# What changed in the 2026 edition of HTM 02-01?

**What changed in the August 2026 edition of HTM 02-01 for medical gas pipeline systems?**

The 2026 edition of HTM 02-01, published by NHS England on 19 August 2026, keeps the core engineering principles of the 2006 edition but moves to risk-based design, adds a Medical Gas Safety Group and stronger competency rules, and creates new chapters on dental systems, quality control testing and decommissioning.

The new edition supersedes all previous versions of HTM 02-01 and HTM 2022. It keeps the two-part structure: Part A covers design, installation, validation and verification, and Part B covers operational management of the MGPS and cylinders. Both parts open with the same list of major changes since 2006. The guidance applies to all new installations and to refurbishment or upgrading; existing installations should be assessed for compliance, and it need not be applied retrospectively unless patient or staff safety would be compromised.

## A different design approach

- Risk-based design: the document moves away from a mainly prescriptive engineering approach and focuses on risk-based design, governance, staff competency, resilience, sustainability and assurance.
- Informed design process (IDP): design starts from clinical need, operational risk, technical requirements and future resilience, with design options, risk assessment and a justified multidisciplinary decision, rather than historic norms or formulas alone.
- Peak and surge demand: drawing on COVID-19 and the HSIB investigation, where the limiting factor was often the ability of the pipeline to deliver the required flow, the guidance puts more weight on designing for peak and surge demand and on system-wide flow and pressure limits.
- Pressure management and resilience: more clarity on the use of pressure-reducing stations, and stronger wording on tertiary supplies, emergency support and documenting the decisions behind the supply configuration.
- Sustainability and net zero become explicit design considerations, including the environmental impact of nitrous oxide.

## Governance and people

- Medical Gas Safety Group (MGSG): the HTM advises that it should be part of the organisation's governance and report to the Board, and advocates that it be led and chaired by the Senior Operational Manager or the Chief Pharmacist. All new installations or modifications should be overseen by it, and large or complex projects should set up a project-specific group (PMGSG).
- More guidance on the Authorised Person and the Authorising Engineer (MGPS), with competency defined as a combination of skills, knowledge, experience and behaviours.
- A new section on the Building Safety Act 2022 and a technical file for the MGPS, with design details, components, material certificates and pressure test validation, updated at every modification or extension.

## New and moved content

- Dental air and dental vacuum now have their own chapters in Part A; in 2006 they sat in HTM 2022 Supplement 1.
- Stand-alone chapters on decommissioning, signage, engineering validation and verification, medical gas quality control testing and mobile vehicles.
- Quality control content previously in paragraphs 15.109 to 15.184 of Chapter 15 has its own chapter, and former Tables 29 to 31 are merged into Table 34.
- Piped nitrous oxide: the HTM reports that anaesthetic organisations recommend it no longer be considered, with a move to point-of-use cylinders by the end of 2026/27 where access remains desirable.
- References are standardised to British Pharmacopoeia monographs, BIM and BS EN ISO 19650 are covered, and the B-form test sheets can be downloaded as Excel files.

## Why it changed

The Healthcare Safety Investigation Branch (HSIB) investigated piped oxygen supply during the COVID-19 pandemic, and the revision takes account of its final report. Its recommendations asked for a review of the roles, responsibilities and competencies in HTM 02-01 (R/2021/132), ongoing assurance of the qualifications of people such as Authorising Engineers (R/2021/133), and an updated HTM that reinforces multidisciplinary working (R/2021/134).

## Other points to note

Following BS EN ISO 7396-1, every medical gas supply should have primary, secondary and tertiary sources. HTM 02-01 says PSA systems should only be considered where geographical or environmental constraints prevent liquid oxygen or compressed gas supply. Part B still cites ISO 10083 for oxygen concentrator supply systems, although ISO withdrew it in 2016. The guidance is not mandatory unless specifically stated. A summary of the whole document is on the HTM 02-01 page.

### Does the 2026 edition apply to existing installations?

It applies to new installations and to refurbishment or upgrading. Existing installations should be assessed for compliance, and retrospective application is not needed unless patient or staff safety would be compromised.

### Is HTM 2022 still valid for dental systems?

No. The 2026 edition supersedes HTM 2022 and moves dental air and dental vacuum into dedicated chapters of Part A.

### Who chairs the Medical Gas Safety Group?

HTM 02-01 advocates that the Senior Operational Manager or the Chief Pharmacist leads and chairs it, and that it reports to the Board.

## Sources

- [NHS England, Health Technical Memorandum 02-01: Medical gas pipeline systems (publication page)](https://www.england.nhs.uk/publication/health-technical-memorandum-02-01-medical-gas-pipeline-systems/)
- [HTM 02-01 Part A (2026), Context and background; Major changes since the 2006 edition, pp. iv to viii](https://www.england.nhs.uk/wp-content/uploads/2016/05/health-technical-memorandum-02-01-medical-gas-pipeline-systems-part-a-design-installation-validation-verification-aug-2026.pdf)
- [HTM 02-01 Part B (2026), Major changes since the 2006 edition and chapter 4](https://www.england.nhs.uk/wp-content/uploads/2016/05/health-technical-memorandum-02-01-medical-gas-pipeline-systems-part-b-operational-management-aug-26.pdf)
- [ISO 10083:2006 (withdrawn), iso.org](https://www.iso.org/standard/32061.html)

Reviewed: 2026-10-22. Ultra Controlo engineering. https://library.ultracontrolo.com/answers/what-changed-in-htm-02-01/