INFRASTRUCTURE
Power is critical in healthcare facilities and operational resilience must be embedded into every stage of any project’s lifecycle.
on major on-site developments did not encroach on BAU project areas. In some cases, we coordinated joint use of contractors’ access and Trust egress routes to minimise disruption and cost. This level of coordination in achieving its aims requires not only technical skill but also empathy, flexibility and a shared commitment to the ultimate goal of effective patient care.
Vakhtang Takov
Vakhtang Takov has over 18 years of international experience delivering high-value residential, commercial, and healthcare developments across the UK, Europe, and Asia. Currently an associate project manager at Turner & Townsend, he is leading the delivery of a multi- million-pound acute healthcare facility in central London. Vakhtang is an NEC4 accredited project manager and highly skilled in contract administration, procurement, stakeholder management, and risk mitigation. He was involved in the Community Diagnostic Centers programme and the National Hospital Programme. His career spans 50+ successfully delivered projects, valued collectively at over £300 m. With dual MSc and MBA degrees, Vakhtang is known for his meticulous planning, strong leadership and commitment to quality and safety standards.
Embedding operational resilience Operational resilience must be embedded into every stage of the project lifecycle, from strategic briefing/ business cases and concept design through to construction and commissioning. This engaged approach ensures that the delivery of new healthcare infrastructure does not compromise the continuity of care or the day-to-day functioning of NHS services. Early in the process, project teams should facilitate
operational workshops that bring together clinical, estates and facilities staff. These sessions help map out critical workflows and identify potential pinch points that could be affected by construction. Live simulation exercises, including real-time walkthroughs and scenario planning, are also valuable tools for testing proposed phasing and access arrangements before works begin. Aligning the construction programme with the Trust’s
operational calendar is essential. Known timeline points, such as major equipment replacements, or planned service reconfigurations, must be factored into the delivery schedule. Dynamic risk registers should be maintained throughout the project, capturing operational risks alongside traditional construction risks. These registers must include clear ownership, mitigation strategies and escalation pathways to the executive board. Project managers can add significant value by treating
operational resilience not as a constraint but as a core deliverable. Their role includes translating the Trust’s strategic objectives, such as delivering care efficiently, safely and sustainably, into tangible design and phasing decisions. Project managers should function as advocates for operational concerns, ensuring that every design choice – from façade layout to waste flow – is considered through the lens of real-world hospital operations. Strong project leadership also means fostering collaboration. Weekly site liaison meetings with estates, FM, clinical leaders, ward staff, infection control and communications teams help maintain alignment. Shared calendars, visible phasing maps and digital dashboards can support transparency and allow for the routine review of both planned and unplanned impacts.
178 Health Estate Journal October 2025
All healthcare projects are increasingly shaped by
the NHS’s commitment to sustainability and the Net Zero agenda. This adds another layer of complexity to the delivery of infrastructure within live environments. Temporary works, for example, must be designed with reuse and minimal waste in mind. Construction logistics plans must consider emissions, noise and air quality impacts on patients and staff. At the same time, the long-term operation of the building must support sustainable practices, from energy-efficient systems to flexible layouts that can adapt to future clinical needs. Engaging operational teams early ensures that sustainability is not just a design aspiration but a lived reality.
Lessons learned and looking ahead Delivering major projects within operational hospital sites is never straightforward. Yet with the right approach, it is possible to balance progress and continuity in a way that enhances both. Success depends on early engagement, shared goals/objectives, open discussions about previous projects, holistic thinking and a commitment to clear, continuous communication. Operational teams must be involved from the outset; not as a late-stage check, but as integral contributors to the design and delivery process. Understanding the full ecosystem of hospital activity, beyond the immediate construction footprint, allows project teams to anticipate challenges and build in the flexibility needed to respond to the unexpected. At the heart of this approach is a people-first mindset. Hospitals are places of care, and every decision, from phasing to access routes, must support that mission. Project managers should play a vital role in translating the Trust’s strategic objectives into practical design and delivery solutions. They advocate for operational realities, ensure risks are actively managed and lead collaborative forums that bring together estates, clinical, FM and communications teams. The Turner & Townsend healthcare project management
team has decades of proven experience working in live hospital environments. As the NHS estate continues to modernise, the ability to deliver complex projects without compromising the delivery of care will be a defining capability. By placing operational continuity at the centre of delivery, we help Trusts ensure that today’s improvements do not come at the cost of tomorrow’s care.
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