CONSTRUCTION


Safety and sustainability Factory conditions also improve safety performance. With up to 90 per cent of the work completed offsite, there is far less need for operatives to work at height or within tight clinical corridors or around live hospital infrastructure. The controlled factory environment reduces risks linked with weather, manual handling, and multiple trades working on site. For NHS estates teams having responsibility for ensuring that clinical operations can continue safely throughout a build, these improvements in health and safety performance are key. Sustainability is no longer an optional consideration –


environmental performance and Net Zero commitments now sit at the heart of every long term NHS estates strategy. Volumetric construction contributes meaningfully to those ambitions. Buildings manufactured using this approach consistently demonstrate improved airtightness and thermal performance, reducing the energy required for heating and cooling. Factory led construction enables tighter materials management, leading to up to 90 percent less waste when design engagement begins early. Traffic reductions associated with the scaled own onsite programme contribute to lower local emissions, reducing the environmental burden on hospital sites and their communities. For estates teams looking to expand their footprint while supporting organisational carbon reduction targets, these environmental advantages form a compelling part of the business case for modular building. They offer practical, achievable steps towards helping the NHS hit its Net Zero targets while adapting the estate.


Delivering a 90 per cent PMV CSSD for Strasbourg One of the most striking recent examples of high PMV healthcare construction is the CSSD facility we developed for University Hospitals of Strasbourg. Manufactured entirely in our Hull factory, the building arrived in France with four washers, three steam sterilisers, a hydrogen peroxide low temperature steriliser and changing rooms, staff rest area, sluice, office space, and storage – all already installed. With its existing CSSD undergoing refurbishment, the


hospital needed a fully operational alternative facility that could be deployed rapidly and safely. A high PMV modular approach made this possible. The building arrived in France ready for rapid assembly, testing, and commissioning. This kind of deployment illustrates the maturity volumetric construction has achieved and how well it aligns with the operational realities healthcare providers face – not only in the NHS but also internationally. Volumetric construction works best when architects,


planners, clinicians, and construction partners collaborate from the start. Early engagement allows for standardisation of designs, reduced waste, faster manufacturing, improved compliance, and clearer cost certainty. Healthcare providers who bring modular partners into the conversation early see the greatest benefits in programme, budget, and operational performance. As the demands on healthcare continue to grow, modern methods of construction offer a scalable, predictable, and high-quality solution. Volumetric construction is not simply an alternative to traditional building. In many cases, it is a better way – quicker, safer, greener, and more aligned with the operational realities of modern healthcare. We believe high PMV modular facilities will play a


central role in how the NHS expands sustainably and strategically in the years ahead.


Understanding how volumetric construction works in


practice is essential for estates teams considering whether it is the right approach for their next project. More than traditional builds, where construction and design often progress concurrently under changing site conditions, modular buildings benefit significantly from early engagement between architects, design teams, planners, clinicians, and modular manufacturing partners. Early involvement allows designs to be standardised


where appropriate, waste to be minimised and manufacturing processes to be optimised. Estate strategies that incorporate modular thinking from the outset tend to see the greatest gains in delivery speed and cost control.


The process The process typically begins with site identification, acquisition, or assessment. No two NHS estates are the same. Some hospitals have clear areas where they can be expanded or temporary infrastructure can be placed – it is more difficult for others. It also depends on what the facility is set to do, and


the procedures it will perform. It may need to be close to specific other wards, theatres, or facilities; patient flow may be a concern, while others can feasibly act as ‘standalone’ solutions, positioned away from the main hospital building. When we are working with a healthcare provider, our


approach includes collaborative early stage assessments that consider utilities, access, relationships with existing services, and the impact on patients and staff. These initial considerations form the foundation for subsequent design work. Design and planning follow, informed by feasibility studies that estimate the number of modules that will be needed and how they will be configured. Because volumetric construction relies on a high level of precision, early engagement is critical. Design teams must develop configurations that meet the clinical, operational, and technical needs of all stakeholders, but also support efficient manufacturing. Standardisation is central to this stage. It makes sure that modules can be produced consistently, with predictable interfaces to foundations, central cores, and existing buildings. Fire compliance, structural loadings, thermal performance, air permeability, mechanical ventilation, façade design, and services integration are all resolved early to reduce the likelihood of changes later. For NHS estates teams, this reduces risk and enables clearer communication with planning authorities, clinical leads, and capital programme boards. Manufacturing then begins in a factory environment


May 2026 Health Estate Journal 55


Nurse station in the modular CDC.


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