HEALTHCARE CONSTRUCTION


Modules being craned onto concrete groundworks – showing how the units are already largely complete internally.


work to the roof can proceed. One of our key criteria was that the internal layout be sufficiently flexible to enable us to house medical wards, surgical wards, children’s wards, and then clinical sub-specialities in turn, as required. So at one point it may be an elective surgery ward, and then – as work progresses – a cardiac ward.” This is where the new building’s second key function comes in. Paul Morris explained: “Rather than simply re-creating a mirror image of what we have in our existing hospital, and recognising that the New Hospital Programme is working towards 100% single rooms, we wanted to examine how we can best achieve this in our new hospital, especially now that we have had the go-ahead to build it. “Patients in the existing hospital are nearly all accommodated in bays of four or more beds,” he continued. “We recognised that with the NHP presumption that all new hospitals should be single-bedded, incorporating a high proportion of single- bedded rooms would enable us both to evaluate the potential patient benefits, and the advantages and challenges for our nursing and clinical staff. In fact we will be undertaking detailed research on all these aspects once the ward is fully in use, comparing nursing and patient experience in the four-bedded bays with that in the single rooms, and hope to learn some useful lessons in the process.”


‘Listening events’ held Prior to drawing up detailed plans for the new building – which is located to the north-west of the existing hospital – and connects to it via a 40-metre link corridor, Paul Morris explained that as Project lead from the clinical side, and working with Health Spaces’ lead architect on the scheme, Jaime Bishop, he arranged a number of ‘listening events’ in the local


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A drone photograph highlighting the traditional groundwork pads which the modules sit on.


community. Here, former patients, patient representative groups, and the public, could hear about the plans, and give their views. He elaborated: “While we followed the national guidance for the New Hospital Programme, we also wanted the views of those who have already been patients with us, or who could be in the future, on our proposals. Equally, early in the project we sought our clinical and nursing staff’s views, and – particularly as the scheme and the designs evolved – have had considerable input from the Trust’s Estates & Facilities team, and staff from a number of other disciplines. Throughout – right from the initial site visit – the Health Spaces team has been receptive and responsive to our ideas.” Paul Morris explained that, having


considered the overall clinical priorities, and what the clinical and nursing teams wanted to achieve – in terms of the new block providing an opportunity to discover more about what looking after patients in such accommodation would entail for staff, and how patients might benefit – the Trust opted for a new building containing 20 single-bedded en-suite rooms – including two isolation rooms, and two four-bedded bays.” As well as being used as a decant


facility, and to evaluate the pros and cons of single-bedded rooms, the new ward will provide an environment in which to evaluate new technologies designed both to improve the patient experience, and clinical efficiencies. Paul Morris said: “Mark Flynn, our Strategic Projects director, the head of Estates and Planning, Steve Balls, and the Estates team, have been heavily involved – including working in conjunction with clinical teams to select technology to enable us to deliver the optimal care. This ranges from an advanced nurse call system which allows two-way communication,


Offsite construction means considerably less disruption on site, and the ability to create a really flexible healthcare building, in terms of how we use the spaces, and adapt their use over time


Paul Morris, James Paget University Hospital 48 Health Estate Journal August 2023


facilitates the creation of a silent ward, and gives patients some control over their room lighting, to specifying items such as patient and clinical washbasins, interior finishes, lighting, and furniture.”


Speed of delivery Paul Morris explained that the main reason the Trust decided on a modular offsite- built solution was the speed at which it could be assembled, delivered, installed, fitted out, and ready to admit patients. He said: “Also key were the fact that offsite construction means considerably less disruption on site, and the ability to create a really flexible healthcare building – in terms of how we use the spaces, and adapt their use over time. Modular-built facilities can employ a repeatable design, meaning we can not only tailor different room uses for patients of differing acuity, age, and condition, but also try out different approaches. For example, patients in the new ward will benefit from a semi-covered outdoor garden, and it also features a ‘traditional’ day room. We worked on this with Jaime Bishop, who based the concept on Japanese research on such spaces’ benefits in healthcare facilities.” He continued: “The design will also ensure that clinical areas benefit from ample light, and – importantly – that there are excellent sightlines for staff – partly a result of the curvature and indentation of the corridor walls. This means that from their touchdown bases, staff can see more than one patient simultaneously; in fact by rotating their chair by 360 degrees they will be able to see two patients in rooms in front of them, and two behind.” “All aspects of the new ward’s internal design have indeed taken a great deal of thought,” Paul Morris added. “For instance, there are bariatric hoists, while two of the single-bedded rooms are designed as isolation rooms, with the ability to change between positive and negative air pressure, and tailored air flows / air change rates. With natural light and external views known to aid recovery, all the rooms feature large windows with internal bench seating. About half will look out over grassy area at the rear, and the other half into a new semi-covered, multi-surfaced


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