Masterplanning Hospitals
> waste management and energy strategy, and consists of
two incinerators each rated at 4,000 lbs/hr steam each
at 9 bar pressure (equivalent to 1.4 MWth each). They
are capable of processing 500 kg/hr of clinical waste
each, though typically process 300 kg/hr. The waste
comes from within Addenbrooke’s (around 2,000
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tonnes a year, thus saving on clinical waste disposal)
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and from other organisations (a further 2,000 tonnes
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annually).

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There are also two steam-raising gas-fired boilers
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rated at 36,000 lbs/hr steam each at 8 bar (equating

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to approximately 12.5 MWth) installed in 1996. In
The overall energy efficiency
internal heat gains and removal of the laundry, the ring
addition, a 4.2 MW gas turbine CHP system generates
of the expanded site will need
main has some capacity to accommodate additional
to improve by 50 per cent
17,000 lbs/hr steam at 8 bar (circa 6 MWth), with an thermal load. Peak steam demand is around 21MWh
to meet carbon-reduction
efficiency of around 60 per cent.
targets in the NHS
and the total capacity from CHP, incinerators and
The CHP system was installed in 1991, and with boilers is around 25MWh, so there is spare capacity for
continued maintenance and refurbishment is expected some of the year. The incinerators are used to meet the
to have a relatively long lifespan. The unit can be base load throughout the year and the CHP operates
operated economically, producing electricity at 6p/kWh next in the hierarchy.
(based on the trust’s current gas price of 2p/kWh). This Energy from waste may form an important
compares favourably with the current purchase price component of meeting future low and zero-carbon
for grid electricity of 9p/kWh. building targets. Alongside the environmental benefits,
there are the existing advantages of waste management
Steam main and the associated economic considerations.
The site steam main is constructed from eight-inch Incineration on site is a criterion that needs to be firmly
insulated piping located within basement and ground- within the 2020 vision, says the trust.
floor service corridors and typically operates at up to While there are many other considerations that
8 bar, although this is reduced in the summer period. need to be included in any master plan for expanding a
During the winter months the load is dominated by hospital, heating often represents a particular challenge.
heating – whereas, in the summer months, hot water Not only is the heating vital to key activities within any
is the main load, with around 20 to 30 per cent of the health estate, it is also a major contributor to carbon
load utilised for sterilisation. emissions. Achieving the best balance that will satisfy all
As a result of reductions in thermal loads over requirements, therefore, depends heavily on the expertise
the years, through efficiency improvements, higher and innovation of the building services engineer. l
Master plan Path to creating long-term solutions
Outline stages for the plan: • The relocation of Papworth hospital to the • Establishing phasing of potential
• Reviewing the Trust data on the existing site; site; developments and any necessary enabling,
• Developing an information pack document; • Further development of staff residences on works and alterations; and
• Reviewing potential master plan options; the north of the existing hospital site; and • Predicting required investment levels per
• Selecting a preferred master plan to address • The planned development of a bio-incubator annum.
the long-term development of the campus; and on the site.
• Developing an estates strategy that Long-term development plan:
considers the master plan’s findings. Current site conditions: In creating a long range development plan,
Understanding the existing site conditions is the master planning team needed to include
The plan incorporates: critical to determining the best way forward in the following key considerations:
• Children’s hospital; the master plan. In particular, it was necessary • Engineering services routes;
• Comprehensive cancer centre; to establish a clear picture of the following: • Expansion capabilities;
• Neurosciences centre; • Determining loads for proposed schemes; • Flexibility provision;
• Re-provision of the emergency department; • Likely impact on infrastructure of future • Maintaining existing services;
• Critical care, additional theatre capacity; predicted loads; • ICT (tele-medicine);
• Perinatal services; and • Determining relationship with infrastructure • Foul and surface drainage;
• Infectious disease facilities. details and economic life of the systems; • Phased development;
• Establishing constraints imposed by existing • Structural philosophy;
The proposed development will include: buildings; • Environmental impact at all levels;
• The Forum, a mixed-use hotel, conference • Assessing suitability of existing site for future • Material assets; and
centre and educational development; healthcare and research; • Cultural heritage.
48 CIBSE Journal June 2009 www.cibsejournal.com
CIBSEjun09 pp46-48 hospitals.indd 48 28/5/09 17:24:21
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