ROUNDTABLE DISCUSSION – ‘DECANTING’
Mel Jacobsen Cox said: “Ideally, the project architects, engineers, consultants, and contractors, should be at the table from the very beginning.”
reach the expectations that are required. The greatest challenge is agreeing on a strategy upfront, and developing a toolkit to help Trusts assess their need for decant, and then propose the correct solution. That would avoid clients having to change plans midway due to changing requirements as the project is developed, as is quite often the case.” Alyson Prince (AP): “It’s absolutely critical that everyone understands what the construction project scopes are at the very beginning when it comes to decant. From a clinical point of view, the perspective is vastly different. If you don’t have a proper understanding of who you’re putting in the space – both in the short-, and possibly the longer term, then you have to specify it to the very highest standard, because you could be using that space in a whole variety of ways.” Martin Harvey (MH): “We have discussed this very issue with our clients, Alyson; however, quite often this results in overdesigning, and consequently much higher project costs which then can put the project at risk. As solution providers, we want to deliver the best healthcare
facilities possible – but that can often become complicated when requirements are not clear – for example whether the space is simply a short-term fix, or it could be repurposed and used in another capacity further down the line.” MJC: “RIBA Stages start at 0, and go all the way through to 7. Quite often, as a healthcare architect, we don’t get involved until Stage 2. However, we do have a role in Stages 0 and 1, and many times don’t have the opportunity to take part in them. Ideally, the project architects, engineers, consultants, and contractors, should be at the table from the very beginning. Frequently, we inherit something at Stage 2 that we must try and make work.” AP: “From an infection control standpoint, we are only ever brought in at Stage 2, and only find ourselves involved in the later stages of design. Many times, the design has been frozen, and budget has already been allocated to other priorities. Chris Argent (CA): “From an MEP perspective, we get brought in at best at RIBA Stage 3. We’re rarely engaged in RIBA 0, 1, 2, or 3, by which time designs are generally quite well developed from a contractor’s perspective. If we were engaged earlier, the resulting cost-benefit ratio could be more positive to deliver a more robust, fit-for-purpose solution that delivers long-lasting results.”
Need for a balance Melissa King (MK): “There is a balance there, because if you were called in at Stage 0, there may be more costs on the front end of that process that weren’t accounted for. However, if you were involved at this earlier stage (Stage 0), costs would probably be a lot lower from RIBA Stage 4 onwards, because you’ll know and understand the design, as you’ll have been brought on that journey. I think having that visibility and going on that journey of a project end to end would be really helpful.” MJC: “I have discussed this same issue with a number of our clients, specifically on Net Zero carbon, and how this standard
Chris Argent asked: “How can we use the existing systems to drive better engagement across the specialisms to enable Trusts / the wider NHS to be informed of risk, compliance, and supporting business case to deliver a long-term, adaptable, solution?”
applies to the architect in Stages 0 and 1. But how is this going to happen if we’re not employed at 0 or 1? Who’s going to do that work? Making the best decisions at the beginning is ultimately going to give you the best success later on.” MH: “It’s up to us to push for this conversation right at the beginning of the project – even if it does cost us some time and effort at that early stage, to achieve a better solution. We need earlier discussion to understand our clients’ needs better, challenging the brief to ensure we are working towards the optimum solution, and bringing everyone on the journey. Also, having the team fully informed, so that designs meet all parties’ requirements, and ensuring that budgets are allocated in the best way possible.” Keith Hodgson (KH): “We should all spend more time pushing for that early engagement collectively, especially in terms of design, process, and specifications. It’s our responsibility. We have the knowledge and experience in this
In 2021, McAvoy delivered a 48-bed ward to Good Hope Hospital in Sutton Coldfield for University Hospitals Birmingham NHS Foundation Trust.
80 Health Estate Journal March 2024
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