SITE VISIT


minutes – why are we doing that? The room should be something that’s multi-use. “These rooms are your admissions, your discharge lounge, first stage recovery, second stage recovery, your anaesthetic – they are everything. So, you come in, you go into a medipod, you get prepped for surgery, you go and have your surgery, you come back to a medipod, you recover, you go home or, in a few cases, to a ward.” Using space in this way has meant that, instead of building a series of patient rooms, MTX has maximised the OR space – fitting seven ORs into a space that, historically, might have contained half that number – just one of the many ways in which the collaboration between MTX and the Trust have worked in partnership to construct a 21st century surgical building that looks to the future instead of simply doing things the way they have always been done.


More, and larger ORs Fitting a higher number of ORs into the space has not meant any compromise in terms of OR size. Indeed, thanks to the way the SEC has been designed, the seven ORs on Level One are significantly larger than the UK average (which sits at between 55m2


modern standard of around 62m2 70-80m2


. Two of the ORs on Level One are cutting-edge,


hybrid ORs that combine ‘conventional’ surgical suites with medical imaging equipment, allowing surgeons to carry out imaging, biopsy, diagnosis, and surgery in the same room – again removing the need to transport a patient between a series of different rooms. In fact, clinicians will be able to adopt a fully hybrid approach, with angiography and fluoroscopy capabilities. While not CTs or MRIs, the technology in these theatres will enable uploading of CT/MRI imaging and will be able to perform 3D CT-like imaging. These functionalities aim to reduce patient and staff radiation doses. Furthermore, the ORs incorporate the Tegris OR Integration platform (supplied by Swedish company Getinge AB) which will enable clinicians to remotely view and collaborate on surgeries from anywhere in the world, and adds another dimension to John Radcliffe’s functionality as a teaching hospital.


The instrument and clinical waste workflow Another key aspect to the surgical workflow at the SEC concerns the supply, storage, and output of surgical instruments, supplies, and waste. The new Sterile Services Department will be located in the basement (Level 0) and is another area where, rather than do things as they have always been done (to wit: giving over significant floorspace to the storage of large stocks of clinical supplies – bulk-sourced by a procurement department


(the minimum required) and a ), coming in at between


– that may or may not get used before they expire and need to be disposed of), OUH and MTX have instead looked at the way things are done in the United States – particularly at urban hospitals in cities such as New York, where, as is in the case in cities such as Oxford, space is at a premium. Instead, at the SEC, aside from a small store of essentials, everything needed for the day’s surgeries will be supplied to the SEC on the day as specified by a surgeon preference card that will list the surgical instruments and implants required, suture materials, and other supplies, as well as details of any preferred surgical techniques and other important information. Clean instruments and other clinical supplies will then be


brought in via the building’s sub-basement and transported via a dedicated ‘clean’ elevator to the relevant floor. Under the auspices of a Surgical Navigator – a key member of staff who sits between off-site and on-site operations at the SEC – surgical carts containing the surgical instruments and clinical supplies needed for a specific operation that day will be placed in the sterile corridor adjacent to the OR, ready to be wheeled in and used accordingly, with some operations requiring multiple carts. Once the surgery is completed, the carts containing the ‘dirty’ materials and clinical waste will be wheeled into another corridor, then taken either off-site for disposal or back to the SSD for cleaning, again via an elevator and the sub-basement. As with other aspects of the SEC, this workflow method seems like a sensible, even obvious way of doing things in an efficient, effective way – albeit at odds with a more ‘traditional’ surgical model.


MTX: a word on kitting and carting


MTX proposed the creation of a basement on Level 0 to house a Sterile Services Department which will use a kitting and carting system. This involves assembling and transporting standardised packs of surgical instruments and consumables. Sterile sets are placed onto mobile


surgical case carts or modular stainless steel cabinets. A single cart generally


contains all the consumables, sterilized instruments, and the surgical equipment needed for each specific operation. After an operation everything is removed and either processed for re-stocking, disposal, or sterilisation. It is a highly regulated logistics process designed to maximize efficiency in operating theatres. Kitting and carting will start in the SEC


from day one as Sterile Services can supply sterile kit for the SEC to from their current location elsewhere on the hospital site. The new Sterile Services facility within the SEC will eventually consolidate all the Sterile Services functions across the Trust. Work to equip the Level 0 basement began in August with a view to complete by mid- 2027.


October 2026 Health Estate Journal 49


HEJ editor Matt Seex chats with MTX project director Adam Robertson next to one of the Level One medipods.


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