HEALTHCARE CONSTRUCTION
very closely with the site FM team, as well as the NHS Trust, and it also meant challenging and testing the brief, so that everyone was sure they were working in the same direction to deliver what was required.
“One of the scary things was that while we were doing what we needed to in terms of refining the brief and developing drawings, construction had already begun,” explains Ged Couser. “We were on a tight timescale, and some elements of the build could not wait. While we were working on designs with NG Bailey, Archus, and the clinical teams, the IHP team, led by John Fowler, IHP Contracts manager, was preparing to lay flooring throughout the convention centre before a line had been drawn on the grid.”
‘Almost like reverse engineering’ The problem for the designers was that they could not work as normal. Just like all of us, they needed to adjust. It was almost like reverse engineering. It was not design and build, but instead more like ‘build and verify by design’. John Fowler and I knew the flooring had to go down, so by Monday we had the material delivered and work had started.
“Meanwhile we had not agreed the bed bay set-up, let alone the overall layout,” says Ged Couser. “This was critical to moving the build forward. Flooring was one thing, but we needed to agree the exact proportions of the bed bay to know the capacity and overall floor plan.” It was thus good to know that NG Bailey team was ahead of the game. Its team had already been working on the Harrogate Nightingale hospital, and knew the likely requirements for bedhead trunking, sockets, switches, and wiring. “We opened up our off-site factory on Sunday, and had begun to collate the materials we anticipated might be needed based on what we had learned from Harrogate,” explains Paul Aulton. “That experience, and the fact we had already been working with BDP, gave us an edge.”
A mock-up of the bed bay To agree the bed bay we needed a mock- up, which was a critical stage of the design process. The beds were a standard size, and we knew approximately the dimensions needed by the nursing team. What we also needed was a partition fit for purpose. Feedback from the London ExCeL Nightingale Hospital was that the system used there was not ideal – so we opted for a temporary hygiene system that the VINCI team had used before. Samples of product arrived on Monday, and on Tuesday NG Bailey brought the kit fabricated in its factory and the mock-up bed bay was assembled. “At one point we had in the region of 20 people spaced out around what amounted to a test bed bay,” says Ged Couser. “The overall
20 Health Estate Journal June 2020
of vinyl flooring needed to be laid, requiring a very frank conversation with the flooring contractor as to how fast could it get materials, and finish the installation.
Around 14,000 m2 NHSE/I
NHSE/I commissioned NHS Nightingale North West via Manchester University NHS Foundation Trust, as the client which runs the hospital. The Client project managers were Mott MacDonald, alongside Archus. Integrated Health Projects was the principal contractor, with BDP as architect and M&E designer. IHP engaged NG Bailey as M&E installer, and other suppliers from the experienced IHP supply chain.
configuration was checked to allow for IT services at every bed, with provision of handwash facilities and nurse space talked through. It was live beta testing of a full-scale working model, and it worked.”
A process of adjustment
This meant that the design, procurement, and construction could move forward. It was an example of how the drawing stage needed to adjust; whereas on a normal project designs might be created, and mock-ups provided over months, this happened in hours. However, flexibility through the project remained fundamental.
What we came to know as ‘the new normal’ at the Manchester Nightingale gained momentum. Decisions began to flow. This was due to a clear hierarchy, but not one that was rooted in any notion
of one leader. Ernst & Young worked alongside the NHS; its requirements were checked, and then conducted down a ‘funnel’ by Mott MacDonald and Archus to the IHP design and delivery team. It was an organic system that allowed individual specialists to focus on solutions. “While commercial concerns, contract paperwork, and pricing, were not the driver on this job, we still needed to track what was going on,” explains Martyn Frackelton, Project principal, Mott MacDonald. “Yes, we needed to crack on – see a problem, develop an answer, test it, build it – but we needed a paper trail too. Timesheets, materials, and orders, all had to be auditable. That’s part of our job as project managers, as well as being the interface with the client team.” The light touch from the project management team gave the authority and flexibility to deliver the solutions needed. It meant that John Fowler could rapidly organise the supply chain, and team members from NG Bailey, BDP, and other suppliers, could liaise seamlessly with IHP.
Go-between, translator, and fixer “Clinical liaison means you are the go- between, the translator almost, and the fixer joining up the thinking of the clinical teams and contractors,” says Caroline Mulholland, Clinical Liaison manager at Sir Robert McAlpine. “I’ve been involved in healthcare contracting for 30 years, but this was unique – indeed special. My job is to ensure that the NHS teams make their concerns heard and understood. In this
Integrated Health Projects
Integrated Health Projects is a joint venture between VINCI Construction UK and Sir Robert McAlpine that operates under the ProCure22 Framework. The Department of Health & Social Care and NHSE/I approached IHP and other ProCure22 providers in late March to discuss the likelihood of field hospitals being delivered. The IHP team in the North West put its name forward for the work proposed at the Manchester Central convention complex.
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