OFFSITE CONSTRUCTION The clinical perspective
Dr Eliot Sykes, Clinical director for Surgery and Elective Care, said: “The building was clinically designed and led, and there was fantastic collaboration and engagement across the clinical, estates, design, and construction teams. This strong working relationship at every level was key to the success of the project. The users were very engaged from the outset, and had the freedom to express their views on the development of the building. “The new facility is designed to maintain lines of sight, and this works very well. You can see every clinical area, which is important for co-ordination within the unit, and is what makes this facility unique nationally. There are six specialisms working here, which could be challenging both from a management perspective, and in maintaining patient safety. This, combined with an advanced IT system, has created a highly efficient care service.
Natural light
“The amount of natural light is another excellent feature, and was a fundamental design requirement. This is so important for staff and patients. The design of new hospital facilities is too often finalised without clinical input – which then compromises both efficiency and the patient environment. This was not the case here. The engagement process was agile, with design details adjusted when required.”
The building provides a logical and integrated care pathway – resulting in an enhanced patient experience, and improved flows and efficiencies, which combine to deliver a better quality of care. The core principle is a progressive care model, where patients move logically through the unit rather than returning to a waiting area. This approach is central to ambulatory care. Patients are mobile, having been referred by primary care or via A&E, so it is important that they do not remain too sedentary. The new unit is already helping to decompress a very busy A&E unit, giving the teams for ambulatory care a dedicated space. In the previous facility, for part of the year, the ambulatory unit had to accommodate inpatients at times of significant pressure. This compromised the flow and capacity of the department. The new facility is now off the escalation plan, and has a dedicated, purpose- designed space to realise the true potential of the service.
Lessons learned
Northumbria Healthcare NHS Foundation Trust is a mature client, highly experienced in construction procurement. The precise clinical needs were identified at the earliest stage. The client team demonstrated good governance and the value of frameworks in procurement. A collaborative form of
154 Health Estate Journal October 2019
A true partnership approach The client’s cost consultants, Summers Inman, reflected the collaborative nature of the NEC contract, and managed the contract in the true spirit of partnering. This was another contributing factor in the project’s success. Robert Sanderson said: “Everyone worked on this project in a completely collaborative and focused way – the Trust, our consultants, McAvoy, and the design team, to define and build the new wing in a highly ambitious timeframe. I believe what we have achieved collectively – in terms of complexity and timescale – is unprecedented in the healthcare sector, and we hope that the partnership will continue on other projects. “The new wing looks exactly the same as the existing building, internally and externally, and there has been absolutely no compromise on the quality of finish and the standard of the clinical facilities. The clinical teams had full involvement right from the inception of the project, so the layout, clinical adjacencies, and patient flows, work really well. We are impressed with the quality that offsite can achieve, and you would never know this was a modular building. No departments in the hospital were adversely affected by the construction process, and the finished building is performing well. We are all very proud of the new facility, and this application of offsite construction has certainly exceeded our expectations.”
Making a real difference to patients Dr Eliot Sykes said: “The new ambulatory care unit has already made a very real difference to our patients. It will significantly enhance our ability to manage peaks in demand, while still providing dedicated ambulatory care. Offsite construction and the McAvoy approach have been brilliant in terms of build quality
contract was chosen. This meant that procurement could run in tandem with the build process, and with a tremendous focus to deliver the clinical needs on time. This was all vital to achieving such an ambitious programme.
The floor cassettes improved the integration of traditional and offsite construction methods. McAvoy believes the interface could be further developed with the advancement of the hybrid building solution. Floors were designed to be solid, and successfully achieved the performance standards required. McAvoy partnered early with M&E contractors, Dowds Group. Bringing the Dowds team to the table at the outset gave the delivery team the benefit of specialist expertise, and ensured that routes through the building were fully integrated and co-ordinated. This partnership approach worked very well, and helped to fast-track the development of the M&E strategy.
and the pace of construction. We were amazed at the rapid progress from our first meeting to commissioning, and for a building of this scale. Most importantly, feedback from patients has been extremely positive. They love the design, and talk about the progressive model of care. Their experience is that waiting times are shorter, and they are impressed with the rapid diagnostics service. This is an outstanding facility for the Trust, and is really unique in the UK.”
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Raymond Millar
Raymond Millar is Construction director at The McAvoy Group, a leading offsite construction specialist in the UK and Ireland. Prior to joining McAvoy, he had built an impressive career in the construction industry, working throughout the UK and Ireland. He brought extensive experience of different contract types and procurement methods, ranging from traditional, framework, design and build, to PFI, and target cost and open book accounting, for a diverse client base, to lead the Group’s contract delivery team. His focus is on the development and roll-out of best practice in the delivery of offsite projects, working across the commercial, procurement, and construction aspects. A qualified quantity surveyor and a Fellow of the Chartered Institute of Building, Raymond Millar has around three decades’ experience in construction, having previously held roles at a number of other leading construction companies.
The McAvoy Group offers the full range of design, manufacturing, fitting out, and construction services ‘for the delivery of high quality, affordable, and sustainable buildings, in the health, education, residential, commercial, and infrastructure sectors’.
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