MTX constructed a single-storey rooftop Interventional Radiology Unit for Norfolk and Norwich University Hospital, comprising four large treatment rooms with dedicated control and technical rooms, recovery wards, and private side rooms. Right: The interior of a three-storey, 98-bed space ward block at the same hospital, completed within a single year.

engineering air movement and clean-air flow pathways within modular buildings – particularly those housing patients. Those factors are a vital consideration for our engineers when assessing the performance of the buildings we provide for health Trusts and hospitals. We have the technical expertise and experience to work with clinicians and facilities teams to ensure that the building is fit for purpose in every case. Optimum airflow is accepted as an important factor in the health, wellbeing, and comfort, of patients and staff. It is much more difficult and expensive to retrofit air-handling systems to modular units, which is why it is so important to give it full consideration at the design and build stages.

David Guilfoyle, a director at consulting M&E engineering company, DSSR, which works with MTX, adds: “Ventilation has become much more of an issue with the emergence of COVID-19, and it has reshaped the priorities for ventilation requirements. We work with MTX to ensure that the air-handling provision is effective, bringing maximum benefit, and enhancing the safety of patients and staff.”

Walking in the shoes of the building’s users

DSSR designs central air-handling for each modular unit produced by MTX according to how it will be used and the internal configuration. David Guilfolyle explained: “You have to walk in the shoes of the people who will be working in that building. If you simply follow the basic HTM guidance you are not walking in their shoes. HTM is a baseline, not a target. “Without talking to the clinicians and the infection control team you cannot possibly design an air-handling system that is fit for purpose. You must know the configuration of the beds and know how they are to be used; then you can design the system around the clinical requirements, not simply pump air into the room. The configuration, and positions of walls and corridors, all influence the effectiveness of the air-handling system.

“For example, people talk about 6 or 12 48 Health Estate Journal February 2021

air changes per hour (ACH) ventilation rate in terms of volume, but that rate depends on the configuration. Previously, one of the priorities for air exchange was mitigating the effects of medical gases that could affect staff. Now it is more about infection control – a priority that has gained momentum over the last year. “Six ACH may be quite appropriate for one layout, but a different layout occupying the same floor space may require 12. It is a bespoke solution every time with MTX, and clients get the benefit of flexible M&E design by experts in their field who understand the needs of staff and patients. We must also take into account air dilution rates – which reduce the particulate content of the air – a vital tool in reducing airborne infection with virus like COVID-19. In addition, clean-air pathways are custom designed according to the configuration of each individual modular building. If you want to capture the ‘bad air’ and vent it – then it all comes down to the pathways you create through the design of the system.”

David Hartley

David Hartley is managing director of MTX, a specialist healthcare construction company providing design, construction, funding and aftercare services for MMC (Modern Methods of Construction) healthcare projects throughout the UK. He has worked serving the NHS and private healthcare sectors for 27 years, and, during this time, has supported MTX in ‘becoming a market- leader in the provision of innovative, compliant, healthcare buildings’. He has overseen the construction of over 200 operating theatres and the provision of 1,500 compliant bed spaces, in addition

to other specialist environments. In recent years, he says that he is particularly proud of several high profile projects delivered by the business – including a £12 m infectious disease ward at Northwick Park Hospital, a 100-bed 4,300 m2 ward development at Norfolk and Norwich University Hospital, a 64-bed rooftop ward for the University Hospital of Leicester, and an award-winning ultraclean operating facility for Johnson & Johnson at Guy’s and St Thomas’ in London. ‘Passionate about the healthcare construction sector’, he is particularly keen on continuing to support the Government’s ‘quest for the safe delivery of fully compliant MMC construction projects’.

Mass-produced shells

Factory-built units are too often simply mass-produced shells – they are not engineered for a specific purpose – which may vary from one hospital site to the next. It is not one-size fits all. For example, people who deliver a building in eight weeks may be working hard to fulfil a need – but the building they produce may be a basic shell which could as easily be a schoolroom or an office. Modular buildings used for patient care should be specifically designed and engineered for healthcare use.

Taking into account the threat from COVID-19, it is apparent that more attention needs to be paid to ensuring that mechanical ventilation is considered in every case when designing and creating modular buildings.

DSSR has been involved as a technical expert in updating the HTM 03-01 memorandum to make it more fit for purpose in modern healthcare. The new version is currently being ratified for publication early in 2021.


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