COMMUNITY DIAGNOSTIC CENTRES On projects like Thurrock CDC and Southlands CDC,


extensive early surveys of structure and existing services were critical, not only to confirm capacity for new equipment but to ensure ongoing hospital operations were not disrupted during delivery. And yet, the benefits are enormous. Accessibility is


markedly improved for people in the local area, health inequalities are addressed, and footfall returns to town centres. Overall, the estate becomes a highly visible and active part of the community.


Early engagement is a cost strategy, not a courtesy If there is one consistent theme across every CDC project, it is this: early stakeholder engagement reduces risk more effectively than any contingency allowance. In our experience, clinical service managers, radiation


protection advisers, imaging suppliers, estates engineers, infection control teams, and many more must be involved at the concept stage, not after planning submission. Why? Because diagnostic spaces are unforgiving. A CT scanner requiring a 0.5 mm floor tolerance does not allow for late design changes, much like how lead shielding calculations cannot be adjusted casually once walls are constructed. At Newmarket CDC, clinical service managers were engaged from concept stage and remained involved throughout, allowing us to refine room layouts and patient flow as a team before construction began rather than correcting errors later. And at Northgate CDC, for James Paget University Hospitals NHS Foundation Trust, our early examination of the existing structure prevented expensive rework later in the programme. A new slab and resin floor was installed in the CT room to ensure it met the 0.5 mm tolerance of the scanner, something we determined was necessary during early engagement sessions. Where full compliance with current standards proved impractical, we secured formal derogations early on to ensure transparency and avoid disputes. Early contractor involvement should be viewed through


the same lens. When contractors are appointed at concept stage, buildability informs the project’s design rather than reacts to it. Specialist supply chains can be engaged sooner and roles between our contracting team and turnkey imaging suppliers can be clearly defined before the procurement scope is finalised. In practice, the importance of aligning contractors early on is underlined by the complexity presented by systems like medical gas provision, electrical resilience, and ventilation performance. All of these are sophisticated and intricate in their own right and require specialist subcontractors, but their interdependencies mean they must be approached as a single integrated system, a system that needs to be understood, mapped, and coordinated from the outset. In CDC delivery, clarity equals programme certainty.


The imaging interface and managing risk Across every scheme, the interface between the Morgan Sindall team as main contractor and imaging equipment supplier has been a critical risk point. MRI, CT, and X-ray suites are not just rooms with


machines placed inside them. They are highly engineered environments with precise tolerances, shielding requirements, and needs. Misalignment in this area can result in confusion around who is delivering what, unassigned responsibilities, or worse, key elements falling between contractual gaps.


The solution is


procedural control: n Early and regular coordination workshops with turnkey suppliers.


n Detailed route- tracking surveys for equipment delivery.


n Early agreement on responsibility for specialist elements.


n Alignment around fixed scanner installation slots.


At Southlands and Grimsby, detailed route-tracking surveys were undertaken early to ensure that large imaging equipment could be delivered through limited existing structures, avoiding costly late-stage redesign or programme delays. Lead times for major imaging equipment are significant and installation windows are rarely flexible. Missing them can have cascading financial consequences, particularly where temporary scanners are hired. So for estates leaders, the message is clear: invest time early in defining interfaces – it pays dividends later.


HTM fluency and regulatory confidence Compliance with Health Technical Memoranda (HTMs) and Health Building Notes (HBNs) underpins safe healthcare delivery. Projects could suffer when design teams lack healthcare experience, leading to delays and costly changes, so getting a team onboard who are HTM- fluent reduces learning curves hugely. Across our projects, early engagement of healthcare-


experienced designers and Radiation Protection Advisers has reduced redesign and avoided modifications to shielding at a late-stage. At Thurrock CDC, close collaboration with Radiation


Protection Advisers and NHS stakeholders ensured that room designs aligned with both HTM and HBN requirements from the outset, avoiding costly later modifications and delays. HTM fluency is not just about avoiding non-compliance, it is about understanding intent. For example, ventilation strategies should support infection prevention and patient throughput, not simply meet numeric targets. As CDCs become more common, building a supply


chain with embedded, highly practiced healthcare knowledge will be essential to maintain quality and consistency.


September 2026 Health Estate Journal 33


Norfolk and Norwich University Hospitals CDC.


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