MODERN METHODS OF CONSTRUCTION Gill Nicolson said: “To mitigate the delay,


our team worked closely with MTX to bring in some of our specialist equipment while the construction team was still active on site. Then, when the handover occurred, we had a target of a week to move from old to new facility. All the microscopes and imaging equipment were moved by a specialist team from Zeiss. The CQC application process for the new facility was a priority, and we worked closely with the Commission to ensure that all the necessary recommissioning of each piece of equipment and CQC sign-off happened promptly. MTX assigned us an area within Urgent Care so we could take receipt of and start the commissioning process while the building was still being completed. We were very much working as a team.”


Planning conditions In addition to addressing the challenges of the sloping site, subterranean void, and old foundations, the MTX team also had strict planning conditions to adhere to. Paul Williams said: “For example, there were badger sets on parts of the site, so we couldn’t start working at the beginning in those areas. We had to get in a Conservation Officer, there were Notice Periods, and people had to come and check, which caused a delay of about 12 weeks. There were also deer running up and down between the trees behind the site. Once we had sign-off from the relevant specialists – including Simon Geary Ecology Services, who put cameras into the badger setts to ensure the badgers had vacated them, the Council gave us permission to begin working in those areas.” He continued: “The pine trees behind


are all under Tree Preservation Orders, necessitating extensive dialogue with the Council and the tree conservationist, because the roots extend so far. There were thus only certain ways we could dig in Tree Protection Zones, which extend three metres around the base of each tree, and there were further restrictions based on trees’ age. All this had to be factored into the design of the car park, which is on that side, to ensure we weren’t encroaching on protected locations.” I asked Gill Nicholson what she


considered were the biggest clinical benefits of the new building. She said: “The 20% increase in the current space is number one. (The new building is just over 4,250 m2


Fit and finish within the new ophthalmic building are to a very high standard.


floor is 300 mm thick concrete.” Gill Nicholson said: “While we have


concrete floors, our consultants still had concerns, having experienced vibrations in the previous building. That is why the structure for the microscopes here is – as Paul Williams described it to me – ‘an independent steel goalpost’.” He elaborated: “So, the uprights, hidden in the walls, are bolted into the concrete, and then the horizontal is in the ceiling void, which is where the microscopes are bolted into.” Paul Williams said Gill Nicholson had


‘done really well’ in sharing the project plans and information. He said: “Often our end-user clients struggle to understand our drawings. As a contractor, we are used to looking at them daily, but put 2D plans in front of most people and they struggle to visualise what’s going on. It’s been good on this project to get that understanding early on.” Gill Nicholson admitted: “It took a lot of learning, but it was also about not being afraid to ask questions. Every time I did so, people sat down and explained the answer to me. It was challenging at times, but we built a really good relationship to navigate those differences and the different languages we all have and bring that back together. In fact, I only joined the project 20 months before completion, just as the first modules arrived, so it was a steep learning curve.”


Inside the building, all the clinical areas, in area). Obviously, the new


REI brings improved access for patients, we have theatres and Outpatients back in one environment, and it’s ophthalmic- specific built. These are the biggest wins for us. Clearly,” she continued, “the amount of diagnostic imaging equipment to be accommodated has required careful thought in terms of the structure’s design.” Paul Williams said: “That’s one of the main reasons why the base floor on the ground


as well as toilets and shower rooms, feature an Altro Whiterock laminate non-porous wall cladding, favoured by the Trust’s Infection Control Team for its hygienic, wipe-clean properties and smooth seamless finish. To differentiate the various clinical and non-clinical spaces, specific areas have their own colour schemes – ranging from light blue to peach for instance. Theatres feature a dark blue finish, and Reception yellow. “All the signage inside is in line with the RNIB recommendations, which is bright yellow, with black writing,” Gill Nicholson explained. As one approaches


the new building, the striking external cladding – finished in a combination of black/ dark and light grey – catches the eye, complemented by tinted brickwork chosen by Plymouth City Council, giving the completed building a handsome modern feel. There is no doubt that the new REI has a distinctly different external appearance. Paul Williams explained that the metallic standing seam cladding was developed by MTX jointly with the planners at Plymouth City Council. He said: “You’d certainly not see some of these features were the building on a hospital site. It has definitely benefited from its location, because the planners have been much more engaged.” Externally, complementing the striking facade, the building was planned with a landscaped paved area through which visitors walk to the main entrance. A one-way entry system for vehicular traffic applies, with a drop-off point at the side of the building, and ambulance access to the Urgent Treatment Centre.


MMC’s benefits Paul Williams told me he is a big advocate of an MMC approach on projects like this. He said: “The major contributor to cost on construction projects is the time spent on site. Take a traditional build and consider that no on-site construction could have started here until the groundworks were completed in August. Here, volumetric unit production was taking place simultaneously, so the units could be installed, and the building quickly made watertight once the site was prepared. We could never have completed such a complex clinical building via traditional build within the same time.” Gill Nicholson explained: “We have all been on a considerable journey, but all the effort that has gone into the scheme ensures that we have an ophthalmology facility that will provide excellent services to our local population for years to come, as well as being a great working location for our staff.”


June 2024 Health Estate Journal 43


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