CONSTRUCTION
Arup says the Exeter Nightingale Hospital was ‘transformed’ into a CDC effectively precisely because the original hospital was built with sustainability and flexibility in mind.
it was necessary to protect only the lowest 5 m of the structure. Establishing this from the outset avoided significant technical, cost, and programme issues. The main acoustic challenge at the start of the project was the unknown acoustic properties of the existing DIY warehouse building, since – due to COVID – no on-site measurements could be taken. Instead, software modelling was used to predict the reverberation characteristics of the space so that recommendations for internal constructions could be made to ensure appropriate acoustic conditions within hospital rooms.
Planning and access considered Phasing and access were also carefully considered, enabling the existing CT scanner to remain in use throughout construction as a valuable facility for the local community. A lot can also be learned from how the project embraced the power of digital technology. For example, the
The reconfigured Exeter Nightingale Hospital used modular construction to expedite the delivery of a new orthopaedic department, comprised of two operating theatres, a recovery ward, and a clinical store.
steel podium was collaboratively designed entirely via the steel fabricator’s 3D model, with the structural engineer, architect, and modular supplier, all feeding in their requirements. This removed the need for multiple rounds of drawing reviews, or duplication of design information. From drone surveys, virtual site visits, and Matterport scans, alternative and innovative solutions were found to replace older, less efficient methods.
Repurposing healthcare facilities The real lesson from the Exeter Nightingale Hospital is found in its continued use beyond the initial pandemic response. It was transformed into a CDC effectively precisely because the original hospital was built with sustainability and flexibility in mind. This is exemplified by the fact that a number of single-storey modular buildings were connected to the existing retail unit in its construction. As well as more than doubling the size of the building, these
off-the-shelf modules were designed to be unbolted and re-used elsewhere when needs changed, allowing for future flexibility and repurposing. For spaces with higher technical demands, such as the X-ray and fluoroscopy facilities, the existing building was upgraded with lead linings and support frames for the imaging equipment. The extended facility provided a range of services, such as a pharmacy, staff welfare spaces, catering, utility rooms, patient transfer rooms, and modular imaging and theatre spaces. Prefabricated plant decks were added on top of existing structures to allow the servicing layout to be re-configured in the spaces below.
Change in fire safety strategy As the functionality of the space shifted to CDC, the fire strategy also evolved to cope with the higher fuel load and intensity of the medical diagnostic equipment. This adaptability was enabled by the very close collaboration between the client and design teams and the fire engineering team, who were on the ground, able to witness changes, and respond rapidly. Existing fire alarms and dampers were repurposed, and the original ventilation fans were incorporated to assist with firefighting operations. With COVID-19 restrictions now
lifted, our acousticians could take in- person measurements of the acoustic performance of the rooms and partitions built in the first phase. This information was then used to inform plans and construction for the new CDC layout. In addition, suitable locations were identified for external plant items and ductwork layouts to reduce intrusive noise in line with best practice targets, for the comfort of patients and staff alike. All of this combined has resulted
Phasing and access were also carefully considered, enabling the existing CT scanner to remain in use throughout construction as a valuable facility for the local community.
44 Health Estate Journal October 2023
in reduced waiting times and quicker discharge for patients following surgery. As a result, the hospital can now provide facilities for a range of services, from high-
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