Sunday, April 10, 2016

Appendix Two - An Open Letter to the Directors of Addenbrookes

To Jane Ramsey and Roland Sinker and the Board of Directors of Addenbrookes

Dear Sirs and Madams,

the hospital is a great one, the staff are wonderful, and I'm grateful for everything the NHS does for me here.

But I do have just one impassioned question and plea...

To put this question in context, I'd like to note some of the excellent features of the wards: every bed has its own light, with two brightness options, and so the patient has some control of their local illumination. Every bed has its own oxygen supply, so that patients like me can have a steady dose of oxygen; and again this supply features a control such that the dose rate can be controlled to the needs and comfort of the patient.

Another aspect of comfort is the thermal environment


Let me describe the room.

I share a four-bed bay with Mr Snooze, Mr Crutch, and Mr Fisher; Mr Crutch and I have the beds by the two large windows, which face south east and have an area of 10 m2 or so. The lower four panes of the windows are all openable to a distance of about 5cm. In front of and slightly taller than the window sill are two killer robots., also known as enormous radiators. These 1.6m wide times 1.2m high impositions steadily belch out, I don't know, kilowatts of heat into our room. [I bet this heat counts as wonderful "green" heat and gets special government credit thanks to being produced by combined heat and power... but that's another rant.]

In the morning if it is a sunny day then the windows (which I think are roughly half-silvered) must be letting in another 5 kW or so; there are internal blinds so this radiation can be diffused, but once it's in, it's in, just like the heat from the killer robots.

If the windows are closed the room's temperature becomes unbearable.

So it is clearly the civic duty of Mr Crutch and me, the guardians of the windows, to attempt to use these cracks to remedy the jungle sauna as best we can. We don't discuss it, we just get on with it. It is not easy. For one thing, Mr Crutch has cancer in his spine and has no use of his legs at all. So every window operation for him involves deft manipulations of his crutch to get the metal clasps rotated and move the window in or out. [Mr Crutch is a youthful, loud, talkative great-grandfather.] As for me, getting up to adjust the windows is difficult too - "my" two windows are about 1.5 m and 2 m away from my right shoulder respectively, so if I'm going to make adjustments I have to get up, and that is about as much effort and exhaustion as a 100m run.

The trouble with our task of opening the windows is, depending on the external wind direction and temperature (which can be an icy midnight April breeze), the flow of air into our room can be mild or arctic. It is quite possible to overdo it and end up creating a stiff draught blasting across the room, freeezing our exposed bodies. (None of us inmates often sleeps under our sheets and blankets. One would boil.)

Moreover the rate of airflow through the windows completely changes when the bay door is opened, which happens on and off for fifteen miinutes at a time in the night.

So, we do our best - we make 1-cm adjustments of gaps. We pull the blinds about when the sun comes up, and wonder what to do when the blinds billow and flap in the breeze.


How about spending some money to fix this issue?
A former doctor at this hospital tells me that there are some controls; indeed that at one point a single thermostat in one visitors' room was responsible for controlling heat flow to the whole of the rest of a ward.

The situation is just ridiculous. Thermal comfort is crucial to recovery, to sleep, to well-being.

The hospital has shelled out thousands of pounds per bed on useless telephone-TV devices, which sit unused above every bed, swithing themselves on automatically, glowing away and causing light pollution. The existence of these absurd telephone-TV installations proves that the hospital is able to retrofit modern technology into its wards.

It just happens to tbe wrong technology and a waste.

So how about spending a similar amount of money, per bed, on making sensible, patient-centred controls for maintaining a pleasant ambient temperature?


There are smart engineers in Cambridge and elsewhere who can figure out cost-effective solutions. Even just thermostatic radiator valves would be start and would cost next to nothing. But I'd recommend going to an organization like Max Fordham to get a well-designed solution.

Please could you do it soon, because my back is simultaneously melting while my ankles are turning to ice in the morning breeze?

Prof Sir David J C MacKay


joabbess said...

I find all public buildings are overheated. It's a "Tragedy of the Commons" : we can have meetings that last hours calmly discussing the minutiae of energy efficiency but people have to fight to get the heating turned off in the meeting room. Overheating of the hospitals and the planet comes about because humanity cannot have a proper conversation about the environment?

joabbess said...
This comment has been removed by the author.
Naomi Davies said...

Thank you for posting this. I hope they will listen. And I wish you all the best. I know my husband Ally thinks you're great, and so I do too.

Ulrike Brauneis said...

Hi David - this kind of thing is intensely annoying and unnecessary. As a quick, immediate stop gap measure you might want to try an electric fan to cool yourself down by evaporation (kind of works in our house). Not the real solution, but might give some relief.

Peter Mumford said...

Perhaps all public buildings are sourced from Siberia, complete with Siberian heating systems..

Keiron Allen said...

There is a solution and it's the application of Bosch patented technology called "chaotic airflow". To understand how it works better there's a video that explains how it works here This company is no longer operating but an off shoot is in the Middle East. They have also developed a technology to clean filter the air to get rid off the majority of 'bad' particulates that can be generated through the recycling of air. All of the plant and additional sensors can be retrofitted easily and at relative speed. But does require a capital cost at the beginning. This is more than offset however by the massive savings in energy bills. Feel free to get in touch - I would be happy to tell you more and come up and spec what would be required for Addenbrokes. said...

Five years ago I had the same problem at Birmingham's outstanding Royal Orthopaedic Hospital. I very much hope that in bringing it to their attention someone, somewhere, has the time to realise the health-related connections. On the face of it, such things seem trivial compared to the treatments. But this is not so. I wish you well and will circulate this blog post in a bid to help.

Joe Public said...

@ Ulrike Brauneis said...

"..... you might want to try an electric fan to cool yourself down by evaporation (kind of works in our house). Not the real solution, but might give some relief."

Whilst other patients in the same room suffer more overheating due to the heat emissions from the fan's motor.

As David suggested, TRVs will be the quickest & most cost-effective solution. Heck the in-house mechanical services dept could probably do it. But there will inevitably be 'down time' for all wards/areas on the same heating loop. So it'll be a summer job. If someone extracts their digit, it's not too late for summer 2016.

Max Fordham said...

My name is Max Fordham. I do know that David MacKay's plea may not yet had a response from from Max Fordham LLP. I apologise for that. Please could someone give me the authority to visit the ward that David MacKay occuppied, and let me get a feel for the problem. My immediate response is to ask how PALS has responded?
My email is and Telephone 020 7485 5113 or M 07711567104
I could visit on Monday late morning, but the time is tight to make an arrangement. My wife has Alzheimers an the rest of the week is full except for Thursday 19th or Friday 20th.

Max Fordham

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Max Fordham said...

This is quite a generalisation. However during the winter it tends to be true.Senior members of an organisation delegate responsibility for heating down the line to the engineer who is made responsible for complaints. The engineer keeps the temperature up to avoid responsibility for complaints. No one complains unless the overheating is really serious. Hence the building tends to be too hot in winter.
In summer the reverse situation applies. Cooling becomes the responsibility of the engineer so the cooling plant is kept in operation a bit too long.
A sustainable solution is to make the engineer responsible for energy use. Then complaints can be answered by pleading the need to conserve energy.
This applies to the use of electricity for lighting as well.
Max Fordham 15 May 2017

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