CONSTRUCTION According to
Mott MacDonald, standardisation in
healthcare ‘extends beyond the design
and construction of the building, to how the
facilities operate and function once in use’.
Ben Carlisle
Ben Carlisle is the Global lead for Industrialised Design and Construction at Mott MacDonald. A Chartered Civil Engineer with broad experience in multiple sectors and locations around the world, he has a background in leading multidisciplinary teams in the design and delivery of transport and social infrastructure, including both capital and transformation projects. A keen proponent
of improving the way projects and programmes are delivered – particularly through the use of design for manufacture and assembly (DfMA), and the better use of information and technology, he has been instrumental in shaping the future of the construction industry, and played a key role in authoring The Value of Platforms in Construction document that aims to support the Construction Playbook’s ambitious goal of using platform approaches to drive innovation and efficiency. He is actively implementing these ideas in the delivery of construction programmes by taking strategic, advisory, and leadership roles in various projects.
transition easily from one part of the hospital or system to another. Andrew Parks adds: “Without the consistency that standardisation brings, this type of transformational change is not possible. Through standardisation, we move towards a system of healthcare facilities where patients and staff can easily move between them, as opposed to individual hospitals.”
Culture change One of the major barriers to standardisation is the different way that each hospital functions. Operating models and models of care within the hospitals need to integrate into the system so that they don’t operate as individual entities but as part of the system. However, this requires a substantial cultural change. Ben Carlisle added that taking a more standardised
approach will call for change in the construction industry too. The sector is currently highly fragmented, and while school and prison projects are starting to shape the sector for standardisation, the supply chain is not yet fully ready. He believes that the construction industry needs a long-term, stable, and visible pipeline of suitable projects across the social infrastructure sector in order to adapt and change.
He adds: “Having an order book of work in this way creates the opportunity for a pipeline of component parts which is enabled through standardisation and the use of rules. For example, if we have standard rooms with standard equipment, we can make pretty accurate estimates of quantities of, for example, medical gas outlets, doors, and bathrooms etc. very early in the design process. This helps with market visibility and engagement, as well as improving decision making.” What is clear is that for healthcare facilities to reap
the benefits of standardisation in the long term, all parts of the supply chain and those working in healthcare will need to accept change and the iterative process that is necessary to deliver that. The change must also extend to how new healthcare facilities are funded. Ben Carlisle adds: “It is well proven in the nuclear sector that a first of a kind design is improved with each further iteration. The first of a kind is always more expensive than the second, but we typically see a 20% improvement from the first, to the second, to the fourth, to the eighth, to the sixteenth. We glimpse these learning effects at a project level too – with improvements made
40 Health Estate Journal May 2025
floor-by-floor in building construction – but variability makes it hard to scale. “The way hospital projects are conventionally planned and funded as ‘one offs’ makes it very difficult to make trade-offs across different schemes and harness the learning effects. We need to be able to say we are going to invest in one hospital as a pathfinder, with the knowledge that the first one is going to cost 10 to 20% more than the second one. “The way that we approach it in construction is we measure, and we lock everything in a project that has its budget, targets, teams, and incentives. The next one will have slightly different teams, slightly different incentives, and slightly different targets. For standardisation to be successful, we need to break that kind of delivery model, and find ways to encourage repetition and learning.”
Future vision Looking ahead 20 years to 2045, healthcare facilities could look and feel quite different from today if standardisation is achieved, according to both Ben Carlisle and Andrew Parks. They envision a healthcare system that continuously learns and improves, with better integration of digital systems, more efficient processes, and improved patient outcomes. “How you conceive and plan a hospital and engage
stakeholders and communities should feel totally different by then too,” says Ben Carlisle. “It takes four to six years now, but it should only take a year in the future if we are successful in adopting standardisation.” He also believes there will be improvements in the way facilities are operated and managed, with standardisation creating the opportunity for digital twins and common data formats across the common designs. “With this information,” he says, “you can start spotting patterns across multiple hospitals, rather than just one, so you know if something is out of the ordinary, or more systemic, and deal with it accordingly.” It is clear that the tools exist to make hospital projects
less risky to build than offshore wind schemes, but the big question is whether all parts of the sector can work together to get there.
Reference 1 The Value of Platforms in Construction report. Construction Innovation Hub. April 2023.
https://tinyurl.com/bdfyu9vw
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