EMERGENCY HOSPITALS
Across four Nightingale sites – in Birmingham, Bristol, Harrogate, and Manchester, the team: n Fitted 234 km of power and data cables. n Installed 33 km of medical gas pipe. n Built 29 km of walls and partitions. n Installed 121,900 m2
of flooring.
In total, 2,500 members of staff worked across all four sites, creating 2,239 beds in 17 days.
Delivery challenges and mitigation Among the key challenges in delivering the four Nightingales, and the means by which these were addressed, were: n Maximising health outcomes in the design: the buildings identified for repurposing had never been designed to support healthcare functionality, so each had its own specific and unique challenges, and required healthcare building specialists, and an integrated supply chain, with careful coordination of sub-contractors. The required technical installation necessitated specialist skills and knowledge, and an accurate understanding of the brief and the clinical model the buildings needed to be designed around.
n The PMO anticipated and responded to challenges, acting as a joint working group with NHS England and NHS Improvement, allowing parallel decision making. Capacity and resource required assessment for the contractors, sub- contractors, and their supply chains. This was a significant achievement by the PMO, and facilitated the rapid delivery.
n The P22 club website was utilised by the PMO, responding to hundreds of offers of help from supply chains, which required coordinating. The PMO responded by setting up a supplier list on the P22 website to facilitate central coordination. The website also provided a sharing space for designs, best practice, and lessons learned from each build.
n Consistency of documents and processes was a positive enabler to delivery, since there was no need for each to develop its own process – resulting in consistency and comparability.
n While coordinating supplies was a challenge, the PMO was key to ensuring resource coordination across the programme. The supply of critical oxygen and other key components was centrally managed by the PMO.
Key enablers to delivery The next version of the ProCure framework will be managed by NHS England and NHS Improvement. Some of the main learning points from the team behind P22 to take forward into this phase are: n Collaboration through working groups. The monthly partnership meeting
2500 members of staff worked across all four sites = nearly 250,000 hours
234 km of power and data cables = the approximate distance between Birmingham and Harrogate
Installed 33 km of medical gas pipe = the sea gap between England and France at the Strait of Dover
between all six PSCPs and the Department of Health & Social Care works well, as do the sub-groups covering design, standard components, training, commercial, media, and promotion. This paid dividends in enabling a rapid response to the request to support the delivery of the Nightingale projects.
n The sharing of knowledge between framework partners is systematically done and open, allowing for greater value and greater efficiency – for example on what is the best way to design a space to maximise clinical operation. The framework has collected evidence over its lifespan in order to gain insight into the optimal approaches and sharing of standard repeatable designs. A standard design formed the basis of the layout at each site.
n The ProCure22 website is key to sharing knowledge; it, for example, hosts toolkits, nine ‘e-training’ modules, and downloadable files for repeatable room design.
n The use of the framework enabled delivery of the four Nightingale hospitals within a short timeframe, and to a budget that would not have been imaginable for a ‘normal’ build.
n Coordination through the central PMO was acknowledged by all as key to the successful delivery. The time element meant a drive for efficiency, which called
for quicker decision making and minimising of bureaucracy.
n Members found it a more efficient experience to have clinicians determine their output requirement and strategy, and to then step back to allow the design and build team to promptly come up with a design solution for these requirements. This contrasts with the current process – which sees clinicians having a hand in development throughout the entire process.
n Delivery of healthcare cannot be based around bespoke design every time; it’s as much about providing something fit for purpose, with efficient and flexible spaces, in which clinical strategies can change to meet evolving healthcare needs.
n There are some wider lessons around how this project allowed for greater economies of scale, component procurement, and coordination, all of which could continue. The NHS Estates team is coordinating ‘lessons learned’ to ensure that these are captured moving forward.
Acknowledgment:
This case study was produced working with the six PSCP leads, the P22 central team, and NHS England and NHS Improvement. It covers the four Nightingales that were delivered through the P22 Framework – in Birmingham, Bristol, Harrogate, and Manchester.
Collaboration in practice
There was a greater urgency to deliver copper piping to the Midlands NEC scheme due to clinical drivers. The Bristol delivery was redirected to the Midlands, where there was less immediate clinical urgency. Creating a timetable/inventory of key suppliers’ stock was key, and required the PMO to contact individual suppliers to create this. This ensured that supplies arrived when and where needed.
May 2021 Health Estate Journal 35
hej
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