EQUIPMENT INSTALLATION
and opportunities for efficient change have been lost. Late discovery of these needs almost always results in cost increases, programme delays, and operational compromises.
Clinical teams also carry a depth of institutional
knowledge about how existing facilities work in practice, including practical shortcomings that may not be visible in drawings or specifications. This insight is invaluable when shaping new environments. Failing to capture this knowledge at an early stage is one of the most common and costly missed opportunities within healthcare capital schemes, and one that can be readily avoided through structured and timely engagement.
Lifecycle blind spots Major clinical equipment assets typically have economic lives of up to 15 years, while the buildings that house them are expected to remain in service for 40 to 60 years or more. Efficient use of this estate is therefore essential. However, this progress is undermined when shortcomings in equipment planning lead to reactive structural or services adaptations that disrupt clinical areas and reduce usable space. Unless replacement routes and adequate services capacity are deliberately designed from the outset, every future equipment refresh carries the risk of reversing the efficiency gains that modern estate strategies seek to achieve.
The real costs of inadequate planning Structural reinforcement works that are identified late in the construction programme, when concrete slabs have already been poured and ceiling voids fixed, are among the most expensive and disruptive variations a project can face. A single CT scanner can weigh more than two tonnes, and some PET CT systems significantly more. When the structural engineer has not been given accurate load data during the design stage, remediation can cost hundreds of thousands of pounds and introduce delays of several months to the programme. In the most severe cases, remediation requires temporary propping of completed structures, demolition, and reconstruction of finished elements, and shut down of adjacent clinical areas. These impacts are wholly disproportionate to the relatively modest structural engineering interventions that would have been required had accurate information been available at the right time. Mechanical and electrical services deficiencies present similar risks. Clinical imaging equipment generates substantial heat loads that must be managed through dedicated cooling infrastructure. MRI systems have complex requirements involving chilled water supply, quench pipe routing, and magnetic field management, all of which influence plant room sizing and duct routing. When these requirements are not understood early, rework such as rerouting ductwork, enlarging plant rooms, or upgrading electrical distribution boards becomes both costly and disruptive to the programme. There is also a broader impact on the estates portfolio. Facilities that are operationally sub optimal from the day they open tend to generate disproportionate maintenance and adaptation costs throughout their operational life.
Key risk indicators: when to escalate equipment planning concerns n Equipment technical data sheets not received from suppliers by the end of RIBA Stage 2.
n Structural loads designed to generic allowances rather than confirmed manufacturer data.
n No documented replacement route for any equipment item weighing over 500 kg.
n Clinical end users not engaged in room data sheet sign off by the end of RIBA Stage 2.
n Mechanical and electrical cooling calculations not based on actual manufacturer heat rejection data.
n No commissioning and activation plan in place by RIBA Stage 4 mobilisation.
A structured approach to early technical assurance The solution is to fundamentally reframe the role of equipment planning within the project lifecycle. It must no longer be treated as a procurement activity, but as a design driver that needs to be integrated from the earliest stages and managed with the same rigour as any other critical design dependency. Experience across a wide range of complex healthcare capital programmes points to an approach that operates across three interconnected dimensions.
Early technical intelligence gathering The process begins with a systematic effort to establish, as early as RIBA Stage 1 or 2, the technical envelope of the equipment that the project must accommodate. This does not require equipment suppliers to be formally appointed at this stage. It does, however, require proactive engagement with manufacturers to obtain indicative technical data for the equipment classes under consideration. This technical intelligence must flow promptly and directly to the design team. Project managers have a key coordination role: facilitating technical workshops, translating equipment data into clear design requirements, and ensuring that structural, mechanical, and electrical engineers and architects all work from a common, accurate understanding of requirements. Equipment planning cannot be conducted in isolation
from wider design coordination. On complex healthcare schemes, equipment coordination should be embedded within the standard design review cycle, ensuring that every RIBA stage gate includes a specific equipment assurance checkpoint. Clinical teams should not be treated as passive consultees but as active design participants, contributing to focused workshops, reviewing room data sheets, and signing off technical assumptions before they are fixed into the design. The interface between clinical teams, equipment
suppliers, and the design consultant team is a particularly high-risk area. When this interface is not actively managed, critical technical information falls into the gaps between professional disciplines.
Clinical imaging equipment generates substantial heat loads.
Vakhtang Takov
Vakhtang has over 20 years’ experience delivering residential, commercial, and healthcare developments across the UK, Europe, and Asia. Currently an associate director at Turner & Townsend, he leads the delivery of a multi-million pound acute healthcare facility in central London. Vakhtang is an NEC4 accredited project manager, highly skilled in contract administration, procurement, stakeholder management, and risk mitigation. He has been involved in the Community Diagnostic Centres programme and the New Hospital Programme, contributing to major national healthcare initiatives. His career spans more than 50 successfully delivered projects, with a combined value exceeding £300m.
October 2026 Health Estate Journal 145
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124 |
Page 125 |
Page 126 |
Page 127 |
Page 128 |
Page 129 |
Page 130 |
Page 131 |
Page 132 |
Page 133 |
Page 134 |
Page 135 |
Page 136 |
Page 137 |
Page 138 |
Page 139 |
Page 140 |
Page 141 |
Page 142 |
Page 143 |
Page 144 |
Page 145 |
Page 146 |
Page 147 |
Page 148 |
Page 149 |
Page 150 |
Page 151 |
Page 152 |
Page 153 |
Page 154 |
Page 155 |
Page 156 |
Page 157 |
Page 158 |
Page 159 |
Page 160 |
Page 161 |
Page 162 |
Page 163 |
Page 164 |
Page 165 |
Page 166 |
Page 167 |
Page 168 |
Page 169 |
Page 170 |
Page 171 |
Page 172 |
Page 173 |
Page 174 |
Page 175 |
Page 176 |
Page 177 |
Page 178 |
Page 179 |
Page 180 |
Page 181 |
Page 182 |
Page 183 |
Page 184 |
Page 185 |
Page 186 |
Page 187 |
Page 188
