The residual current monitoring component identified several circuits with consistently high readings, prompting investigation and potential adjustments to response values. AC residual current levels remaining at 150mA since commissioning on specific circuits highlighted the need for targeted maintenance attention, while intermittent faults provided early warning of any developing problems.

Power quality monitoring detected brief events, including under-voltage conditions and harmonic distortion. Some of these events coincided with broader HV ring problems affecting several adjacent sites, demonstrating how comprehensive monitoring can identify the systemic issues that extend beyond individual facilities.

Perhaps most notably, the system enabled early identification of a developing fault in a circuit supplying access control systems. This early warning allowed the maintenance team to plan and execute repairs before the issue could escalate into a critical failure, potentially avoiding a major security system outage.

The energy monitoring component revealed usage patterns across medical IT systems, showing similar consumption between active theatre systems, while recovery room systems rarely supplied significant loads. This granular visibility enabled more informed decisions about system load and capacity planning.

The data generated by monitoring systems creates a foundation for decision-making beyond day-to-day maintenance. Real-time energy consumption data supports SECR and ERIC reporting requirements while providing the evidence base for Green Plan development and Net Zero strategy.

The system demonstrates how monitoring data can support multiple strategic objectives simultaneously. Power quality monitoring ensures equipment protection and system reliability, while energy monitoring provides the consumption data needed for regulatory reporting and carbon reduction planning. Residual current monitoring enhances safety and reduces the risk of electrical fires, while automated reporting capabilities ensure BS7671 compliance without operational disruption.

This integrated approach converts raw data into strategic intelligence that supports immediate operational needs and long-term planning objectives. The same data that alerts maintenance teams to developing faults also informs energy efficiency initiatives and promotes compliance with increasingly insistent regulatory requirements.

Regulatory requirements and running costs

One thing is evident, the cost of maintaining the status quo is becoming increasingly unsustainable. Healthcare estate running costs continue to rise while regulatory requirements become more demanding. The Building Engineering Services Association’s analysis suggests that £400 m in annual savings is achievable through smart energy management — but only for organisations willing to move beyond legacy methods.

The regulatory environment is tightening, the technical requirements are becoming more sophisticated, and the infrastructure challenges show no sign of relenting.

Estate stakeholders have carried this burden for too long. The cost of inaction is rising. The data and the tools exist. The regulatory requirements are already in place. The only thing missing is the decision to stop firefighting and start using foresight.