UTILITY ENABLING WORKS
Small works, big consequences At the opposite end of the spectrum are enabling activities that look small but carry disproportionate influence. Fibre, copper, and data diversions are often the clearest example. These routes sit at shallow depths beneath pavements, verges, or car parks. They are physically modest but operationally essential. They carry clinical systems, estates platforms, life safety networks, and communication lines that cannot be disrupted without careful planning.
In one of our current sequences, the interdependencies
Concept design for 33kV cable routes.
current workstreams, this defining activity is the design of a new dual-33 kV electrical supply. On paper, it is a single line item. In practice, it is a 10-kilometre sequence of negotiations, surveys, legal agreements, and design challenges. The route crosses public highways, interfaces with
Trenching & resurfacing work for data diversions.
Network Rail, passes by listed buildings, interacts with utilities laid down decades earlier, and depends on input from landowners, highways authorities, and the Distribution Network Operator (DNO). Each step requires careful sequencing. Many must be completed long before civils work begins. From a Project Manager’s (PM) perspective, this type of activity can feel like managing several realities at the same time. We are working with the DNO to understand statutory constraints and network capacity. We are briefing internal teams who want clarity on timelines. We are translating technical design discussions into language that governance panels can engage with. We are then translating assurance queries back into something actionable for designers and suppliers. This translation role often becomes one of the most important parts of delivery. These high impact utilities sit at the very top of the
programmes dependency chain. When they progress, the programme progresses. When they pause, everything beneath them compresses. This does not reflect failure. It is simply the nature of early-stage infrastructure. Recognising this early, communicating it clearly, and maintaining transparency with stakeholders builds trust and avoids unnecessary pressure. The lesson is simple: early enabling works are not small because they are unseen; they are major strategic drivers that shape the entire redevelopment. These major utilities
often dominate early conversations, but they are only one part of the picture. Some of the most influential enablers are far smaller, yet they can dictate the sequencing just as strongly.
48 Health Estate Journal May 2026
illustrate this clearly. The future hospital will be built on the footprint of an existing car park. To release that land, a new multi-storey car park must be delivered. To construct the new car park, a bus stop must be relocated. To relocate the bus stop, the fibre and copper infrastructure beneath it must be diverted. A short data diversion therefore became a critical path activity for an entire chain of enabling works. This pattern is common across healthcare estates. The
works that appear to be the least significant often carry the most immediate operational risk. Colleagues instinctively understand why a 33 kV route takes years to plan. It can be more surprising to discover that a short fibre diversion requires several layers of assurance, detailed outage planning, and clinical engagement. Part of the PM role is helping teams see the relationships
between these activities. When people understand why a small diversion matters, and how it enables several other workstreams, decisions become more aligned and confidence increases. When even the smallest diversion can shape the order of construction, it becomes clear that no single team can manage these decisions in isolation. The real challenge is coordinating every discipline around a shared plan.
Why no single discipline can deliver this alone Utility enabling works sit at the centre of a complex intersection. They involve technical design, operational constraints, commercial frameworks, and organisational governance. The PM role therefore becomes inherently multidisciplinary, often shifting focus several times within the same day. A technical issue in a cable route quickly becomes a resilience discussion with clinical teams and then a commercial discussion with finance. A change in a chamber location affects ambulance flows, fire evacuation routes, and accessibility. A procurement decision influences design flexibility, programme certainty, and assurance requirements. The PM does not need to be the technical expert
in every discipline. Instead, the role is to integrate the expertise of others. The PM forms the narrative that clinical teams, estates colleagues, digital specialists, commercial advisors, and external providers can all engage with. When done well, this reduces duplication, prevents misaligned assumptions, and accelerates decisions. Multidisciplinary leadership is not about mastering
every detail. It is about understanding how different disciplines influence each other. When a PM recognises the operational consequences of an outage, the financial impact of sequencing, and the governance requirements of assurance, the programme moves with greater confidence.
Bringing teams together is essential, but coordination does not stop at the hospital gates. External providers and statutory processes introduce another layer of complexity that must be managed with equal care.
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