CONSTRUCTION AND THE REGULATORY FRAMEWORK
Andy Buckley said: “Linking with those two points, it’s about people understanding what connectivity means, because a facility can be structurally connected, or structurally independent, but touching, and part of the same estate. We’re finding challenges on existing healthcare sites where you have a large, complex high-risk building, connected to a sprawling estate that’s all single or two-storey. If we’re doing a refurbishment 200 metres away, is that connected to the high-risk building? We’d argue it wouldn’t be, but people are debating that.”
‘Access connectivity’ Phil Morrison explained: “If you go to the Act, it talks about the ‘access connectivity’, so if your access is through a fire door that’s normally closed, then you’re not connected, but if you have a free-flowing connection above ground, you would be connected. The current problem is that if you have four opinions, just come and ask me, and I’ll give you two others, depending on who’s asking.” Steve Crow of Clarion said: “I guess it’s going back to the early concept stage of the building. In my experience, on large, complex projects such as a hospital involving several different multidisciplinary organisations, the more time you spend focusing on getting things right at concept stage, the more likely you are to achieve a project on budget, on time, and to the client’s quality expectations. For me, it’s all about creating a true partnering approach between the client and the design/ construction team – think back 30-35 years to Sir John Egan, and the whole idea of partnering – to bring the whole supply chain together, working with an informed client to consider all the risks at the start, and then mitigating them, so that as you develop into the construction stage, you’re mitigating the risk. That concept of partnering still gets discussed, but I’m not sure it’s really properly evolved. I wonder whether others have a view?” Hoare Lea’s Connie Campbell said:
Stuart Dalton
Stuart Dalton is a Project and Programme Director at Hive Projects, specialising in the development and delivery of capital programmes of transformation. Having worked with public sector clients throughout his career, including NHS Trusts and healthcare providers across the UK, he has a diverse mix of experience, and is used to working in a secondment environment alongside EFM departments.
With a background in building surveying, Stuart has used his skills and experience to advise clients on the design and delivery of capital programmes to seek best value, and strategic planning to deliver projects of all sizes alongside operational and budget constraints. Utilising available data and commissioning new estates data, he has worked with a number of clients in optimising their capital programmes to target specific objectives – whether that be decarbonisation, statutory compliance, or critical infrastructure improvements to satisfy the requirements of an organisation’s Estates strategy.
Dean Payton
Dean Payton, an Associate at Stephen George + Partners, is a technical architect and lead designer for healthcare and laboratory facilities, including interior fit-outs and refurbishments, new-build extensions, and critical infrastructure upgrades. He is involved with compliance and derogation reviews, stakeholder engagement, brief development, applications and liaison with statutory authorities, and understands complex multi-phase construction, from feasibility to handover. Equally, his knowledge of construction techniques underpins his proven successful partnership with contractors and proactive working within multidisciplinary teams. He has developed an in-depth knowledge of Revit and delivering buildings to BIM Level 2.
With extensive experience in designing for acute healthcare, he has sector- specific knowledge of ADB (Activity Database), HBNs, HTMs, and other relevant standards. He has completed the intensive Health Facilities Planning Course from IHEEM / TAHPI.
“Working within the building services sector – when designing services and the associated details, we’re seeing that now as an individual you have to sign your name, and that when you tell your client the building will be ‘satisfactory and compliant’, you must be confident it actually will be; the industry is becoming significantly more risk-averse. Even though the building may not meet the ‘high-rise building’ criteria, or it has fire doors and is separated from the HRB, some designers are more likely to now recommend that buildings should incorporate further fire management strategies, particularly when they feel legislation will likely change in future. As much as the client wants to save costs, it’s about making the right choice, i.e. best practice means we need to be designing safe buildings, even if the legislation doesn’t specifically stipulate something. For us it’s an education piece for us to try and sell this concept to clients and service management teams, and say: ‘Actually, we think this is the best approach.’” Andrew Varley said: “From the
private sector standpoint, design and build contracts are all about risk, and
it all depends what expertise the team possesses from the client’s standpoint to be able to manage that. With traditional build, with a large team, and everyone being collaborative and doing all the upfront work, it’s great, but you don’t really know where your end-costs will be at that point. Where we’re doing work particularly within the NHS – and I think it needs a culture change back the other way – this is all about being ‘smart’, and doing the work at the beginning. So, you’re almost into a two-stage tendering process now that you need to do that design work, and traditionally everybody wants to pass on the risk. You then start paying for risk, so it becomes too expensive. It used to be a race to the bottom, and a case of trying to pass that risk on to another contractor. However, it needs to change; you’re going to have to partner to do that upfront design work and then the costs could rise. Effectively it’s design / build, but it’s not. You’re effectively building that design, but it’s a lesser element of design / build, working within value engineering – because everything’s driven on cost.”
Value engineering aspects Andrew Varley continued: “Value engineering still needs to happen, but from the beginning, and must be something that meets regulations, because we’ve seen recently interpretation from contractors on what they see as value engineering, and they’ve got a big learning curve. They think they were doing it right, but can’t evidence this, and thus what was done yesterday can’t be done tomorrow.” Andrew Varley said this scenario
necessitated more time being devoted to the upfront design work. He said: “You can’t return a tender in three weeks, because there can be substantial work – especially if we’re talking about interconnecting to hospitals. Many NHS Trusts don’t really know what their estate’s like, and the condition of their buildings. They haven’t even got evidence that it’s
September 2024 Health Estate Journal 29
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
