# How do you keep a hospital oxygen plant running for years?

**What makes a hospital oxygen plant sustainable over years: funding, energy, staff and spares?**

Global Fund guidance on PSA plant sustainability (2024) lists minimum considerations that include funding for a life cycle it puts at 10 years on average, reliable three-phase power with appropriately sized backup, trained staff on site doing daily checks, a spare parts inventory of at least two years and a long-term warranty and maintenance contract.

## Funding for the whole life cycle

The Global Fund sustainability guidance for PSA oxygen plants (22 August 2024), written by Build Health International for Project BOXER, separates capital costs (plant equipment, plant house, electrical upgrades, cylinders and transport carts, and pipeline work) from operating costs: spare parts, scheduled maintenance, repairs, electricity, diesel, distribution and staff salaries, which can be integrated into the hospital's annual budget. It asks for long-term financial planning over the plant's life cycle, on average 10 years, with funds set aside for unexpected repairs or system upgrades. UNDP (REQ-OXY-001, effective 1 January 2025) says end users should budget for operation, maintenance and repair using planning tools such as the UNICEF Oxygen System Planning Tool. The Lancet Global Health Commission (17 February 2025) notes that operational costs account for 50 to 80% of total oxygen system costs but have received little investment.

An Open Critical Care answer by Assist International starts a sustainability plan with a cost analysis of operating expenses: power to run 24/7, including grid power and diesel for backup generators; a spare parts package for the installed equipment, with a confirmed supply chain to order and import parts; engineers for service and daily operation; and service contracts with an outside provider for regular maintenance.

## Power and site

The Global Fund guidance asks for properly balanced three-phase power, correctly sized distribution cables, protection from voltage fluctuation and appropriately sized backup power, and suggests considering renewable power instead of generators for operational and financial sustainability. Extreme heat and cold should be mitigated, and plant siting should reduce the risk of air pollution, flooding and noise.

## People and daily routine

The guidance recommends trained staff on site during plant operation, with the competencies defined before the manufacturer training and capacity building to supplement it. Staff should complete daily checklists for early identification of critical malfunction, record daily oxygen production (separating pipeline supply from cylinder filling) and purity with at least two different analysers, follow a site-specific operational plan with an escalation pathway, and keep records of daily checks, preventive maintenance and repairs.

## Spare parts, service and backup

- A spare parts inventory of at least two years, stored in a designated secure space, actively tracked, with the list developed after consulting the manufacturer.
- A long-term warranty and maintenance contract, which the guidance puts at 5 years and strongly advises; see [how long a service contract should last](https://library.ultracontrolo.com/answers/how-long-should-a-psa-service-contract-last/).
- Contact details of the manufacturer, the spare parts source and the local service agent.
- A back-up plan for breakdowns and scheduled shutdowns, with a maximum number of shutdown days and an escalation procedure; see what backup to keep.

## Beyond the hospital

The Global Fund guidance calls PSA plants only one part of a complex national oxygen ecosystem. It asks for production to be compared with consumption every year: an underused plant can extend the pipeline or cylinder distribution to peripheral facilities, while an overused one can be supplemented with secondary or tertiary sources. WHO's Foundations of medical oxygen systems (17 February 2023) says long-term sustainability needs a resource ecosystem focused not only on production but also on distribution and delivery, ongoing maintenance and upkeep. See [what a national medical oxygen plan is](https://library.ultracontrolo.com/answers/what-is-a-national-medical-oxygen-plan/).

## Ultra Controlo

UltraCare, the Ultra Controlo technical assistance programme, covers preventive maintenance and monitoring, corrective service, original spare parts and rental equipment while a unit is serviced, 24 hours a day, 365 days a year. The ULTRAOX SC datasheet states one service at 10,000 hours, and an ULTRAOX enrolled in the UltraGreen plan runs on 100% renewable electricity, from on-site solar or certified green energy contracts.

### How much spare parts stock should a PSA plant keep?

Global Fund sustainability guidance (2024) recommends an inventory of at least two years, stored in a designated secure space and actively tracked, with the list developed after consulting the manufacturer.

### What if a plant is underused or overused?

The same guidance says to compare production with consumption every year: extend the pipeline or cylinder distribution if the plant is underused, and add secondary or tertiary sources if it is overused.

## Sources

- [Global Fund / Build Health International, Overview: Sustainability Guidance for PSA Oxygen Plants (22 August 2024)](https://resources.theglobalfund.org/media/bwrp43cm/cr_c19rm-psa-oxygen-plant-sustainability_overview_en.pdf)
- [UNDP, REQ-OXY-001 v01, Technical and regulatory requirements for oxygen plants (effective 1 January 2025)](https://healthimplementation.undp.org/wp-content/uploads/2025/01/REQ-OXY-001-v01-UNDP-TECHNICAL-REGULATORY-REQUIREMENTS-FOR-OXYGEN-PLANTS.pdf)
- [Lancet Global Health Commission on medical oxygen security (Lancet Glob Health 2025; 13(3): e528, 17 February 2025)](https://pmc.ncbi.nlm.nih.gov/articles/PMC11865010/)
- [Open Critical Care FAQ (Assist International): What are the key considerations when designing a sustainability plan for oxygen supply?](https://opencriticalcare.org/faq/what-are-the-key-considerations-when-designing-a-sustainability-plan-for-oxygen-supply/)
- [WHO, Foundations of medical oxygen systems (17 February 2023)](https://iris.who.int/server/api/core/bitstreams/4ad6f5fd-089e-4142-8439-b64e98d816d8/content)
- [Ultra Controlo, Medical gas answers: What is UltraCare?](https://www.ultracontrolo.com/medical-gas-answers#what-is-ultracare)
- [Ultra Controlo, Medical gas answers: What is UltraGreen?](https://www.ultracontrolo.com/medical-gas-answers#what-is-ultragreen)
- [ULTRAOX SC datasheet, p. 2](https://www.ultracontrolo.com/products/ultraox)

Reviewed: 2026-10-22. Ultra Controlo engineering. https://library.ultracontrolo.com/answers/what-is-an-oxygen-ecosystem-sustainability-plan/