HOSPITAL DESIGN AND CONSTRUCTION
and patients were moved to the new, state-of-the-art building in Cambridge. A ‘sprawling’ estate
Antoinette Reis said: “While the old Papworth Everard site, with its beautiful parkland setting, was much loved, in the latter years the estate comprised a real sprawl of, in some cases, quite ageing buildings. These were not only unfit for 21st century surgery, but also hard to properly maintain. Many patients were accommodated in open four and six- bedded bays, which were not ideal from either a nursing or an infection control standpoint, and clinical adjacencies were poor – for instance moving patients from one side of the hospital to another often entailed a journey by trolley outside. The theatres’ housing in some quite antiquated buildings, meanwhile, made making significant improvements impractical.”
HOK, Antoinette Reis explained, first got involved in the new hospital scheme in late 2010. She said: “I began working on the project in December that year.” I wondered why – given the obvious driving factors – the re-location had taken so long to achieve. Antoinette Reis explained: “There was a strong drive to site the new hospital close to Addenbrooke’s; the two Trusts have a long-standing relationship, and the new Cambridge Biomedical Campus was seen as the ideal location. However, developments on the PFI-funded project took time. We got through the first design phase, and then got stopped. On resuming a year later, nothing more appeared to have happened. There were several ‘stop-starts’ throughout. Initially there were three PFI consortia in competition – led by Bouygues, Skanska, and Apex Health. The Skanska-led consortium was appointed as preferred bidder, with HOK’s London studio as architects, Troup Bywaters + Anders as the M&E consultant, and Skanska Tech as structural engineer, in 2012.”
Several design iterations
Antoinette Reis explained that there were several iterations of the design. She said: “In the first competition stage, the brief was quite a challenge; we received an excellent Trust brief, but it was much larger than we could build given the available funds and the site constraints. Our first task was thus to interrogate the brief and bring it down to size. This meant looking at maximising space, and considering which facilities could be shared, both inside the new hospital, and with the neighbouring Addenbrooke’s Hospital. Within the new hospital,” she continued, “we looked at elements such as incorporating shared staff hubs; these combine rest rooms and break spaces and, in contrast to practice at some other
46 Health Estate Journal January 2020
An operating theatre: MTS Health, which managed equipment procurement, worked with the Project Team, clinical staff, IT, and clinical engineering personnel, to select and appoint Jones AV to install the complex theatre infrastructure.
hospitals, are shared between departments.” This, the Medical planner explained, ‘is about blurring the boundaries between clinical departments, which encourages communication, staff interaction, and sharing of expertise and good practice’. There are three such staff hubs on the ground floor, while the Critical Care Units, theatres, and cath labs on the first floor, share a hub.
Ability to convert offices to theatres Our meeting – during which I also met the Trust’s head of Estates, Facilities & PFI, Shelley Hugill – took place in an area of ‘soft space’ on the first floor, which, in addition to the various theatres, also houses open plan offices for clinical staff. Antoinette Reis explained that a key goal on this ‘hot floor’ had been to move away from cellular offices to open plan working with ‘hot desks’. She said: “While the ground floor houses all the hospital’s administrative functions in one large open plan space, the first provides a mixture of open plan offices, pods, and meeting rooms for clinical personnel. The design brief stipulated that there should be the capacity to expand by 11,000 square metres to meet clinical demand, without major additional construction work. One of the major facilitators is that the first floor office space is designed so that it can easily be converted to further theatres and cath labs should demand necessitate this in the future. “We have ensured that this can be done with minimal disruption, both through the structural design, and the way that the various M&E services are configured. If the Trust decides to add further theatres or cath labs, the main theatre corridor can simply be extended, and, because all the rooms are on an identical grid, it should then be
straightforward to demolish the office space and convert it to surgical facilities. There are no imminent plans to do this, but the Trust’s brief stipulated to us the ability to future-proof the building.”
Equipped for a broad range of surgeries
From the transfer over of patients in late April/early May last year – a process which was undertaken extremely efficiently by the East of England Ambulance Service and Amvale Medical Transport, and completed two days ahead of schedule – the Trust had at its disposal five standard theatres, five cath labs, and two hybrid theatres. Eleven of those rooms were used from the start, with the final hybrid having opened in October, primarily as a theatre for surgical use.
Antoinette Reis explained: “With the cath labs and theatres on the same grid, if, in future, there is, say, more demand for cardiology than cardiac surgery, or vice- versa, a cath lab can be turned into a theatre, or vice-versa.” All radiological imaging and nuclear medicine facilities, meanwhile, are on the ground floor, which also houses a ‘Rehab’ unit, a robotic pharmacy, and other more public-facing areas – such as the Discharge Lounge, day ward, and PALS. Imaging equipment includes two Siemens Somatom Force Dual Source CT scanners, a 1.5 Tesla Siemens Magnetom Aera MRI scanner for regular scans/appointments, and a larger 3 T Magnetom Prisma MR, which is intended to be primarily used for research, but is also being used for regular appointments. In addition to the dedicated lift which takes visitors up to the CCA, there are two specific lifts to transport emergency patients to the cath labs extremely fast. There are also two bronchoscopy suites on the surgical ‘hot
The Royal Papworth Hospital NHS Foundation Trust
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