A superb neurosurgery theatre is the latest, beautiful, life-saving healthcare facility resulting from collaboration with Lancashire Teaching Hospitals

2023      Neurosurgery theatre

The Vanguard facility most recently opened on a Lancashire Teaching Hospitals site is the splendid second neurosurgery theatre at Royal Preston. This theatre provided the capacity required to establish a regional neurosurgery centre for the Lancashire and South Cumbria Integrated Care Board (ICB). 

Vanguard provided a full turnkey service for the building of the theatre. Modules were constructed in its factory, while, on site, some gas containers were moved to a new location across the road and groundworks completed. Because the making of the modules and the preparation of the site were simultaneous, disruption of hospital activities and build time were greatly reduced. The new building was integrated with an existing theatre, previously supplied by Vanguard, requiring construction of a shared corridor and alterations to air conditioning ducting and to supplies of medical gases and power. Construction required lifting material by crane, over occupied hospital buildings, and this was completed over weekends in order to minimise disruption. Now that the two theatres are complete and operational, Vanguard is responsible for the servicing, maintenance and regular environmental testing.

Part of the project which saw the construction of the new neurosurgery theatre, was the repurposing of the neighbouring Vanguard modular construction. 

It improves patient experience. It improves our throughput, our emergency pathways, our trauma pathways, and our elective programme. 

2020      Interventional radiology room

This facility was built in 2020, when the Trust needed to refurbish an interventional radiology room. With the Trust having set ambitious plans for the project, between June and December 2020, Vanguard installed the modular build facility to replace the capacity for interventional radiology being lost during the refurbishment, complete with floor and ceiling mounted Philips Biplane.  Vanguard provided this facility on a turnkey basis while working within a constrained area, close to a Covid ward.

The Vanguard project team worked in close collaboration with the Trust on all aspects of the commissioning, deployment and delivery. This approach minimised risk as well as any ‘drift’ in the project timeline, something that was crucial to ensuring the facility was delivered on time and within budget.

“It was felt to be the only solution – to employ a modular lab while upgrading the current room and at the same time undertake to deliver our normal services. If we hadn’t chosen this solution, we would have had to reduce our services. We have a hybrid theatre with the surgeons, which we could have used, but it would have meant a lot of weekend working, impacting on morale, the wards and emergency services.”

When the Trust the reopened its newly refurbished interventional radiology room, it also identified an opportunity to introduce a new capability into the Integrated Care Board; neurosurgery.

2021      Neurosurgery theatre

Vanguard repurposed the modular interventional radiology room, including sealing the viewing window and creating a scrub area in the viewing room. This modular building, intended to serve as an interventional radiotherapy room for six months, is now a long-term neurosurgery theatre.

2019      Surgical hub for Ophthalmics and later, General Surgery

Lancashire Teaching Hospitals and Vanguard Healthcare Solutions first collaborated to provide a surgical hub for ophthalmic procedures. The Trust was repurposing theatres at Royal Preston from ophthalmics to trauma, and transferring the ophthalmic services to Chorley and Ribble District Hospital, where a new Eye Centre was being built. To bridge a gap between the repurposing at Preston and the opening of the new Eye Centre, the Trust discussed possible solutions with Vanguard.

Vanguard is unique in being able to provide mixed-modality facilities, which seamlessly combine mobile surgical theatres with modular constructions. Using the operationally ready mobile theatres reduces lead times and reduces costs, while the modular element provides design flexibility, ensuring the Trust’s and patients’ needs are met.

The modular section between the theatres has helped with patient flow in that we can admit and review pre-operatively and post-operatively in the same location. This has really helped to boost patient experience as it has meant that patients can be admitted on a pathway separate to the main admission area, keeping elective work going. We want to thank Vanguard for their support and expertise in getting the hub up and running.”

This facility comprised of two mobile theatres and, within the modular part, rooms in which patients would present, be seen by a nurse or consultant, and after the procedure recover, before being discharged. A corridor was built to connect the ophthalmic hub to the main hospital, and a back-up generator installed in case of the need for emergency power. One theatre delivered cataract vitreoretinal procedures under local anaesthetic. General anaesthesia ophthalmology procedures were conducted in the second theatre.

As well as providing the facility, Vanguard supplied staff and equipment to maximise the number of patients who would benefit.

The theatres were used daily, helping to reduce waiting lists for conditions such as glaucoma, ocular plastics, cancers of the eye, and cataracts. Covid-19 forced changes upon the Trust and the ophthalmic hub was repurposed. Being located away from the main hospital site and a self-contained environment made it ideal for emergency surgeries. During the first months of Covid-19, with elective surgery lists halted, the unit was used for emergency ophthalmology procedures, including emergency vitrectomies for detached retinas, as well as plastics, trauma and cancer surgeries.

The lists were full every day and the Vanguard team increased in number from five to eight to account both for the new procedures the team had to follow to be Covid-secure, and to allow for PPE changes, without slowing lists down. Staff were also sometimes asked to supplement the Trust’s staffing teams on the main theatres within the hospital.

When Covid restrictions eased, the surgical hub was again repurposed. This time, the versatile facility and clinical team concentrated on general surgery, contributing towards the Trust's determined efforts to address the elective backlog,