Skip to Content Skip to navigation
General Policy
Estates, Facilities and Capital Services
Estates Compliance Manager
Head of Estates, Sector Estates Managers
Director of Property & Asset Management
24 July 2020
23 September 2022
24 September 2024

General Note

NHS Fife acknowledges and agrees with the importance of regular and timely review of policy statements and aims to review policies within the timescales set out. New policies will be subject to a review date of no more than 1 year from the date of first issue.

Reviewed policies will have a review date set that is relevant to the content (advised by the author) but will be no longer than 3 years.

If a policy is past its review date, then the content will remain extant until such time as the policy review is complete and the new version published, or if national policy or legislative changes are made


1.1 The Health and Safety at Work Act 1974, the Management of Health and Safety at Work Regulations 1999, and the Pressure Systems Safety Regulations 2000 place a duty on NHS Fife to publish, issue and implement a Pressure Systems Safety Policy which outlines the organisation and procedures required to achieve the objectives set out in those legislative documents.

1.2 NHS Fife regards Health and Safety as a matter of prime importance which is to be given an equal priority with other business and operating objectives and so far as is reasonably practicable, will ensure that the safety of employees at work, patients and other persons is not adversely affected by any of NHS Fife’s operational activities.

1.3 NHS Fife recognises that the lowest acceptable standards of Pressure Systems safety are contained in legislation, and it is the aim of NHS Fife as an organisation committed to quality performance to improve upon these standards. This policy is to ensure the correct management of Pressure Systems and the associated safe methods of work for Estates staff and Contractors.

1.4 NHS Fife is committed to the safe operation of all the pressure systems for which it has a responsibility, by implementing the requirements of Scottish Health Technical Memorandum:-

08-08: Pressure Systems – Procedure & Guidance

The above Technical Memorandum mentioned in 1.4 are managed by the Estates teams under the Estates Health & Safety Management SOP for pressure Systems.

1.5 The Estates Department has detailed procedures on pressure systems management and safe systems of work and is a much more in depth level of management and safety, over and above this NHS Board policy. (See section 6).

1.6 NHS Fife proposes to continue to promote and develop a pro-active pressure systems safety regime by providing information, training and instruction for all Estates employees together with safe workplace procedures and rigorous maintenance routines for all equipment.

1.7 NHS Fife’s review procedures for health and safety matters, identification of hazards and elimination of risks shall also take account of the pressure systems, with the safety codes’ guidance, to ensure compliance with statutory legislation.

1.8 The effectiveness of this safety policy and procedures depends to a large extent on the full co-operation and active participation of all Estates employees to implement safe work practices, under the control of a suitably appointed authorised person.
This pressure systems safety policy will apply wherever any NHS Fife employees are working and to all equipment belonging to NHS Fife, wherever it is located.


Applicable to all NHS Fife owned premises.


3.1 Chief Executive

The Chief Executive of NHS Fife has overall executive responsibility for ensuring that effective arrangements are in place to manage all safety, health and risk matters within NHS Fife. This responsibility has been delegated to an appropriate senior manager, The Director of Estates, Facilities and Capital Services but the Chief Executive remains accountable to the Board.

3.2 The Director of Property and Asset Management is the Executive Lead for Health and Safety and is responsible for:

• Making sure that there are arrangements for identifying, evaluating and managing risks associated with work on Pressure Systems;
• Making sure that the Board regularly reviews the effectiveness of the policy

3.3 Head of Estates

3.3.1 The Head of Estates is responsible for ensuring:
• implementation and management of the policy and associated procedures across NHS Fife
• NHS Fife staff are aware of and have access to the policy and associated procedures
• NHS Fife staff understand the importance of compliance with the procedures associated with this policy
• staff receive training commensurate with their role and responsibilities
• that risk assessments are carried out and reviewed regularly
• that putting procedures and safe systems of work into practice which are designed to eliminate or reduce the risks associated with work on Pressure Systems
• making sure that staff groups and individuals identified as being at risk are given appropriate information, instruction and training, including training at induction, updates and refresher training as necessary
3.4 The Estates Manager and/or the Authorised Person are responsible for
• Making sure that all staff are aware of this policy
• Providing resources for putting the policy into practice
• Making sure there are arrangements for monitoring incidents linked to work on Pressure Systems
• Making sure that appropriate support is given to staff involved in any incident
• Managing the effectiveness of preventative measures through an effective system of reporting, investigating and recording incidents
• Ensuring that staff are consulted through partnership arrangements, on matters relating to their Health and Safety
• Taking reasonable care of themselves and others who may be affected by their actions
• Co-operating by following rules and procedures designed for safe work on Pressure Systems
• Reporting all incidents that may affect the health and safety of themselves or others and asking for guidance as appropriate
• Reporting any risks they identify or any concerns they might have in respect of work on Pressure Systems.
• Taking part in training designed to meet the requirements of the policy


4.1 The Management of Health and Safety at Work Regulations 1999 create a duty to assess significant risks in the workplace. This duty extends to those risks associated with Pressure Systems. The Pressure Systems Safety Regulations 2000 further refers.

4.2 Managers must make sure that staff are not exposed to the risks associated with work on Pressure Systems or, if that is not reasonably practicable, that the risks are adequately controlled.


The key risks involved in implementation of this policy are:-

5.1 Lack of staff awareness of this policy, resulting in non-compliance.

5.2 Lack of robust organisational arrangements around policy implementation.

5.3 Failure to implement and maintain the required procedures associated with the policy.


6.1 It is recommended that this document is read in conjunction with the following:

SOP 15/1 Pressure Systems and Procedures


7.1 PSSR 2000 (Pressure Systems Safety Regulations 2000)

7.2 NHS Fife Risk Register and Risk Assessment Policy (GP/R7)

7.3 Management of Health and Safety at Work Regulations 1999

7.4 Personal Protective Equipment at Work Regulations 1992

7.5 Provision and Use of Work Equipment Regulations 1998

7.6 Lifting Operations and Lifting Equipment Regulations 1998

7.7 Construction (Design Management) Regulations 2015

8. Related Publications

• GP/P9 – Pressure Systems - EQIA