Have it all, with Modern Methods of Construction

Ask the Architect Blog Series #2: With Luke Irlam from DAY Architectural

Tell us a little about your experience in the industry.

I left university in 2003 having completed a 4-year architectural technology degree which covers design and the technical side of creating buildings, and I have been lucky enough to work with people who have allowed me to flex my own design muscles. After working with a small practice, I joined the healthcare team of a larger architectural practice. In 2013 I moved from being an Associate in that healthcare team to join DAY Architectural which had just six staff and one healthcare job. I wanted to help build a company from the ground upwards. I am now MD of a company with 80+ employees and a wide range of expertise and experience covering residential, student accommodation, education and healthcare which accounts for more than half of the business. We are a market leader and specialists in delivering complex and specialist large scale schemes in the acute healthcare environment, which is why we enjoy a natural partnership with MTX.

Why healthcare?

In healthcare every project – even the same type of facility – is different because of the environment or the specific requirements. We must be more creative in space planning, adaptable, pragmatic, have an ability to work with stakeholders who give hugely valuable input because they are the experts in their fields. We need an incredibly talented team who want to learn, and must share experiences and be able to delegate. We are also creating some of the most important and profound environments that you could ever work on, environments for clinical care or mental health, where people’s lives are saved or changed every day. It is incredibly rewarding and challenging. Within the architectural business there is sometimes a stigma attached because in healthcare we are not designing glitzy glamorous buildings. But you need to really understand how spaces come together to work and, of course, be able to do glitz and glamour when you get the chance.

MMC and Design for Manufacture & Assembly are key elements within the Construction Playbook, what are the key advantages?

Speed, control on costs, and the challenge of creating a building using these building blocks. MMC can sometimes restrict the design, so you need to consider the whole building and the whole design to produce a solution that suits specific modules and build-ups. The process is much more efficient and cost effective because all the components are there and easy to cost, enabling standardisation. When MMC works, it works well, but a lot depends on the delivery partner. MTX have great experience, passion, history and with them it works very well. I have worked on other MMC projects where it has not been so successful. The beauty of MMC is that if it is designed correctly and well managed, you can have it all – you can have it quick, at the right price and the right quality.

What are the most important considerations when designing for the healthcare sector?

It is all about the patients and the staff. We start from inside out – the schedule of accommodation, any critical adjacencies and the clinical circulation; how the best patient and staff flows can be achieved. The early feasibility stage is when experience is absolutely invaluable. If you have never designed for healthcare you will struggle. From the start you must understand how to create space that is compliant, that works and that is designed in conjunction with the key stakeholders. The rest looks after itself.

Is there a single project that demonstrates DAY Architectural relationship with MTX, and why the collaboration works so well?

The Diagnostic and Inpatient Unit at Frimley Park in Surrey – for Frimley Health NHS Foundation Trust – is a good example of our outstanding working relationship with MTX. Working with MTX and the design manager we made enhancements to the design with regards to buildability and fire regulations guidance and within weeks had RIBA stage 3 sign-off on a more effective solution, using the best elements of volumetric delivery within the cost envelope, and taking into account health guidance notes. But that fast turnaround and favourable result was only achieved through working as a team with MTX. We now have General Arrangement plans that will finally see it progress quickly. It is a delight to be working with reactive and innovative people who are prepared to be part of the journey to achieve the best solution for patients and staff.

Another example is the A&E at Leighton Hospital. We embarked on that with MTX in 2021 and delivered the project within 15 months. At the same time Day Architectural won a large A&E extension with a major Trust using traditional build techniques, and it is only now coming out of the ground. That illustrates the speed of good MMC – it is on another level.

What are the most significant barriers to the wider use of MMC?

Sometimes site considerations and constraints simply don’t lend themselves to module delivery, but education and perception are the biggest factors. Buildings using MMC are not cheap or shoddy; we are simply employing a kit of parts that is used to construct a high quality building that is just as safe and solid as a conventional build. More people need to understand and recognise the advantages, and forget outdated stereotypes.

Looking to the future of healthcare environments and MMC – what are the most significant changes ahead?

Zero carbon is going to have a profound impact on how buildings are designed, delivered, and costed, and added efficiency and speed of build is needed to make them more affordable. Healthcare is being broken down into elements of critical need, with business cases going in for innovative solutions like Community Diagnostic Centres to impact the COVID backlog and waiting lists. How can we get these non-acute diagnostic patients seen for procedures like CT scans and endoscopy – things you don’t necessarily need to go into hospital to access? The strategic solution appears to be more integration within the community with smaller more agile developments, that can meet the needs of patients without putting extra pressure on ‘hot’ clinical areas in hospitals. Much of the healthcare estate is at the end of its natural life and not fit for purpose, and we must find ways in the short term to make it work better.

What is the most important driver for you personally in delivering healthcare design and architecture?

I want to create the best environments that are adaptable and agile – and have longevity. I want to be able to go back in 20 or 30 years and see projects that may have changed but are still working. That they stand the test of time. I want to be proud of what we hand over and see staff and patients proud of it too.
There are no second chances on healthcare, because once it is designed, delivered and handed over, it is hugely difficult to go back and change it, because it is a vital asset in use daily to save and change lives. Getting it right first time requires using our knowledge and experience to design 90% of a project, but then the users come up with that extra 10% based on their knowledge and experience, and that helps to create the environments that work best.