Rarely do environments pose as many challenges for construction companies as hospitals, especially when it comes to the refurbishment of existing facilities and estates. Paul Gouland of Clugston Construction looks at the challenges and opportunities this approach brings to health clients
The refurbishment of healthcare facilities presents a specialised set of challenges to construction companies.
The vital nature of such work, essential for keeping our health services up to date and to meet the needs of staff and patients; has led companies within the construction industry to adapt their refurbishment practices, ensuring that the demands of the healthcare sector are met and that the challenges are overcome.
Today’s healthcare system faces a growing problem with its older buildings and estates.
On the one hand, it has to deal with the fabric of its buildings becoming tired and worn out; while, on the other, advances in technology, increasing demand, and modern healthcare practices mean many older buildings, even if in a good state of repair, are no longer fit for purpose.
An ideal option would be to demolish existing facilities and build new ones in their place. However, with NHS finances seriously stretched, this is not always feasible.
Advances in technology, increasing demand, and modern healthcare practices mean many older buildings, even if in a good state of repair, are no longer fit for purpose
Even if funds exist, the heavy demand for critical services means there may not be capacity to ensure continuity of service during a protracted building project.
The alternative is to refurbish or upgrade existing facilities to bring them into line with the needs of the modern healthcare system.
This, however, poses its own challenges, such as how to carry out these essential works without disruption to day-to-day care, while maintaining a sterile environment and ensuring construction work fits around the prescribed time constraints.
Achieving a cost, time and quality balance is a significant challenge in a live working environment, such as a hospital.
It requires detailed planning and budgeting and a high degree of flexibility.
Above all are the needs of the patients and staff, and these must be addressed in every aspect of the project if it is to run smoothly and meet client approval.
The best practice, one which has been proven to deliver healthcare projects on time and on budget, is for a more-collaborative approach between contractors and healthcare providers.
Today’s leading construction companies are now adopting smarter processes when working within the healthcare system; utilising innovative technologies during the planning, design, and build stages and using pioneering construction practices that enable the facility to meet the demands of modern healthcare.
For a case in point we can look at Sheffield Teaching Hospitals NHS Foundation Trust.
The recent refurbishment of six operating theatres within the Firth Building at Sheffield’s Northern General Hospital was a complex £3m project, delivered by ourselves and requiring internal works to each theatre, along with an exit lobby and areas for scrub-up, anaesthetic preparation and dirty utility.
It also involved 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 and ceilings and installing fitted furniture and door sets.
To provide each theatre with dedicated services for ventilation, power and medical gases, existing units and ductwork needed to be stripped out and replaced with Air Handling Units (AHU), humidifiers, medical gas plant and UPS/IPS.
The best practice, one which has been proven to deliver healthcare projects on time and on budget, is for a more-collaborative approach between contractors and healthcare providers
Additionally, the existing finishes and equipment needed to be carefully removed and replaced with new floor coverings, fire stopping ceilings, walls and secondary glazing.
Pressure stabilisers were also required to maintain a safe environment. And new control systems, centred on the theatre and surgeons’ panel, were also installed.
As the works were to be carried out in a live working hospital, thorough logistic planning was undertaken from the start, with detailed discussions involving Clugston Construction; Sheffield Teaching Hospitals NHS Foundation Trust’s estates team; M&E designers, Arup; and the architectural team from P+HS.
To meet the project’s challenges, refurbishment was conducted in three stages. This limited disruption to the hospital’s operations, reduced timescales, and improved outputs.
As a result, surgical teams could continue to carry out medical procedures as four of the six theatres were always fully operational, thus ensuring that high-quality care was ongoing.
To maintain a sterile environment, hermetically-sealed hoardings were employed to segregate construction and clinical areas, while hygiene regimes were implemented to clean and maintain corridors after deliveries and waste removal.
Additionally, an external scaffold structure was erected on the multi-storey building and a window removed, enabling all building materials and M&E equipment to be transported into the working area with the minimal disruption to operations.
The refurbishment of healthcare facilities can pose significant challenges for both the NHS trust and the construction company.
However, at Sheffield’s Northern General Hospital, Clugston Construction and the estates and clinical teams have illustrated how a collaborative approach helps to deliver complex projects in highly-sensitive, live healthcare environments.