MODULAR BUILDINGS
being delivered using modular building techniques.
Modular building systems bring a number of advantages in this context. Because the majority of the construction work is completed offsite, the level of disruption at busy hospital sites is dramatically reduced. This is particularly valuable in large acute hospitals where services must remain operational throughout building projects. Modular construction also enables more predictable timelines, as fabrication in factories is less subject to weather delays and other on-site variables. Furthermore, when the same design is replicated across multiple sites, time is saved not only in construction but also in the planning stages. Building layouts, as well as detailed Mechanical and Electrical (M&E) specifications, can be standardised and reused, ensuring consistency and efficiency from project to project. Beyond speed and convenience, modular methods also contribute to the NHS’s sustainability agenda. The process typically produces less material waste, requires fewer deliveries to site, and consumes less energy overall, making it a lower-carbon alternative to traditional building approaches. Taken together, these factors explain why modular construction has become such a powerful tool for the NHS in its efforts to modernise facilities, reduce environmental impact, and deliver better healthcare spaces for patients and staff alike.
How are compliance checks carried out currently on traditional builds? In the NHS currently, there are a number of building services compliance standards known as Health Technical Memorandums (HTMs). There are also standard documents known as Health Building Note (HBNs). These standards cover all the building
services in a clinical building such as ventilation, electricity, water, and medical gases. There is also a HTM for Fire Safety, known colloquially as the Firecode, which is the HTM05 which comprises 14 documents. Taking the example of healthcare
ventilation in new building being constructed using a traditional building process where the building is being constructed on a building site. The ventilation is supplying a new Ultra Clean Ventilation (UCV) theatre. In this case the compliance checks may be carried out by an Authorising Engineer – Ventilation (AE(V). The first process would be to review the design of the new theatre and its associated air handling unit and assess whether the air flows are compliant, which means that air flows from clean to dirty and that there are sufficient air changes for the particular area of the healthcare building. For example isolation rooms
IFHE DIGEST 2026
The structure of the checks Design Stage Review
l An Authorising Engineer – Ventilation (AE(V)) (or the equivalent specialist for other services) reviews the design drawings and specifications.
l They check that the system (e.g. ventilation) meets HTM requirements: •Correct air change rates (e.g. 22 for operating theatres). •Correct airflow direction (clean → dirty). •Specialist cases (e.g. isolation rooms must have negative pressure).
Construction Stage Checks
l During construction, the AE(V) (or relevant Authorising Engineer) conducts regular site inspections.
l These spot checks confirm that the installation of equipment and ducting matches the approved design and complies with standards.
l Many systems are bespoke to the facility, so this process is critical.
Commissioning and Verification l Once installation is complete, the system undergoes commissioning tests (e.g. air velocity, pressure differentials, filtration performance). l The AE(V) reviews commissioning results and certifies compliance.
Handover and Ongoing Compliance l Only when compliance is demonstrated can the facility be signed off.
l For ongoing assurance, Authorised Persons (APs) and Competent Persons (CPs) carry out routine maintenance, monitoring, and re-verification against HTMs.
Summary l Design review (paper compliance). l Onsite inspections (build quality). l Commissioning tests (system performance). l Handover sign-off and ongoing monitoring.
have to be supplied with air flows to make them negative pressure and theatres are expected to have 22 air changes. This is all deduced by a close inspection of the drawings.
When the building of the new facility
commences the AE(V) will carry out regular spot checks to ensure the ventilation system including the ducting is being installed to a required standard. The ventilation equipment may have been built bespoke to that particular healthcare facility. Then the AE (V) will carry out construction stage checks followed by witnessing commissioning and verification followed by sign off and handover to the Appointed Persons (AP’s) and their counterpart Competent Persons (CP’s). The structure of the checks is outlined in the panel above.
How are modular buildings checked for compliance at the moment? The essence of a modular building process is that the majority of construction takes place within a factory setting, where the building’s key components are manufactured and assembled before being transported to the final site. This approach brings efficiency and consistency, but it also creates unique challenges. Once the modules and their integrated systems arrive on site, they are already in a near-
The inspection stage risks becoming a formality rather than an effective safeguard
complete state, which makes significant modifications extremely difficult, costly, or in some cases practically impossible to carry out.
Because modern methods of
construction are based on standardised, repeatable processes, there is often an assumption that if a design has been used successfully before, it will automatically be suitable in future applications. For instance, a modular design previously used for a healthcare facility might be rolled out to another site without undergoing the same level of initial scrutiny. This assumption can weaken the first stage of the typical four-step compliance process – ‘Design Review’. Instead of carefully reassessing the design for each new project, stakeholders may believe that the design is already proven, even though specific site conditions or updated standards might demand reconsideration.
31
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104
