Yorkon News Archives
07/07/2008 – How Off-site Construction is Challenging Conventional Hospital Building Methods
David Johnson, Director and General Manager of healthcare construction specialists, Yorkon, looks at the latest advances in off-site technology, and how it can help public and private sector healthcare providers deliver world class hospital facilities more effectively.
Changing Perceptions
Modular building is challenging conventional methods of construction through innovation, and the value it can add to the development process has been proven. Completion times can be halved, and work on site is safer, quieter and less disruptive - with a direct and positive impact on patient care.
The perception that modular healthcare buildings are draughty, restrictive in layout and temporary has changed. With good design, committed architects and clients, and more efficient processes, off-site construction is now providing comfortable and welcoming environments for staff and patients, with complete long-term flexibility.
Buildings can be easily expanded, vertically or horizontally, without the need for decanting. Non-load bearing partitions and clear unrestricted internal spans of up to 12m facilitate space planning and the ability to meet a hospital's changing needs.
Quality is also significantly improved because construction work is moved from a muddy site into a more efficient and cleaner factory environment, with a permanent, highly trained workforce which is committed to the drive for zero defects.
Reducing the Risk of Time and Cost Overruns
A key advantage of building off site is the higher degree of predictability it can offer - reducing the risk of time and cost overruns. Over the past five years, for example, Yorkon has delivered 96 per cent of building projects on time and 94 per cent on budget.
And with the technological advances in off-site construction, there is no compromise on design:
- A wider range of dry cladding options allows designers to achieve architectural variety for the building envelope, with all the speed and quality benefits of building off site.
- Full height curtain walling can be specified to reduce the reliance on artificial lighting and enhance the internal environment.
- Windows in ribbon, punched hole or composite configurations are factory-installed to improve safety on site and build quality.
- Module sizes, configurations and layouts can be designed to suit individual sites and project requirements, with larger modules up to 15m long and 3.3m wide providing greater cost efficiency, fewer vehicle movements to site, less cranage and fewer construction joints.
- Curved modules can create shaped buildings and façades, and allow more efficient development of irregular hospital sites.
Meeting the Sustainability Challenge
The issue of sustainability continues to increase in importance - and construction has perhaps the greatest impact on the environment than any other sector or activity. Until now, there has been limited evidence to prove the case that off-site construction is a more sustainable method of delivering high quality healthcare buildings.
The advantages include:
- Up to 67 per cent less energy is required to produce a modular building compared to an equivalent traditionally-built project (source: Arup)
- Off-site construction can generate up to 90 per cent fewer vehicle movements to site - reducing carbon emissions, congestion and disruption (source: Mtech)
- Off-site construction can reduce on-site waste by up to 90 per cent (source: WRAP)
- Full-scale independent tests for air permeability have shown that Yorkon modular buildings consistently perform up to 70 per cent better than Building Regulations requirements - improving the thermal efficiency of hospital buildings, lowering running costs, and reducing carbon emissions.
A wide range of ‘greener' design options is also now available for healthcare buildings constructed off site, including passive ventilation, biomass boilers, solar thermal heating, rainwater harvesting, solar photovoltaics for electricity, ground source heat pumps, green roofs, and combined heat and power systems.
The Advantages and Design Possibilities of Off-site Construction in Practice
St Mary's Treatment Centre, Portsmouth
A purpose-designed healthcare facility at St Mary's Hospital in Portsmouth demonstrates some of the design possibilities of off-site construction.
The £11m centre provides a wide range of NHS services including a minor injuries unit, a walk-in advice centre, diagnostics such as x-ray and ultrasound, and non-emergency day surgery procedures.
The contract, awarded to Yorkon by AMEC, was for a rainscreen-clad modular building, developed and operated by Mercury Health in partnership with Portsmouth City Teaching Primary Care Trust.
72 steel-framed modules were manufactured by Yorkon off site in York and craned into position ready for fitting out and completion of the external claddings. This provided a watertight envelope for fitting out only 12 weeks after start on site and reduced the programme time to just 42 weeks. Yorkon also succeeded in handing over the building one week ahead of schedule.
A Landmark Building
The architectural design features cedar cladding at ground floor level, white rendering and light grey ceramic granite to add interest at either end of the building. Areas of curtain walling span two storeys and horizontal bands of windows are finished in blue.
A cantilevered canopy runs the full length of the front elevation to provide shelter for three patient entrances and a drop-off zone. Sun pipes maximise natural light along the first floor of the building and cedar louvres give shade from the sun.
Yolande Wyer, Project Architect, Nightingale Associates for the scheme, said, "You would never know this is a modular building. There was a planning requirement for a landmark facility, which would significantly improve the frontage of the hospital. This has been successfully achieved, despite budget, site and programme constraints. The building has generous spacing, a pleasant ambience and the system was sufficiently flexible to allow a double height area internally and feature strips of ribbon windows. The benefits of off-site are clear to see."
A New Building for the Latest Thinking in Emergency Care
A new Emergency Assessment Unit was required at the University Hospital of North Tees in Stockton, as part of the Government's drive to reduce waiting times for emergency cases. The initiative followed a review of acute services in the region, which would centralise emergency surgical care and expand the number of assessment beds on the Stockton site.
The unit adopts the latest thinking in emergency care and is staffed by specialist teams to give quicker access to treatment, more efficient streaming of patients and greater operational efficiencies for the Trust to meet its business objectives.
The £2.8m ProCure21 project was awarded to Yorkon by Interserve Project Services, for the off-site construction and fitting out of a 42-bed Emergency Assessment Unit.
Minimising Disruption to Patient Care
The recently completed building comprises 42 steel-framed modules, which were manufactured in York and installed on site in just a few days - minimising disruption to patient care and reducing the programme time for the new unit.
The 1,710sqm single storey extension to the existing department was delivered in just over six months from start on site and provides a range of facilities for acute emergency care. These include four-bed wards, single ensuite bedrooms, an isolation ward, high dependency beds and consulting rooms.
Roof lights were incorporated into the design to increase the amount of natural light in the centre of the unit, and it has been equipped with the latest technology. Wireless workstations are available for use at patients' bedsides and this is one of the first units in the country to have an electronic information board.
Commenting on the project, Kevin Oxley, Director of Operations at North Tees and Hartlepool NHS Foundation Trust, said, "This is a fantastic building. We are impressed with the benefits of the off-site approach, its accuracy and the speed of construction, which has a direct impact on the patient experience."
"The faster completion allowed us to increase capacity and introduce a new model of care at an earlier stage, and benefit from operational efficiencies. There was also less disruption to the hospital during construction because of the shorter time on site."
He added, "The installation process went very well and the building is defect-free. The unit has the feel, quality and appearance of the best traditionally-built building and is allowing the Trust to achieve the highest levels of clinical care possible in any environment."
Dr Nick Roper, Consultant at the Emergency Assessment Unit, said, "After much planning, it is brilliant to see the new unit up and running. We have designed in features such as isolation rooms, ensuite bathrooms, no-touch taps and bespoke window blinds. The final result is a spacious and calm working environment, which is properly equipped to look after patients with emergency medical needs."
UK's Largest Modular Building Contract in the Healthcare Sector
Healthcare projects currently on site include a new Acute Admissions Unit (AAU), which is now under construction at Watford General Hospital by Yorkon in a £12m contract awarded by Medicinq Osborne - believed to be the UK's largest modular building contract in the healthcare sector.
Scheduled for completion this year, the scheme for West Hertfordshire Hospitals NHS Trust is also believed to be the largest AAU in the country. It forms part of a £34m reorganisation and modernisation of acute services in the area. A new model of care will be employed to improve the patient experience with rapid, consultant-led diagnosis for emergency cases and treatment closer to home.
Designed by Murphy Philipps Architects, the three-storey building will provide 120 beds for emergency admissions, two cardiac catheterisation laboratories, diagnostics including x-ray, ultrasound and CT scanner, pharmacy manufacture and robotics, library and a roof-top plant room.
142 steel-framed modules have now been delivered to site and craned into position substantially completed, with partitions, electrics, plumbing, sanitary ware and finishes pre-installed.
Graham Ramsay, Medical Director at West Hertfordshire Hospitals NHS Trust said, "2008 will see a major improvement in hospital care in West Hertfordshire and the development of the Acute Admissions Unit will play a crucial part in securing the very best hospital services for the 21st Century. We are particularly pleased that we chose the off-site approach for providing the new facilities as it is significantly reducing disruption to our patients, staff and the local community during its construction."
What Next?
There is more interest in off-site construction from the health sector than ever before - a reflection of the Government's investment programme in the NHS and the fact that the perception of modular buildings has changed dramatically. It is now being used for a wide spectrum of new facilities - from ward accommodation to more complex buildings such as independent treatment centres, emergency departments, operating theatres and day surgery units.
But there is still work to do in educating public and private sector healthcare providers, local communities, architects and contractors about the huge potential of off-site construction and the options available for combining innovative design with all the benefits of modern construction methods.
