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HOSPITAL DESIGN


only to its own changing requirements, but those of local and neighbouring environments, populations and infrastructure; whether driven by unforeseen events like COVID-19, or longer-term political and social changes. For example, we designed


accommodation areas within the hospital using future climate change scenarios and the latest adaptive thermal comfort methodologies. This has allowed the design to reduce its reliance on comfort cooling systems with their associated operational carbon emissions and refrigerants while still delivering good occupant comfort. In addition, the commercial model


dictated high levels of occupancy of the building from day one, which drove the design of a nucleus facility from the early stages. This building could then expand as the business grew and shape itself for any potential clinical scenarios. The best response to the demands


of sustainability is to create the most efficient, flexible and adaptable design. The efficient use of materials is core to our platform approach, which naturally tends to the leanest and most compact design by optimising every element, eliminating approximation and allowances, and taking every opportunity to reduce inefficiency and waste. We are also faced with a climate crisis that requires every building to be designed and built for reduction in both embodied and operational carbon. The platform approach led to a structure with significantly lower embodied carbon compared to a traditional construction. Furthermore, the site and adjacent


area were also prone to annual flooding, causing damage to infrastructure and residential neighbours. We created a sustainable drainage solution on site which prevented this.


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Increased quality at reduced cost The flexibility in the design was fully exploited on this project. Following the initial design for the elective surgery facility, we were able to incorporate a large-scale rehabilitation facility. This will be the first large-scale centre of its kind in the UK and has been designed to provide the missing link between acute and community care provision. By adopting best practice from Europe and the United States, this facility will: l Provide intensive therapy that exceeds National Health Service (NHS) levels and is proven to improve patient function.


l Enable care to be delivered at 30 per cent lower cost compared to the cost of an NHS acute bed.


l Release 10-20 per cent acute beds enabling local NHS trusts to increase their operational facility and flow.


l Increase patient functionality resulting in reduced cost of long-term care – 80 per cent of patients in European facilities return home leading to significant potential benefits in relation to independent living and return to work.


The design as delivered represents a step change in healthcare design, delivering enhanced patient and staff experience, as


well as significant cost savings. The typical cost of NHS hospital stock in the English Midlands is £3,000-£3,500 per square metre. For this building, we achieved a cost of £2,300 per square metre, a saving in the region of 30 per cent.


Setting a precedent for healthcare construction platforms The building has been seen as an exemplar by the Department of Health of Social Care and a number of NHS Trusts. It is a marker for future UK hospital projects and the benchmark by which they can be measured in terms of flexibility, adaptability, quality, cost, delivery, patient experience, patient safety and clinical outcomes. In September 2021, the UK


government’s Infrastructure and Projects Authority (IPA) published Transforming Infrastructure Performance: Roadmap to 2030. The IPA said that the roadmap describes ‘a vision for the future in which we collectively prioritise the societal outcomes we need, and use modern digital approaches and technologies, alongside improved delivery models to achieve them.’ To deliver this vision, and apply it to the £650 billion national infrastructure and construction pipeline, they identify five key focus areas. The third of these is ‘addressing the need for social infrastructure using a platform approach.’ The IPA says that they are working to mandate a platform approach to construction across social infrastructure within the next two years. Circle Birmingham Hospital


demonstrates what a platform design can bring to the form and function of a hospital. Given what the UK government has said, it is one of the earliest exponents of how all hospitals will soon be designed, for the benefit of all of us.


IFHE IFHE DIGEST 2022


©Rory Mulvey


©Tim Cornbill


©Tim Cornbill

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