Architecture & construction
Reducing the risk of falling “We also harnessed Chemgrid over service risers – a GRP grating which provides collective fall protection for site staff in the construction period ahead of mechanical and electrical services being installed through floor slabs. This very much accords with BAM’s Zero Harm culture of designing, procuring, and constructing our buildings with the intention not to cause harm. In place of the traditional theodolite, we used point cloud surveys to take real-time images of millions of points, so that when we input the steel frame into the model, we could see any clash points, for example to prevent a vertical column running right the way through an overhang.”
The BAM Construction team had also re- used much of the existing structure. Rob Bailey said: “We also used modular construction for the new seminar building, the Outpatient Department, and a section of the Trauma and Orthopaedic areas. We undertook a huge amount of engagement and consultation – from consultation with different users, through all the focus groups. We also engaged with well over a dozen different clinical departments. It’s a tremendous achievement to construct a facility like this without losing time, or having to close down services to any of the departments, and a tremendous challenge.” Having discussed the project from a construction standpoint, Rob Bailey took me to see Paul Fitzpatrick, who began by emphasising that, had space been available, the obvious way to reconfigure and refurbish the hospital’s A&E department – while increasing its footprint, and keeping the facilities open throughout – would have been ‘to start again somewhere else’ on the site. However, such space ‘simply didn’t exist’. He said: “We were thus forced to look at how we could refurbish and reconfigure the existing facility and grow it, while keeping it live and open in situ.”
Acuity of patients
Although the hospital’s A&E attendances had not especially risen, Paul Fitzpatrick explained that the acuity of the patients
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had significantly increased. He added: “The desire to create a new A&E and Critical Care Unit also coincided with our designation as the single trauma receiving site for Cheshire and Merseyside.” Recognising that it had ‘a complex problem’ to solve, and that its solution would require completion of a series of enabling schemes, the Trust acknowledged the need to work with an experienced healthcare construction partner. Paul Fitzpatrick said: “The progression of the various schemes effectively became our estates strategy implementation plan for three years.” I asked about the deficiencies of the existing A&E and critical care facilities. He said: “The main issues were the age of some of the buildings, which were no longer fit-for-purpose, space constraints, non-compliance with HBNs and HTMs, and a series of backlog maintenance issues, as well as some non-ideal adjacencies, in particular involving the critical care and A&E and trauma services, which were dispersed around the hospital, and not optimally positioned. Our aim, as far as possible, was to bring all the key services associated with dealing with major trauma together in one area.”
Two projects ‘inherited’ Paul Fitzpatrick explained that when he started in his current role as director of Estates and Facilities in 2008, he ‘inherited’ two projects that were ‘very much the embryos of the UCAT scheme’ – one a £250,000 refurbishment of A&E, and the other a £900,000 reconfiguration of critical care. He said: “Two schemes have effectively become one scheme. It simply wasn’t possible to deliver the user and service requirements by simply refurbishing the existing A&E, or reconfiguring the existing critical care unit.” He added: “The early enabling schemes we worked on with BAM very much helped us to establish and build upon the relationship with the company and, in turn, enabled it to build its team around our needs to be at its peak to deliver the main scheme.”
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I asked Paul Fitzpatrick about the extensive liaison there had been on what Rob Bailey had dubbed ‘optioneering’ on the project. He said: “I think just about every potential option has been explored, and the best options – given the available budget – chosen. We could probably have constructed the new UCAT from scratch for less given the required space on site, but we were constrained by both location and adjacencies, and the need for continued operation of the department in situ. As you would anticipate, that has caused us some problems, and some compromises have had to be made. For example, we have had to retain existing structural columns, and to work the design around these. We have also had to keep existing building services operational, necessitating us putting in parallel services. In fact, all the infrastructure has been replaced in parallel to keeping the building running on the old infrastructure.”
Changeovers facilitated Rob Bailey interjected: “The building services have been designed by Steven Hunt & Associates, and we have worked very closely with the company and the Trust’s maintenance team to gauge how this building operates, and stays ‘live’. “Gaining this knowledge has, for example, helped us to determine how and when to carry out changeovers for electrical supplies, and what we put in place to enable us to maintain essential services and have essential back-up. In a lot of senses, although some people have seen us around, nobody has known we are here – in that we haven’t, for example, had the huge impact of all the electricity going off, or the water supply being interrupted.” Paul Fitzpatrick added: “In fact, as part of our estates strategy, we have delivered a £1 m electrical infrastructure reinforcement scheme as part of the project. Due to the time such a complex project takes to complete, and with the current pressures on urgent and emergency care centres nationally, a lot of new guidance and advice has been
Heat and Power... imised CHP % share
systems.com Health Estate Journal 43September 2016
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