No 'one-size-fits-all' solution for modular buildings

David Hartley, managing director of MTX, a specialist healthcare construction company that provides design, construction, funding, and aftercare services for MMC healthcare projects throughout the UK, highlights the importance of ensuring that modular buildings have fully compliant ventilation systems, an imperative put into even sharper focus given recent evidence of airborne transmission of the COVID-19 virus, and the potential impact of well-considered engineering interventions in preventing its spread in indoor environments.

The availability of high quality modular buildings has been a huge advantage for hospitals and NHS Trusts faced – especially in recent years – with an urgent need for additional facilities, and increased pressure on funding. Rapidly deployed modular buildings can offer a design life of up to 60 years, but can be delivered in a fraction of the time taken for conventional build methods, making them an attractive option. However, there is a concern that the drive to get the best value is often driven simply by the lowest price or fastest turnround, without taking into account vital requirements for patient care, and in particular infection control. One area of primary concern is ensuring appropriate ventilation of modular buildings that complies with the highest standards, and not simply meeting the minimum requirements within guidance documents.

Supplied with no mechanical ventilation

Many such buildings are indeed supplied with no mechanical ventilation or air- handling system. That may be considered adequate to meet these minimum standards, but 'adequate' and 'appropriate' are not the same thing. Specific clean-air air-handling design for the internal configuration of each building should be a requirement to ensure appropriate air flow where accommodating patients. Ventilation is a crucial tool to protect patients and staff from the spread of potentially harmful pathogens, and ensure their comfort and safety. Infection prevention and control is of course vital in healthcare settings at any time, but has been a primary focus during the recent COVID-19 pandemic. With research into the coronavirus having indicated that the greatest danger of transmission is via aerosol-based routes and droplets carried in exhaled breath, ventilation and airflow are thus increasingly important.

An award-winning MTX-built orthopaedic operating theatre, which was delivered to Guy’s Hospital in central London, along with accompanying ancillary accommodation across two storeys, and a fluid passageway into the existing theatre department.

Evaluating the need for clean-air ventilation

When specifying a modular building and choosing a supplier, hospitals and NHS Trusts need to carefully evaluate the need for clean-air ventilation and its impact on a specific space configuration. The underlying concept of factory-built accommodation is production for a mass market at the cheapest price – not specifically designed and engineered modular building solutions for the medical sector.

Professor Cath Noakes, from the School of Civil Engineering at the University of Leeds, addressed the issue of ventilation, and what is already know about transmission of the COVID-19 virus and some of the engineering and estates- related interventions which can help minimise its spread, in an IHEEM Digital Week ‘virtual’ seminar early last October (HEJ – November 2020).

Professor Noakes, who leads research

into ventilation, indoor air quality, and infection control in the built environment, has a background in fluid dynamics, and significant expertise in ventilation and indoor air quality. Her research group conducts experimental and modelling- based studies with a strong focus on ventilation – including exploring the transport of airborne pathogens, and the effectiveness of engineering approaches to controlling infectious disease transmission. An investigator on multiple projects, having worked with researchers across numerous disciplines, she has written over 100 peer-reviewed papers, and co-authored design guidance for CIBSE and the Department of Health.

Also Deputy Director of the Leeds Institute of Fluid Dynamics, she has, since last April, led a UK SAGE sub-group focusing on the science underpinning the transmission of COVID-19.

February 2021 Health Estate Journal 45

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