Rarely do environments offer as many challenges for construction companies as hospitals. Like any public building they require refurbishment and upgrades to keep the facilities up-to-date, modern and capable of meeting the needs of patients and staff. Paul Gouland, Marketing Director at Clugston Construction, explains how today’s leading construction companies are adapting their refurbishment practices to meet the demands of the healthcare sector and overcome these challenges.
It is no secret that the proliferation of ageing buildings across the NHS estate can make it difficult for Trusts to cope with the demands of modern-day healthcare. The issue is rarely out of the headlines at the moment, with backlog maintenance at its highest ever level (£6bn) and healthcare experts arguing that the situation urgently needs addressing.
It isn't just the ageing estate that presents a challenge. Rapid advancements in technology across the healthcare sector in recent years have prompted further demands for change, especially in complex facilities such as operating theatres and specialist care departments which are often required to house critical medical devices and machinery.
The task of improving the buildings where one million patients are treated every 36 hours, and within which one of the world’s biggest workforces operates, is not a straightforward one, especially as the healthcare sector looks to upgrade cost effectively against a backdrop of stretching budgets.
For hospital projects, the achievement of a cost, time and quality balance is particularly
challenging, as the ‘live’ working environment presents several challenges in its own right. Flexibility, detailed planning, budgeting and above all, respect for the needs of patients and staff are all vital for ensuring projects run smoothly and to the satisfaction of the client.
While hospitals in the public sector face considerable challenges to restore and upgrade their current estates to meet the ambitions of the Long Term Plan, a shift towards smarter refurbishment and a more collaborative approach between contractors and healthcare providers is already helping to deliver projects to tight timescales, on time and on budget.
The challenges associated with refurbishing and retrofitting healthcare facilities can be great. Operating in ‘live’ working environments without disruption to day-to-day care, maintaining a sterile environment and working to time constraints are just some of the hurdles that modern construction companies have to overcome.
Adopting smarter processes, such as employing innovative construction methods and practices, and utilising the latest technologies during the planning, design and build stages of the project, construction companies are bringing tangible benefits to the healthcare sector and helping transform facilities to meet the demands of modern healthcare.
Sheffield Teaching Hospitals
A key example of such work can be seen with the major refurbishment of six operating theatres within the Firth Building at the Northern General Hospital, Sheffield.
Currently being delivered by Clugston Construction, the £3m scheme, which will be completed in three phases to ensure operations within the hospital continue uninterrupted, involves the complete refurbishment of six theatres.
A highly complex project, comprising internal works to each theatre, along with an exit lobby, scrub-up, anesthetic preparation areas and dirty utility areas, also involves the replacement of Mechanical & Electrical (M&E) services including new air handling units, theatre lights, theatre panel and medical gas pendants, as well as changing finishes to walls, floors, ceilings, and installing fitted furniture and door sets.
Central to the M&E solution is the need to provide each theatre with its own dedicated services for ventilation, power and medical gasses. This has required existing units and ductwork to be stripped out within the associated plant rooms and replaced with a newly-installed set of six Air Handling Units (AHU), one humidifier, medical gas plant and UPS/IPS.
Refurbishment within each theatre involves careful removal of all existing finishes and equipment followed by installation of new floor coverings, ceilings (including firestopping in line with latest regulations), walls and secondary glazing. In conjunction with this and the introduction of the new ventilation system, pressure stabilisers are being installed in the theatre walls to maintain positive pressure and a safe environment for procedures to take place.
New control systems, centred on the theatre and surgeons’ panel, are also being installed, to provide the medical teams with the information and ability to control all aspects of procedures.
Given the ‘live’ working hospital environment in which the works are being undertaken, thorough logistic planning has been undertaken from the outset of the project, with detailed discussions between Clugston, the Sheffield Teaching Hospitals NHS Foundation Trust's Estates team, M&E designers Arup and the architectural team from P+HS.
To meet the challenges of the proposed programme, a phased plan of refurbishment was agreed with the Estates team, to reduce timescales, limit disruption to hospital operations and improve outputs. To enable the surgical teams to carry out their daily duties, the theatres are being refurbished in sets of two, so that the other four theatres can remain in full operating mode to support high-quality care for all patients.
Equally important is the need to maintain a sterile environment, consequently hermetically-sealed hoardings are being employed to segregate construction areas from clinical areas, whilst a strict regime ensures that immediately after any deliveries or waste removal, the corridors are cleaned and maintained.
Located on level E of the 1960s multi-storey Firth Building, the team has installed an external scaffold structure to enable all building materials and M&E equipment to be transported into the working area. Each delivery is carefully fed into the building following the removal of the windows from the outer envelope of the structure. This solution has minimised disruption to critical day-to-day operations.
The refurbishment of hospitals can pose substantial challenges for the NHS Trust and construction companies alike. However, at Northern General Hospital in Sheffield, Clugston Construction and the Estates and clinical teams are demonstrating how a collaborative approach can help deliver complex projects in highly sensitive live healthcare environments.
