Reducing overcrowding and waiting times in the NHS
posted: 11th Mar 2019
The Modular and Portable Building Association says that hospitals need to ‘act now’ to ensure that they can provide the best possible facilities with the ever increasing need to reduce waiting times and overcrowding.
The Modular and Portable Building Association (MPBA) believes that the cost-effectiveness and speed with which modular buildings can be used to both construct new state-of-the-art hospitals from scratch and extend existing structures make them ideally suited for the health sector.
Jackie Maginnis, chief executive of the MPBA, explains: “Modular buildings provide a perfect solution for hospitals looking to access long-lasting buildings that truly cater for their needs both quickly and painlessly. It’s been well documented that many hospitals and part of the health sector face increasing pressure on their infrastructures over the next few years.
“At the MPBA, we want procurement departments/buyers to realise that modular buildings have the potential to be more cost-effective than conventionally built projects. Furthermore, because the structures are made to the highest standards off-site, modular buildings can and are frequently installed causing minimal disruption to staff and the existing patients.”
Jackie added that modular building companies specialise in providing a ‘complete service’ to hospitals and a variety of medical facilities from undertaking the initial design and carrying out all necessary groundwork to construction and nal t out. They can create standalone structures, single-storey ‘cluster’ departments, two-storey schemes or whole hospital con gurations. In addition to being tted-out for, wards, theatres, general of ces, kitchen and dining purposes, the expertise also exists to design, create and subsequently install more ‘specialist’ accommodation required by the clients.
Jackie continued: “When a hospital appoints a modular building company they know that on an agreed date they’ll be able admit patients to purpose-built, fully functioning premises that have been designed according to their precise requirements and budget. It’s my impression that nally clients are now starting to realise that you don’t have to employ one of the really big contractors and undertake a conventional build to get the premises they require.”
DID YOU KNOW?
Modular buildings are built in controlled, energy-efficient environments. From initial works to completion, it takes up to 67 per cent less energy to produce a modular building compared with a traditionally-built project. Whilst initial, onsite ground works are being completed; modules – which make up a modular building – are manufactured off-site, in a controlled, factory environment. Pre-fitted with electrics, plumbing, heating, doors, windows and internal finishes before they are taken to site, modular buildings can also be installed with energy-efficient systems such as PIR sensors, enhanced ‘U’ values and solar panels. Not only is the off-site manufacture greener, buildings are also designed to be energy-ef cient for their entire life cycle, all within the NHS requirements.
Modular buildings now come with a range of external options to cater for nearly every look, including brickwork and tiled roofs to give a traditional appearance if that’s what’s required. When you build off-site, you plan and construct gorous co-or with meticulous precision. It takes strategic thinking and ridination, but modular construction allows for minimal disruption to staff and patients which is particularly key in the acute care environment. Off-site construction also allows for a 90 per cent reduction of the total number of deliveries to site as well as reducing up to 90 per cent of waste generated as the structure is recyclable.
COST-EFFECTIVE AND TIME-SAVING
NHS bed availability is at an all-time low, but off-site building techniques are the NHS’s construction dream. Modular buildings can be delivered up to 50 per cent quicker than traditional methods, which affords healthcare establishments a degree of certainty in meeting their needs quickly and ef ciently. Although initial costs are comparable with traditional construction, the whole-life ef ciencies weigh in favour of off-site. Easily adaptable to any future, changing industry needs and standards, 21st century medical modular buildings are built to stand the test of time.
There are also many cost savings associated with modular build, stemming from a reduction in project timeframes, leading to reductions in overall construction costs.
DAISY HILL HOSPITAL
The McAvoy Group completed a £2.5 million contract to provide additional operating theatres and day surgery facilities at Daisy Hill Hospital in Newry for Southern Health and Social Care Trust in Northern Ireland.
This complex 800m2 extension was constructed off-site by McAvoy and installed on a specially engineered steel gantry, 15m above ground level. This solution allowed the new facilities to be connected to the existing theatre complex at first floor level of the main hospital to maintain patient flows. A 230m2 plant room was located on the roof to accommodate specialist air handling equipment and other M&E systems.
Designed to provide the highest standards of infection control, the building provides two operating theatre suites which include scrub areas, preparation, utility and anaesthetic rooms; stage one and two recovery wards with discharge lounges and ancillary spaces; an eight-bed day surgery unit, and an endoscopy decontamination suite. The design and specification of the new facilities were in compliance with current Health Technical Memoranda (HTMs) and Health Building Notes (HBNs).
McAvoy has extensive experience in developing bespoke building solutions for highly constrained hospital sites and in minimising disruption to patient care during construction. As at Daisy Hill Hospital, sites that are less suited to traditional construction methods can be developed and existing facilities can be expanded rapidly and cost effectively, both vertically and horizontally.
McAvoy is accredited under the LHC Modular Buildings Framework, NHS London Procurement Partnership, NHS Shared Business Services, and the Southern Modular Building Framework. Content extracted from company case study – full details are available on the company web site.
BASINGSTOKE CONSULTANTS AND RADIOTHERAPY FACILITY, HAMPSHIRE
Extraspace were awarded the project to design and build a new, steel framed, consultants building, including demolition of an existing building. Works included MRI and Linac facilities, CT suite, Step down facility, X-ray suite and Consultant assessment facility at Basingstoke Hospital. The 2,030m2 building was delivered in 80 separate modules.
The new building comprises of two main elements. Front of house offers a Private Patients Facility which includes 12 Consultant Suites, six secretarial rooms, staff rooms, offices, bespoke main entrance and modern reception area. The second part of the building is a dedicated Radiotherapy building which contains CT Room, X-ray room, MRI room and a Linac Bunker. In addition to this, each element of the building has its own dedicated ancillary rooms to accompany the treatment areas. Four internal garden areas were incorporated into the design to get natural light into the building and provide aesthetic focal points. A BREEAM Very Good rating was achieved on this project.
CHALLENGES AND SOLUTIONS
Live healthcare environment: The site was alongside a live hospital and adjacent to a nurse’s accommodation building and mental health hospice which meant security was paramount. In order to protect the surrounding area from the works, the entire site was hoarded with secure fencing and a single, secure, point of access. Regular tests of noise levels to ensure works didn’t exceed maximum levels agreed and implemented dust suppression measures.
Module design: A number of the units were 4.2m high which meant they could not be transported to site. The solution was to design a flat pack system which was then built on-site before being craned into position. The approach also meant that three modules could be transported on one lorry, reducing the environmental impact of transportation and pressure on local roads. Temporary foundations were installed to construct the modules.
The original contract was to design and build the front of house. With their extensive experience in the design and build of healthcare buildings and local supply chain, the company were able to include the Radiotherapy building within the programme without delaying the handover of the consultant suites. Modular design is extremely versatile and flexible to support the project requirements. For example, a number of facilities within the building were designed by specialist providers incorporating unique design details such as copper lined walls and concrete protection from radiation. These were seamlessly incorporated into the design. The company was able to deliver floors without floors, to install concrete floors on-site, and temporarily remove panels once watertight to support the delivery and installation of large, bulky, equipment. In addition, the entrance lobby and reception area was a traditional build. This was seamlessly linked within the modular structures.
The Site won a Bronze Considerate Constructors Scheme National Site Award in 2014 which was a first for Extraspace Solutions. Basingstoke Consultant & Radiotherapy Facility received a nomination for an LABC Building Excellence Award for Best Public Service Building in 2014.
Another key factor for 2017 was the introduction of several framework agreements put in place to make it much easier to choose a supplier, the majority of the work already undertaken to reduce the stress to the end user. Never was there a better time to go Modular with everyone now realising the value.