CONSTRUCTION


elements (façade, MEP, and fit-out) could be connected. Mechanical and electrical services are a more critical part of healthcare facilities (in terms of not just cost, but also clinical flows and ongoing operations) than in other assets. The team therefore used the separation of critical/ non-critical spaces to maximise the clarity and efficiency of the MEP strategy.


Prefabricated MEP distribution The prefabricated MEP distribution was ‘concentrated’ into the shallowest units possible. Traditional, separate zones for ductwork, pipework, cable tray, lighting, ceiling finishes etc. result in large ceiling voids, which increases the overall volume of building, and in turn increases the running costs, while also increasing the costs of façade etc. By deploying ‘concentrated’ MEP cassettes in key areas we could expose areas of the structural soffit (although the accuracy and quality of the structure meant that this ‘read’ as traditional ceiling). Benefits included: n Removing the cost and carbon associated with procuring, installing, and maintaining, a ceiling finish;


n Maximising floor-to-ceiling heights and quality of space within given floor-to- floor heights;


n Fitting another storey within the planning envelope in the inpatient block.


This project used common standardised grids that allowed several functions to take place within the same room sizes – for instance consulting rooms, treatment rooms, and inpatient bedrooms. What unlocked flexibility of use was that each of these rooms was conceived as an ‘empty box’, whose final function was determined by a kit of ‘enabled furniture’ that could be placed in the room late in the programme. In the inpatient bedrooms, the bedhead services units that incorporate the architectural finishes, medical gas distribution, nurse call, lighting, and small power etc, are a single piece of ‘furniture’. Another piece includes the window lining, guest sofa (that doubles as a bed for overnight stays), and patient wardrobe. These were manufactured and installed late in the programme, with numerous benefits, including: n Manufacturing levels of accuracy, quality, and consistency, that cannot be achieved by even the best fit-out teams in ‘construction’.


n A supply of spares, so that it is easy to keep units well maintained and looking new.


n The ability to re-purpose a room quickly with minimal disruption (the mix of bedrooms and treatment rooms can be adjusted by simply removing the bedroom ‘furniture’ from a double room, and replacing it with the ‘physiotherapy treatment’ room kit).


42 Health Estate Journal March 2021


Circle Birmingham – further progress


The Bryden Wood team has continued to work with Circle, and recently completed work on the new Circle Birmingham Hospital. The hospital has five operating theatres, 10 first stage recovery beds, 20 second stage recovery beds, and 140 bedrooms. It has a comprehensive imaging department, and a significant physiotherapy and rehabilitation department. The 18,000 m2 hospital represents a step change in healthcare design, delivering enhanced patient and staff experience, as well as significant cost savings. The typical cost of NHS hospital stock in the UK (Midlands) is £3,000 - £3,500 per m2


.


For this building, we achieved a cost of £2,300 per m2


, a saving in the region


of 30%. The hospital, which opened in September 2020, will now become a template for future projects, and the benchmark by which they can be measured.


Conclusion


MMC will allow the HIP programme to be delivered within a timescale and budget that would otherwise be impossible, with improved quality and clinical outcomes. Critical to the application of MMC is the time taken at strategy stage to enable a data-led approach.


The scale of the programme provides an unprecedented opportunity to leverage and accelerate the Platform approach, described by the IPA as ‘currently the most promising trend in the construction and engineering sector’. By committing £3.7 billion over several years and 40 projects, the HIP programme creates a unique set of conditions that could foster a transformational approach: n A series of projects which are regionally distributed, but will have a high degree of overlap in terms of function and content.


n A sustained programme that allows learnings to be disseminated and shared between Trusts.


n Strong backing from a government that has made a long-term commitment to change the construction sector and create the policy framework to make it happen.


Much of the initial work has also been done, such as the creation of the P22 repeatable rooms, and the Construction Innovation Hub’s ‘Platform Design Programme’. There is a huge opportunity for the HIP programme to allow NHS Trusts, working with central government and the wider industry, to become a world-leader in social infrastructure design, procurement, and delivery. We look forward to helping Trusts seize this opportunity.


Jaimie Johnston


Jaimie Johnston is director and head of Global Systems at Bryden Wood. He joined the practice shortly after its foundation in 1995. He leads on the development and adoption of a manufacturing-led approach to the built environment, on major projects in the UK, Europe, and Asia, for clients including the NHS, Circle Healthcare, GlaxoSmithKline, Heathrow Airport, and several government departments, including the Department of Health & Social Care and Ministry of Justice. He is one of the UK’s leading thinkers and speakers on modern methods of construction, and in particular the government-endorsed Platforms approach to design for manufacture and assembly. He was an original member of the UK Government BIM Task Group, and was the co-author of the Design for Manufacture + Assembly overlay to the RIBA Plan of Works. He is the author of Delivery Platforms for Government Assets: Creating a Marketplace for Manufactured Spaces (2017), Platforms: Bridging the gap between construction + manufacturing (2018), and Data Driven Infrastructure: From digital tools to manufactured components (2017). These widely referenced publications have been central to the UK Government’s aspiration to adopt a more manufacturing-led approach to construction.


Jaimie Johnston is also the Design lead for the Construction Innovation Hub, which was awarded £72 million in 2018 to drive innovation and technological advances in the UK construction and infrastructure sectors. He was a key contributor to The Construction Playbook, published by the Cabinet Office in December 2020.


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