NES 106 Part 1 Requirements for Medical and Dental Organization in HM Surface Ships and Submarines

Ministry of Defence Defence Standard 02-106 (NES 106)

Issue 1 Publication Date 01 April 2000

Incorporating NES 106 Category 2

Issue 1 Publication Date July 1993

Requirements For Medical AndDental Organization In HM Surface

Ships And Submarines

Part 1Common Requirements - Medical And

Dental Facilities

DStanDStan is now the publishing authority for all Maritime Standards (formerly NESs). Any reference to any other publishing authority throughout this standard should be ignored.Any queries regarding this or any other Defence Standard should be referred to the DStan Helpdesk as detailed at the back of this document.

AMENDMENT RECORD

Amd No Date Text Affected Signature and Date

REVISION NOTE

This standard is raised to Issue 1 to update its content.

HISTORICAL RECORD

This standard supersedes the following:

Naval Engineering Standard (NES) 106 Part 1 Issue 1 dated July 1993.

Ministry of Defence

Naval Engineering Standard

NES 106 Part 1 Issue 1 (Reformatted) July 1993

REQUIREMENTS FORMEDICAL AND DENTAL ORGANIZATION

IN HM SURFACE SHIPS AND SUBMARINES

PART 1

COMMON REQUIREMENTSMEDICAL AND DENTAL FACILITIES

This NES Supersedes

DGS 89DGS 90

Record of Amendments

AMDT INSERTED BY DATE

1

2

3

4

5

6

7

8

9

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NAVAL ENGINEERING STANDARD 106

REQUIREMENTS FOR MEDICAL AND DENTAL ORGANIZATION

IN HM SURFACE SHIPS AND SUBMARINES

PART 1

ISSUE 1 (REFORMATTED)

COMMON REQUIREMENTSMEDICAL AND DENTAL FACILITIES

The issue and use of this Standard

is authorized for use in MOD contracts

by MOD(PE) Sea Systems and

the Naval Support Command

ECROWN COPYRIGHT

Published by:

Director of Naval ArchitectureProcurement Executive, Ministry of DefenceSea Systems, Foxhill, Bath BA1 5AB

NES 106Part 1

Issue 1 (Reformatted)

iii

SCOPE

1. This Part of the NES defines the Common Requirements for Medical and Dental Facilities inHM Surface Ships and Submarines.

Note: Specific requirements are contained in Parts 2 to 4.

NES 106Part 1Issue 1 (Reformatted)

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NES 106Part 1


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FOREWORD

Sponsorship

1. ThisNaval Engineering Standard (NES) is sponsored by theProcurement Executive, Ministryof Defence, Director Naval Architecture (DNA), Section NA 145.

2. This NES comprises:

Part 1 Common RequirementsMedical and Dental Facilities

Part 2 Specific RequirementsMedical and Dental Facilities in HM Surface Ships

Part 3 Specific RequirementsMedical Organization for Action in HM Surface Ships

Part 4 Specific RequirementsMedical and Dental Facilities in HM Submarines

The Specific Requirements are to be read in conjunction with the Common Requirements,Part 1.

3. If it is found to be technically unsuitable for any particular requirement the Sponsor is to beinformed in writing of the circumstances with a copy to DNA, NA 145.

4. Any user of this NES either within MOD or in industry may propose an amendment to it.Proposals for amendments that are

a. not directly applicable to a particular contract are to be made to the Sponsor of the NES

b. directly applicable to a particular contract are to be dealt with using existing proceduresor as specified in the contract.

5. No alteration is to be made to this NES except by the issue of an authorized amendment.

6. Unless otherwise stated, reference in this NES to approval, approved, authorized or similarterms, means by the Ministry of Defence in writing.

7. Any significant amendments that may be made to this NES at a later date will be indicatedby a vertical side line. Deletions will be indicated by 000 appearing at the end of the lineintervals.

8. This NES has been reissued to reflect changes in technical requirements and supersedes DGS89 and 90.

Conditions of Release

General

9. This Naval Engineering Standard (NES) has been prepared for the use of the Crown and ofits contractors in the execution of contracts for the Crown. The Crown hereby excludes allliability (other than liability for death or personal injury) whatsoever and howsoever arising(including but without limitation, negligence on the part of the Crown, its servants or agents)for any loss or damage however caused where the NES is used for any other purpose.

10. This document is Crown Copyright and the information herein may be subject to Crown orthird party rights. It is not to be released, reproduced or published without written permissionof the MOD.


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11. The Crown reserves the right to amend or modify the contents of this NES without consultingor informing any holder.

MOD Tender or Contract Process

12. ThisNES is the property of the Crown and unless otherwise authorized in writing by theMODmust be returned on completion of the contract, or submission of the tender, in connectionwith which it is issued.

13. When this NES is used in connection with aMOD tender or contract, the user is to ensure thathe is in possession of the appropriate version of each document, including related documents,relevant to each particular tender or contract. Enquiries in this connection may be made ofthe local MOD(PE) Quality Assurance Representative or the Authority named in the tenderor contract.

14. When NES are incorporated into MOD contracts, users are responsible for their correctapplication and for complying with contracts and any other statutory requirements.Compliance with an NES does not of itself confer immunity from legal obligations.

Related Documents

15. In the tender and procurement processes the related documents listed in each section andAnnex A can be obtained as follows:

a. British Standards British Standards Institution,389 Chiswick High Road,London W4 4AL

b. Defence Standards Directorate of Standardization and Safety Policy,Stan 1, Kentigern House, 65 Brown Street,Glasgow G2 8EX

c. Naval Engineering Standards CSE3a, CSE Llangennech, Llanelli,Dyfed SA14 8YP

d. Other documents Tender or Contract Sponsor to advise.

Note: Tender or Contract Sponsor can advise in cases of difficulty.

16. All applications to Ministry Establishments for related documents are to quote the relevantMOD Invitation to Tender or Contract Number and date, together with the sponsoringDirectorate and the Tender or Contract Sponsor.

17. Prime Contractors are responsible for supplying their subcontractors with relevantdocumentation, including specifications, standards and drawings.

NES 106Part 1


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Health and Safety

Warning

18. ThisNESmay call for the use of processes, substances and/or procedures thatmay be injuriousto health if adequate precautions are not taken. It refers only to technical suitability and inno way absolves either the supplier or the user from statutory obligations relating to healthand safety at any stage of manufacture or use. Where attention is drawn to hazards, thosequoted may not necessarily be exhaustive.


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NES 106Part 1


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CONTENTSPage No

TITLE PAGE i. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SCOPE iii. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

FOREWORD v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sponsorship v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Conditions of Release v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .MOD Tender or Contract Process vi. . . . . . . . . . . . . . . . . . . . . . . . . .

Related Documents vi. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Health and Safety vii. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Warning vii. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CONTENTS ix. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 1. ORGANIZATION 1.1. . . . . . . . . . . . . . . . . . . . . . . . . . .1.1 Authority 1.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1.2 Relationship with DGST(N) 1.1. . . . . . . . . . . . . . . . . . .1.3 Medical and Dental FacilitiesSurface Ships 1.1. . . . .1.4 Classification 1.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1.5 Primary Medical and Dental Facilities 1.2. . . . . . . . . . .1.6 Medical Complex 1.2. . . . . . . . . . . . . . . . . . . . . . . . . . . .1.7 Secondary Medical Facilities 1.2. . . . . . . . . . . . . . . . . . .

TABLE 1.1 UTILIZABLE SPACE (m2) OFPRIMARY MEDICAL AND DENTALCOMPARTMENTS 1.3. . . . . . . . . . . . . . . . . . . . . . . . . .TABLE 1.2 UTILIZABLE SPACE (m2) ANDQUANTITY REQUIREMENTS OFSECONDARY MEDICAL FACILITIES 1.4. . . . . . . . .

1.8 Medical and Dental FacilitiesSubmarines 1.4. . . . . .

SECTION 2. LAYOUT 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.1 Surface Ships 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.2 Submarines 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

FIGURE 2.1 CO-RELATIONSHIP OFCOMPARTMENTSMEDICAL COMPLEXCLASS A AND B SHIPS 2.2. . . . . . . . . . . . . . . . . . . . . .FIGURE 2.2 CO-RELATIONSHIP OFCOMPARTMENTSMEDICAL COMPLEXCLASS C SHIPS 2.3. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 3. DRAWINGS 3.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.1 Drawing Standards 3.1. . . . . . . . . . . . . . . . . . . . . . . . . . .3.2 Security Classification 3.1. . . . . . . . . . . . . . . . . . . . . . . .3.3 Layout Drawings 3.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.4 Medical Organization for Action 3.2. . . . . . . . . . . . . . .

FIGURE 3.1 SYMBOLS FOR MEDICALORGANIZATION FOR ACTION 3.2. . . . . . . . . . . . . .

SECTION 4. FURNITURE AND FITTINGS 4.1. . . . . . . . . . . . . . . . .4.1 Modular Range of Furniture 4.1. . . . . . . . . . . . . . . . . . .


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4.2 Manufacture 4.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.3 Finish 4.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.4 Installation 4.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.5 Plinths 4.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.6 Bulkhead-Mounted Items 4.1. . . . . . . . . . . . . . . . . . . . .4.7 Overhead Transfusion Hooks 4.1. . . . . . . . . . . . . . . . . .4.8 Telephones 4.2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.9 Specialized Equipment 4.2. . . . . . . . . . . . . . . . . . . . . . . .4.10 Controlled Drugs Cupboard 4.2. . . . . . . . . . . . . . . . . . .

FIGURE 4.1 HOOKSOVERHEADTRANSFUSION 4.3. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 5. DOORS 5.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.1 Double Doors 5.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.2 Stable Doors 5.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.3 Sliding Doors 5.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.4 Door Hold-Back 5.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.5 Kick-out Panels 5.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.6 Sills 5.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 6. COMPARTMENT REQUIREMENTS 6.1. . . . . . . . . .6.1 Protrusions 6.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6.2 Insulation 6.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6.3 Lining 6.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6.4 Deck Coverings 6.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6.5 Painting 6.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 7. SERVICES 7.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7.1 Water Supplies and Drainage 7.1. . . . . . . . . . . . . . . . . .7.2 Electrical Requirements 7.1. . . . . . . . . . . . . . . . . . . . . . .7.3 240V AC Supply 7.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . .7.4 Emergency Power 7.1. . . . . . . . . . . . . . . . . . . . . . . . . . . .7.5 Safety Precautions 7.1. . . . . . . . . . . . . . . . . . . . . . . . . . .7.6 Distribution Boxes 7.1. . . . . . . . . . . . . . . . . . . . . . . . . . .7.7 Loudspeakers 7.2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7.8 Air Supplies 7.2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 8. ENVIRONMENTAL CONDITIONS 8.1. . . . . . . . . . . .8.1 Temperature 8.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8.2 Ventilation 8.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8.3 Illumination Levels 8.1. . . . . . . . . . . . . . . . . . . . . . . . . . .

TABLE 8.1 ILLUMINATION LEVELS (LUX) 8.2. . .

SECTION 9. MATERIALS 9.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9.1 Responsibility for Supply of Fittings 9.1. . . . . . . . . . . .9.2 Timber and Plywood 9.1. . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 10. INSPECTIONS 10.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10.1 Planning 10.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10.2 Attendance at Inspections 10.1. . . . . . . . . . . . . . . . . . . . .

NES 106Part 1


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10.3 Line-Out Inspections 10.1. . . . . . . . . . . . . . . . . . . . . . . . .10.4 Preliminary Inspection 10.1. . . . . . . . . . . . . . . . . . . . . . . .10.5 Final Inspection 10.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . .10.6 Certification 10.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10.7 Inspection of Dental Equipment 10.1. . . . . . . . . . . . . . . .

ANNEX A RELATED DOCUMENTS A.1. . . . . . . . . . . . . . . . . . . .

ANNEX B DEFINITIONS AND ABBREVIATIONS B.1. . . . . . . .


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NES 106Part 1


1.1

1. ORGANIZATION

a. This section deals with the Organizational Requirements and factors thatenable an efficient Medical and Dental Facility in HM Ships to be achieved.

1.1 Authority

a. The MDG(N) is responsible for all matters relevant to Medical and DentalFacilities at sea. MDG(N) advises the DOR(Sea) on the extent of Medical andDental Facilities to be incorporated into the Naval Statement of Requirement(NSR) for each design.

b. The Staff Officer 3 (Medical (Policy and Plans)) SO3(MED (P&P)), superviseson behalf of MDG(N), the disposition and detailed design and equipmentaspects for Medical Facilities incorporated into the Ship Specification.

1.2 Relationship with DGST(N)

a. The S03 (Med P&P) provides a consultancy service to DGST(N) for RFA vessels.Department of Trade regulations will be applied where these are in accord withoperational requirements.

1.3 Medical and Dental FacilitiesSurface Ships

a. A completely self-contained hospital facility capable of treating both INPATIENTS and OUT PATIENTS is to be provided on all HM Ships of Frigatesize and larger.

b. The Medical and Dental Facilities required in Minor War Vessels, with acomplement up to 100, are to be identified in consultation with MDG(N) whenthe Ships Requirement is prepared.

c. The extent of Medical and Dental Facilities incorporated into the NSR dependson the function of the ship and both its permanent and temporarily embarkedcomplement.

d. Certain ships or classes of shipsmay be required to provide an increased ormorecomprehensive Medical cover to other ships in the Fleet or to assist in civilemergencies.

e. Facilities provided afloat may be augmented by helicopter transportation tocivil or military hospitals ashore or other RN vessels in the area. Under actionconditions or from a consideration of a patients medical condition, this optionmay not be immediately available.

f. Medical and Dental Facilities are divided into Primary Medical and DentalFacilities and Secondary Medical Facilities.

1.4 Classification

a. The classification of Medical and Dental Facilities are as follows:

Class Function Complement

A CVS 1000 and over

B LPD/LPH 301 to 1000

C DD/FF/OSV/MCMV 101 to 300

D Minor War Vessels up to 100


1.2

1.5 Primary Medical and Dental Facilities

a. The Primary Medical and Dental Facilities and their corresponding utilizablespaces for designated purposes are shown in TABLE 1.1.

b. The compartment areas shown are to be considered as a minimum. Whenconsidering larger ships within each class, larger areas and additional facilitiesmay be required.

1.6 Medical Complex

a. The Medical Complex, made up from the Primary Medical and Dental Facilitieslisted in TABLE 1.1, is to be sited inside the Citadel and is to be:

(1) entirely self-contained with access to all internal compartments withinthe confines of the Complex;

(2) as near as possible to midships;

(3) on or above the Main Communications Deck;

(4) readily accessible to all members of the ships company;

(5) at a height such that the ships motion is at a minimum;

(6) as far away as possible from sources of heat, noise and infection;

(7) in ships with aircraft lifts, to have direct access to the Flight Deck viathe lift;

(8) accessible to stretcher cases from all parts of the ship. The dimensions ofa General Service Stretcher are 2300mm 590mm requiring a clearopening of 700mm and a minimum turning radius around corners of3000mm.

b. Some Medical and Dental Facilities may be combined. Where this occurs theMedical Compartments are to be enhanced in area to accommodate the DentalFacilities.

c. Compartments that may be combined are the Waiting Areas and Receptions.

d. Where Dental Facilities are incorporated with Medical Facilities there will be amixture of permanent Dental fittings and optional fit equipment as advised byDNDS/MDG(N).

e. In Ships where Dental Facilities are separate from the Medical Complex theDental Waiting Area, Dental Reception, Dental Surgery and Dental Laboratoryare to be in a block unit and not separate from one another so forming a DentalClinic.

1.7 Secondary Medical Facilities

a. The Secondary Medical Facilities are to provide cover under emergencyconditions through the distribution of medical equipment throughout the shipand the provisioning of locations from which First Aid Parties may operate.

b. Secondary Medical Facilities comprise:

(1) Secondary Medical Position (SMP).

(2) Casualty Sorting area.

NES 106Part 1


1.3

(3) Medical (Emergency) Stores.

(4) Upper Deck Medical Station.

(5) First Aid Posts.

(6) First Aid Boxes.

(7) Stretchers.

These are to be provided in all Classes of Ship. Class A and B ships are to be alsoprovided with an Emergency Ward.

c. Secondary Medical Facilities form an integrated system which is incorporatedinto the Medical Organization for Action as detailed in Part 3 of this NES.

d. The Secondary Medical Facilities area requirements and quantities are detailedin TABLE 1.2.

Class of Ship (see Clause 1.4a.) A B C

Compartment Area m2

Lobby/Waiting Area 21 16

Reception 7.5 6.5

Consulting Room 8.0* 8.0

Surgery 11

Treatment Room/Dispensary 12.0 12.0

Dental Surgery 16.0 16.0

Dental Laboratory 10.0

Pathological Laboratory/Dark Room 7.0

Main Ward 46.0 28.0 6.0

Isolation Ward 10.0

Ward Pantry 3.5

Operating Theatre 17.0

Sterilizing Room 4.5 4.5

Toilet and Wash Facilities

Bathroom 4.0 4.0 4.0

Shower-room 3.0* 3.0

WC 1.5* 1.5

Medical Stores See NES 126

*2 compartments requiredTABLE 1.1 UTILIZABLE SPACE (m2) OF PRIMARY MEDICAL AND DENTAL

COMPARTMENTS


1.4

Class of Ship (See Clause 1.4) A B C

Facility Area m2

Secondary Medical Position comprisingSecondary Medical Position comprising

Permanent Fittings Area 0.8 0.8 0.8

Working Area 5.7 5.7 5.7

Emergency Ward SuitableWardroom/Dining Room

Casualty Sorting Area Room 7.5 7.5 7.5

Emergency Medical Stores See NES 126

Numbers required

Upper Deck Medical Station 2 2 2

First Aid Post 46 46 23

First Aid Box As advised byMDG(N)

Stretchers

Neil Robertson 5% of complement

General Service 3% of complement

Transport 2 2 1

TABLE 1.2 UTILIZABLE SPACE (m2) AND QUANTITY REQUIREMENTS OFSECONDARY MEDICAL FACILITIES

1.8 Medical and Dental FacilitiesSubmarines

a. Medical and Dental Facilities required for Submarines are as follows:

(1) Primary Facilities These require a dedicated space for consultation andtreatment.

(2) Secondary Facilities These require space to carry out emergencyoperations augmented by First Aid Boxes and Bags.

(3) Storage A secure store comprising 4m3 of usable space is to be provided.

NES 106Part 1


2.1

2. LAYOUT

2.1 Surface Ships

a. To assist in planning an acceptable Medical Complex layout and to meet statedrequirements the co-relationship of Medical and Dental Compartments issummarized in FIGURE 2.1 and FIGURE 2.2. The subject of Ship Husbandryis to be taken into account and is to comply with NES 139.

b. The minimum effective deck areas for designated compartments are detailed inTABLE 1.1 for each class of ship based on its function and complement.

c. The Primary Facilities are to be entirely self-contained with access to allinternal compartments within confines.

d. As a general rule individual compartments are to be arranged into two groups,Out Patients and In Patients, thus ensuring that day-to-day traffic issegregated.

e. The Out Patients group will comprise those compartments which are attendedby walking patients and will include Dispensaries, Consulting Rooms andReception.

f. The In Patients group is composed of those compartments which are used byor for non-mobile patients.

g. No ward is to be accessed from another ward.

h. Treatment Room/Dispensaries are not to be directly accessible from Wards butare to have direct access to the Operating Theatre.

i. Medical Reception is to be positioned near the main entrance doors and next tothe Consulting Room(s).

2.2 Submarines

a. The layout of Medical and Dental Facilities for Submarines is detailed in Part 4of this NES.


2.2

FIGURE 2.1 CO-RELATIONSHIP OF COMPARTMENTSMEDICAL COMPLEX CLASS A AND B SHIPS

NES 106Part 1


2.3

FIGURE 2.2 CO-RELATIONSHIP OF COMPARTMENTSMEDICAL COMPLEX CLASS C SHIPS


2.4

NES 106Part 1


3.1

3. DRAWINGS

a. The following clauses outline the drawings required for the design andconstruction of Medical and Dental Compartments.

3.1 Drawing Standards

a. Drawings are to comply with DEF STAN 0510 and NES 722.

3.2 Security Classification

a. All drawings associated with Medical and Dental arrangements are to beclassified no higher than RESTRICTED.

3.3 Layout Drawings

a. The Shipbuilder/Contractor will be provided with guidance sketches and itemlists by MOD(PE) in consultation with MDG(N) based on the Ship or ClassSpecification and this NES.

b. The Shipbuilder/Contractor is to prepare and submit toMOD(PE) for approval,layout drawings and item lists of each Medical and Dental Compartmentshowing the main features of the structure and the position of all the fittingsto enable the compartment to be completely fitted out.

c. The layout drawings, in scaled outline, are to detail the position of the followingfeatures:

(1) all fitted furniture;

(2) all doors and drawers, showing their open positions in critical areas;

(3) all major Medical and Dental equipment in their working and stowedpositions;

(4) general compartment lighting positions including Auxiliary EmergencyLights (AEL) and Red Safety Lights;

(5) overhead Operating Theatre lights centred over the operating position;

(6) overhead transfusion hooks;

(7) switch sockets stating their voltage, current rating and usage;

(8) wash basins, sluices, sink fittings etc, stating type(s);

(9) hot and cold fresh water supplies, deck drains etc;

(10) all communications;

(11) portable furniture positions and stowages;

(12) line of bulkhead, deckhead and shipside linings.

d. All extraneous services are to be kept clear of medical spaces particularly insterile areas.


3.2

3.4 Medical Organization for Action

a. A drawing for the Medical Organization for Action known as the WhereaboutsDiagram is to be prepared by the Shipbuilder/Contractor and submitted to theMOD(PE) for approval by MDG(N).

b. The Whereabouts Diagram is for use during emergencies to direct casualtiesand First Aid party movements throughout the ship.

c. The Whereabouts Diagram is to be metric, scale 1:100 or 1:200, showing alldeck plans, accesses, including hatches and doors, with the symbols shown inFIGURE 3.1 superimposed to indicate the locations of First Aid equipment inthe ship.

COMPARTMENT OREQUIPMENT SYMBOL COLOUR REMARKS

Primary Complex PC BLACK letteringRED ground

Compartmentperiphery to beoutlined in RED

Secondary Medicalposition

SMP BLACK letteringGREEN ground

Compartmentperiphery to beoutlined in GREEN

Upper Deck MedicalStation

UDMS

Medical Store MS

Emergency MedicalStore

EMS BLACK letteringRED ground

Compartmentperiphery to beoutlined in RED

First Aid Post FAP

First Aid Cabinet(Fixed)

C

First Aid Cabinet(Portable)

C

First Aid Box 1. (below) RED crossWHITE groundStretcherNeil Robertson 2. (below)

BLACK letteringRED ground Enter the Number of

StretcherGeneral Service 3. (below)

BLACK letteringBLUE ground

Enter the Number ofStretchers in thebottom half of the

b lStretcherTransport 4. (below)

BLACK letteringGREEN ground

symbol

FIGURE 3.1 SYMBOLS FOR MEDICAL ORGANIZATION FOR ACTION

1. 2. N3. G4. T

NES 106Part 1


4.1

4. FURNITURE AND FITTINGS

4.1 Modular Range of Furniture

a. All furniture and fittings in theMedical Complex other than specializedMedicalitems are to comply with the Modular Range of Furniture specified in NES 128and in consultation with MDG(N) at the design stage.

4.2 Manufacture

a. All furniture carcases and doors are to be flush-sided and devoid of anypanelling, ornamental mouldings etc, where dust and dirt could accumulate.

b. The inner floor of cupboards, shelves etc, are to be flush for easy cleaning.

c. Furniture manufactured to sizes and shapes different from the ModularFurniture Range are to be to the same design, quality and materialspecifications.

4.3 Finish

a. Furniture in all clinical areas is to be finished in white, whilst that in offices isto have a colour scheme conforming to MDG(N) selection in compliance withMaster Decor Scheme NES 184.

b. Finishes are to be solvent resistant.

4.4 Installation

a. Furniture and Fittings are to be securely fastened and fitted without gaps andspaces so that they can be easily cleaned and sterilized to maintain a hygienicstate at all times.

b. Where tops of cupboards or lockers extend above eye level (approx 1700mm), thespace above is to be fitted into the false ceiling or deckhead to avoid theaccumulation of dust. If space permits a cupboard may be fitted.

4.5 Plinths

a. Plinths are to be scribed to the shear and camber of the deck.

b. Plinths are to be sealed to prevent the ingress of water and dirt.

4.6 Bulkhead-Mounted Items

a. The bottoms of bulkhead-mounted cupboards, shelves etc, are to be sited460mm above the work surface.

4.7 Overhead Transfusion Hooks

a. Overhead stainless steel transfusion hooks are to be provided and sited asfollows:

(1) Two over each ward two-tier bunk sited 300mm in from each end of thebunk and 100mm out from the side.

(2) Four over each operating table, casualty/resuscitation couch or trolley;the hooks are to be 300mm in from each end and 100mm out from thesides.


4.2

b. In the SMP the hooks are to be removable and stowed in theMedical EquipmentCupboard when not in use.

c. The hooks are detailed in FIGURE 4.1.

4.8 Telephones

a. Telephones are to be bulkhead mounted where possible.

4.9 Specialized Equipment

a. Specialized equipment, where specified, is to be supplied by DNDS/MDG(N)and to be fitted by contractors nominated by MOD.

4.10 Controlled Drugs Cupboard

a. Controlled Drugs are to be stored ina cupboard constructed and fitted to complywith the Misuse of Drugs (Safe Custody) Regulations 1973 and BS 2881.

b. Cupboards are to be provided with an internal lockable compartment complyingwith Service Policy.

NES 106Part 1


4.3

FIGURE 4.1 HOOKSOVERHEAD TRANSFUSION


4.4

NES 106Part 1


5.1

5. DOORS

a. Standard non-watertight double skinned aluminium alloy doors are to beprovided in compliance with NES 127.

b. Medical Compartment doors are not to be fitted with viewing windows.

5.1 Double Doors

c. Double doors are to be provided for the Main Entrance to the Medical Complex,and doors into the Operating Theatre, Surgery, Treatment Room/Dispensaryand Wards.

d. The doors are to suit an opening of 1800mm high 12001400mm wide. Onedoor, for normal use, is to be 765mm wide with the narrower door making upthe balance of the opening. The narrower door is to be bolted top and bottomwith the other secured by a mortice lock.

e. A kick-out panel is to be fitted to the wider door.

5.2 Stable Doors

a. Stable doors are to be provided for Dispensaries, the lower door is to have ahingedwork surface on the compartment side and to be provided with akick-outpanel.

b. The doors are to be capable of being fastened together as one door.

5.3 Sliding Doors

a. Sliding doors are to be provided for Consulting Rooms, Medical Reception andfor all other compartments in preference to hinged doors.

b. A kick-out panel is to be provided.

c. A curtain and fittings are to be provided over the door in the Consulting Roomsand Medical Reception. The curtain is to comply with NES 129.

5.4 Door Hold-Back

a. Doors are to be provided with automatic hold-backs to secure the doors in theopen position.

5.5 Kick-out Panels

a. Kick-out panels are to comply with NES 119, andmay be louvred to assist in aircirculation.

5.6 Sills

a. Sills at the main entrance and between main compartments within theMedicalComplex are not generally specified as they restrict access of trolleys andwheeled equipment, however the watertight integrity of the ship must remainparamount and where sills are unavoidable they are to be 150mm high.


5.2

NES 106Part 1


6.1

6. COMPARTMENT REQUIREMENTS

6.1 Protrusions

a. Compartments are to be free from protrusions to facilitate cleaning and themaintenance of a high standard of hygiene.

b. Through-runs of trunking, cables, pipes, valves etc are to be routed through thecompartment above the deckhead lining. Portable access covers are to beprovided and suitably numbered. A key is to be provided in each compartmentfor the access covers.

c. System exhausts and supply are not to be terminated in ceiling spaces.

d. Bulkhead stiffeners, angles, swedging brackets etc are to be arranged outsidethe compartment.

6.2 Insulation

a. All insulation is to comply with NES 703.

6.3 Lining

a. Bulkheads, shipsides and deckheads are to be fully lined with aluminiumbacked 3mm thick HPL, fitted in compliance with NES 130, Parts 1 and 2.

6.4 Deck Coverings

a. Deck coverings are to comply with NES 157, Part 1 and laid in compliance withNES 157 Part 2.

b. Deck coverings are to be laid up to but not under fixed furniture and equipment.

c. Boundaries are to be finished with covings to suit the deck covering.

d. In all classes of ship coil matting is to be provided inside the main entranceextending 1000mm into the complex.

e. The matting is to be sunk into a well such that the surface is continuous withthe rest of the deck covering.

6.5 Painting

a. Painting of compartments is to comply with NES 763 and 774.

b. The decor scheme will be selected by MDG(N) from the Master Decor Schemein compliance with NES 184.

c. The decor scheme once selected is to be maintained in its entirety and notaltered or raised subsequently unless at a Major Refit with the approval ofMDG(N).


6.2

NES 106Part 1


7.1

7. SERVICES

7.1 Water Supplies and Drainage

a. The installation of hot and cold fresh water supplies is to be in compliance withNES 728.

b. Hot water requirements are to be from the ships main domestic supply.

c. Bathrooms, wash facilities, WCs, sluices etc are to comply with NES 120.

d. All thermostatic mixing valves controlling supplies of hot water to shower headsare to be pre-set at 43 C.

e. Elbow level taps are to be fitted to surgeons sinks andwash basins in all clinicalareas. A clear space of 300mm each side of the top of the basin is to be provided.

f. Drainage facilities for sewage and waste water, including screw-down type deckdrains, are to comply with NES 712 and NES 710.

g. Leads of pipes are to be run behind linings and above false ceilings where fitted.Portable covers or doors for access to valves etc are to be flush-fitted in liningsand ceilings. Each cover is to be identified by a tally plate.

7.2 Electrical Requirements

a. Electrical installation in all Medical and Dental Areas is to be in compliancewith NES 502.

b. The lighting system is to comply with NES 587 Parts 1 and 2.

c. Switch sockets and light switches are to be flush fitting and all electrical cablesare to be run behind the lining and between beams above false ceilings. Wherethis is unavoidable, cables running on the surface of linings are to be enclosedin a suitable easy-clean conduit with switches adequately secured to the lining.

7.3 240V AC Supply

a. A 240V AC supply, as well as the ships normal 115V AC supply, is to be providedin the Complex for Medical Equipment.

7.4 Emergency Power

a. An emergency power supply for both 115V and 240V AC is to be provided.

7.5 Safety Precautions

a. The following safety precautions are to be taken in the Operating Theatre,Treatment Room/Dispensary and Dental Surgery:

(1) the floors are to be covered by an anti-static floor covering;

(2) controlled earth leakage is to be fitted to the Operating Table;

(3) spark-proof electrical equipment and fittings are to be supplied;

(4) low-level vent exhaust systems are to be installed.

7.6 Distribution Boxes

a. Distribution boxes are to be mounted external to Medical and DentalCompartments. Where this is impracticable they should be grouped together ina recess with a suitable, tallied, flush access cover.


7.2

7.7 Loudspeakers

a. SRE loudspeakers with volume control are to be fitted in all Compartments.

7.8 Air Supplies

a. Air supplies are to comply with NES 314.

NES 106Part 1


8.1

8. ENVIRONMENTAL CONDITIONS

8.1 Temperature

a. Clinical areas are to maintain a range of temperatures for maximum comfortof patients. Values given are ambient; variation is to be achieved by use ofnon-luminous radiant heaters or air-conditioning units.

b. An ambient temperature of 18 C is to be maintained in the following areas:

(1) Lobby/Waiting Area and passageways.

(2) Reception.

(3) Dental Surgery.

(4) Laboratory.

(5) Ward Pantry.

(6) Sterilizing Room.

c. An ambient temperature of 21 C is to be maintained in the following areas:

(1) Consulting Room.

(2) Main Ward.

(3) Isolation Ward.

d. An ambient temperature of 21 C is to be maintained but is to be quicklyadjustable by the surgeon as dictated by the patients condition in the followingareas:

(1) Operating Theatre.

(2) Treatment Room/Dispensary.

(3) Surgery.

8.2 Ventilation

a. The integrity of the Citadel remains paramount in considering the ventilationrequirements. Within this constraint the Medical Complex is to maintain apositive pressure in relation to adjacent compartments in order tominimize thespread of infection.

b. Similarly the Operating Theatre is to have a relative positive pressure inrelation to adjacent Medical Compartments.

c. Ventilation within the Complex is to be sufficient to achieve five changes of airper hour within each compartment.

d. Air-conditioning and ventilation are to be arranged in compliance withNES 102.

8.3 Illumination Levels

a. Lighting levels as detailed in TABLE 8.1 are to be provided. Colour-correctedtubes are to be used where indicated.

b. Red safety lights are to be provided in areas as indicated in TABLE 8.1.


8.2

c. Light fittings in Reception are to be provided with diffusers to reducereflectivity and glare on to computer screens.

COMPARTMENT LuxGeneral Lux LocalRedSafetyLights

Lobby/Waiting Area 300 Colourcorrected

1

Reception 350 400 1

Consulting Room and Surgery 350 400 Colourcorrected

Treatment Room/Dispensary 350 400 Colourcorrected

1

Dental Surgery 200 400 Colourcorrected

Laboratories 200 400

Main Ward and Isolation Ward 150 400 Colourcorrected

25

Operating Theatre 400 Special Colourcorrected

1

Toilet Facilities 100

First Aid Posts 300 1

TABLE 8.1 ILLUMINATION LEVELS (LUX)

NES 106Part 1


9.1

9. MATERIALS

9.1 Responsibility for Supply of Fittings

a. Where indicated in this NES items defined as Shipbuilder Supply or MinistrySupply Items are for guidance only and do not supersede the ShipsSpecification.

b. The Ships Specification will state which items are the responsibility of theContractor/Shipbuilder, MDG(N) and MOD(PE). The compartment layoutdrawing will indicate their allowances and stowage positions.

c. Supply of Medical and Dental Equipment is the responsibility of MDG(N).

9.2 Timber and Plywood

a. The use of timber and plywood is to be kept to a minimum; however, where itis used, it is to comply with NES 188. Any hardwood used is to be obtained froma sustainable source.


9.2

NES 106Part 1


10.1

10. INSPECTIONS

a. The inspection of Medical and Dental compartments is to be carried out incompliance with BR 1921 and NES 32.

10.1 Planning

a. Planned dates for Line-Out, Preliminary and Final Inspections ofcompartments are to be communicated to DCOS(MEC) CINCFLEET who willbe the Inspecting Authority for the acceptance of each stage. Inspections are notto be requested until each space has been completed.

10.2 Attendance at Inspections

a. MOD(PE) representatives are to attend in a design advisory capacity for theFirst of Class building and major refits.

b. Where a separate Dental Clinic is provided a representative nominated byDNDS toMDG(N) is to attend all First of Class inspections and subsequent restof class inspections where requested to do so.

10.3 Line-Out Inspections

a. Line-Out Inspection equipments are to be identified in the contract by theWarship Project Manager.

10.4 Preliminary Inspection

a. A Preliminary Inspection of compartments is to be conducted at the 60%completion stage with important items, such as the Operating Table andlighting arranged to highlight:

(1) any operational difficulties and

(2) to give guidance on the application of the approved layouts and equipmentdrawings.

10.5 Final Inspection

a. The Final Inspection requires that the compartments are complete and fullyoperational so that a complete check can be carried out.

b. Inspection of the Secondary Medical Facilities is to be scheduled at such timewhen all other work in passageways has been completed. This is to be done toavoid the possibility of subsequent damage to fittings.

10.6 Certification

a. At Final Inspection, the following certification is required:

(1) Earthing integrity of the Operating Table and the Dental Equipment;

(2) Lighting standards achieved.

10.7 Inspection of Dental Equipment

a. DNDS or his representative is to be requested to attend ship before final placingand fixing of theDental chair and Specialized Dental equipment to confirm thatthe positioning of these items conforms to the approved drawings and isacceptable.

b. The requirement of Clause 10.7a. is not necessary if it can be agreed andincorporated at the Line Out or Preliminary Inspection stage.


10.2

NES 106Part 1


A.1 ANNEX A

ANNEX A.

RELATED DOCUMENTS

A.1 The following documents and publications are referred to in this NES:

Clause

BS 2881 Specification for cupboards for the storageof medicines in health care premises.

4.10a.

DEF STAN 0510 Drawing procedure 3.1a.

NES 32 Procedures for Inspections and TrialsDuring the Construction of Surface Ships

10.a.

NES 102 Requirements for Air Conditioning andVentilation Design

8.2d.

NES 119 Requirements for Fire Protection andDamage Control for Surface Ships

5.5a.

NES 120 Requirements for WCs, Urinals, Bathroomsand Washing Facilities in Surface Ships

7.1c.

NES 126* Requirements for Store Compartments inHM Surface Ships and Submarines

TABLE 1.1&TABLE 1.2

NES 127 Requirements for Access Fittings andEquipment

5.a.

NES 128* Requirements for Furniture and Fittings inSurface Ships and Submarines

4.1a.

NES 129 Requirements for Soft Furnishings andFabrics

5.3c.

NES 130 Requirements for Decorative Linings andComposite Bulkheads

6.3a.

Part 1 Decorative Linings

Part 2 Composite Bulkheads

NES 139 Code of Practice for Ship Husbandry 2.1a.

Part 1 Surface Ships

Part 2 Submarines

NES 157 Requirements for Deck Coverings 6.4a.

Part 1 General Requirements

Part 2 Deck Preparation and LayingProcedures

NES 184* Requirements for the Master Decor Schemefor Accommodation Areas in Surface Shipsand Submarines

4.3a.

NES 188 Requirements for the Procurement, Storageand Use of Timber

9.2a.

NES 314 Compressed Air Systems 7.8a.

NES 502 Requirements for Electrical Installation 7.2a.

* Not yet published


A.2ANNEX A

NES 587 Requirements for Lighting Systems 7.2b.

Part 1 Surface Ships

Part 2 Submarines

NES 703 Thermal and Acoustic Insulation of Hulland Machinery

6.2a.

NES 710 Fluid Systems General Requirements 7.1f.

NES 712 Requirements for Sewage and Grey WaterSystems for Surface Ships

7.1f.

NES 722 Requirements for the Preparation,Identification and Management ofDrawings

3.1a.

NES 763 Requirements for the Preservation andPainting of Compartments in Surface Ships

6.5a.

NES 774 Requirements for the Preparation andPainting of Submarines

6.5a.

BR 1921 Procedures for the Procurement of Ships,Submarines and vessels building bycontract

10.a.

Misuse of Drugs (Safe Custody) Regulations 1973 4.10a.

NES 106Part 1


B.1 ANNEX B

ANNEX B.

DEFINITIONS AND ABBREVIATIONS

B.1 For the purpose of this NES the following apply:

a. Definitions

Utilizable Space The area within a minimum deck height tothe underside of the deckhead lining of2135mm.

Classification of Medical andDental Facilities

(See Clause 1.4a.)

b. Abbreviations

AEL Automatic Emergency Lantern

CSA Casualty Sorting Area

DGST(N) Director General Stores & Transport (Navy)

DNDS Director Naval Dental Service

DOR(SEA) Director Operational Requirements (Sea)

FAP First Aid Post

HLP High Pressure Laminate

MDG(N) Medical Director General (Navy)

QAWT Quick Acting Watertight

RFA Royal Fleet Auxiliary

SO3 (MED(P&P)) Staff Officer 3 (Medical (Policy and Plans))

SMP Secondary Medical Position

SR(Sea) Staff Requirement (Sea)

SRE Sound Reproduction Equipment

UDMS Upper Deck Medical Station

VDU Visual Display Unit

Vessels

CVS Carrier

DD Destroyer

FF Frigate

LPD Landing Platform Dock

LPH Landing Platform Helicopter

MCMV Mine Countermeasure Vessel

OSV Ocean Survey Vessel


B.2ANNEX B

Inside Rear Cover

Crown Copyright 2000

Copying Only as Agreed with DStan

Defence Standards are Published by and Obtainable from:

Defence Procurement AgencyAn Executive Agency of The Ministry of Defence

Directorate of StandardizationKentigern House65 Brown Street

GLASGOW G2 8EX

DStan Helpdesk

Tel 0141 224 2531/2 Fax 0141 224 2503

Internet e-mail [email protected]

File Reference

The DStan file reference relating to work on this standard is D/DStan/69/02/106.

Contract Requirements

When Defence Standards are incorporated into contracts users are responsible for their correctapplication and for complying with contractual and statutory requirements. Compliance witha Defence Standard does not in itself confer immunity from legal obligations.

Revision of Defence Standards

Defence Standards are revised as necessary by up issue or amendment. It is important thatusers of Defence Standards should ascertain that they are in possession of the latest issue oramendment. Information on all Defence Standards is contained in Def Stan 00-00 Standardsfor Defence Part 3 , Index of Standards for Defence Procurement Section 4 Index of DefenceStandards and Defence Specifications published annually and supplemented regularly byStandards in Defence News (SID News). Any person who, when making use of a DefenceStandard encounters an inaccuracy or ambiguity is requested to notify the Directorate ofStandardization (DStan) without delay in order that the matter may be investigated andappropriate action taken.

CONTENTSTITLE PAGESCOPEFOREWORDSponsorshipConditions of ReleaseGeneralMOD Tender or Contract Process

Related DocumentsHealth and SafetyWarning

1. ORGANIZATION1.1 Authority1.2 Relationship with DGST(N)1.3 Medical and Dental FacilitiesSurface Ships1.4 Classification1.5 Primary Medical and Dental Facilities1.6 Medical Complex1.7 Secondary Medical FacilitiesTABLE 1.1 UTILIZABLE SPACE (m^2 ) OF PRIMARY MEDICAL AND DENTAL COMPARTMENTSTABLE 1.2 UTILIZABLE SPACE (m^2 ) AND QUANTITY REQUIREMENTS OF SECONDARY MEDICAL FACILITIES1.8 Medical and Dental FacilitiesSubmarines

2. LAYOUT2.1 Surface Ships2.2 SubmarinesFIGURE 2.1 CO-RELATIONSHIP OF COMPARTMENTS MEDICAL COMPLEX CLASS A AND B SHIPSFIGURE 2.2 CO-RELATIONSHIP OF COMPARTMENTS MEDICAL COMPLEX CLASS C SHIPS

3. DRAWINGS3.1 Drawing Standards3.2 Security Classification3.3 Layout Drawings3.4 Medical Organization for ActionFIGURE 3.1 SYMBOLS FOR MEDICAL ORGANIZATION FOR ACTION

4. FURNITURE AND FITTINGS4.1 Modular Range of Furniture4.2 Manufacture4.3 Finish4.4 Installation4.5 Plinths4.6 Bulkhead-Mounted Items4.7 Overhead Transfusion Hooks4.8 Telephones4.9 Specialized Equipment4.10 Controlled Drugs CupboardFIGURE 4.1 HOOKSOVERHEAD TRANSFUSION

5. DOORS5.1 Double Doors5.2 Stable Doors5.3 Sliding Doors5.4 Door Hold-Back5.5 Kick-out Panels5.6 Sills

6. COMPARTMENT REQUIREMENTS6.1 Protrusions6.2 Insulation6.3 Lining6.4 Deck Coverings6.5 Painting

7. SERVICES7.1 Water Supplies and Drainage7.2 Electrical Requirements7.3 240V AC Supply7.4 Emergency Power7.5 Safety Precautions7.6 Distribution Boxes7.7 Loudspeakers7.8 Air Supplies

8. ENVIRONMENTAL CONDITIONS8.1 Temperature8.2 Ventilation8.3 Illumination LevelsTABLE 8.1 ILLUMINATION LEVELS (LUX)

9. MATERIALS9.1 Responsibility for Supply of Fittings9.2 Timber and Plywood

10. INSPECTIONS10.1 Planning10.2 Attendance at Inspections10.3 Line-Out Inspections10.4 Preliminary Inspection10.5 Final Inspection10.6 Certification10.7 Inspection of Dental Equipment

ANNEX A. RELATED DOCUMENTSANNEX B. DEFINITIONS AND ABBREVIATIONS

NES 106 Part 1 Requirements for Medical and Dental Organization in HM Surface Ships and Submarines

Documents

Transcript of NES 106 Part 1 Requirements for Medical and Dental Organization in HM Surface Ships and Submarines