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Richard Hipkiss, Development Director of the Modular and Portable Building Association (MPBA), discusses how volumetric manufactured buildings are meeting the needs of the health sector
Covid-19 has had a dramatic effect on the way we live, work and socialise but one of the unforeseen consequences is the wider adoption of modern methods of construction.
It’s no secret that NHS trusts across the UK are struggling to find enough space. In a market where material and workforce shortages exist and building standards are extremely high – this can prove particularly challenging for NHS estate managers.
The health sector demands buildings that are flexible and adaptable in use, and which can be constructed rapidly to meet tight programmes. Sustainability, comfort and infection control are all crucial, but budgets are tight.
Volumetric modular manufactured buildings are now becoming a greater part of the solution. Large-scale modular building projects offer the possibility of freeing up space within the main hospital to help reduce disruption, cut waiting times and improve the patient experience for urgent care services.
I’m pleased to report that MPBA members operating in both the portable and volumetric modular sectors have been making huge efforts not only during the height of the pandemic but are now vital in bringing much needed facilities rapidly on stream to alleviate pressure and help improve waiting times.
Premier Modular for example has recently installed the final modules on site for a new 3,450sqm outpatient services building at King’s College Hospital in London, being delivered with construction partner Claritas. This involved careful logistics planning to maintain access through the hospital campus at all times, and to co-ordinate cranage to avoid any disruption to the helipad and air ambulance helicopters.
The King’s College Hospital site is highly constrained with roads to three sides and is immediately adjacent to another hospital building, but this is where volumetric modular technology really comes to the fore. When complete later this year, the building will provide 48 consulting rooms and eight procedure rooms for a range of outpatient services, including dermatology, rheumatology, neurosciences, as well as other aspects of surgery and therapy.
From increasing the space in emergency departments and acute care to improving facilities and bringing them up to date – the health sector is benefiting greatly from modern methods of construction.
Throughout the past year another MPBA member Vanguard Healthcare Solutions has supported the NHS in addressing the need for additional clinical infrastructure during periods of rising capacity demands in the wake of the pandemic. Vanguard Health Solutions has had considerable success in implementing a number of surgical hubs across the country to help tackle elective care waiting times to ultimately reduce the backlog. These bespoke modular solutions not only increase capacity but maximise infection control.
A notable example of this is the modular surgical hub installed at Queen Mary’s Hospital in Roehampton. In this instance, the St George’s University Hospital NHS Foundation Trust was performing fewer than 10,608 procedures between March 2020 and May 2021 as a result of the shutdown of elective care during the initial stages of the pandemic.
To address the growing surgical backlog and increase capacity, the Trust commissioned Vanguard to design and install a bespoke modular solution. The Vanguard volumetric modular surgical hub was installed in just five months from initial design and consisted of four dedicated operating rooms, a recovery ward, consulting rooms, staff welfare facilities and utility areas. The complex was designed with patient flow and infection control in mind, with the Head of Surgery and Theatre Managers consulted throughout the design process to ensure maximum efficiency and improve the patient journey.
The four theatre day surgery complex is capable of completing in excess of 120 weekly procedures, helping to tackle the elective care backlog in South West London and highlighting the importance of the implementation of further surgical hubs across the country.
The use of modern methods of construction is pivotal in accelerating the build process with theatre complexes such as that in Roehampton, being installed in a matter of months. It is now established that volumetric modular approaches are a game changer in reducing build times, increasing quality, productivity and safety. But what is not so widely understood are the sustainability benefits – an important factor following the NHS’s pledge for carbon neutrality by 2040.
Modular approaches are revolutionising the construction industry. Whilst traditional build processes are laced with pitfalls, hidden costs and are highly disruptive – volumetric modular buildings are easy to plan, budget, and are quick to install. Modular technology brings a host of benefits to health businesses by contributing to safer and more cost-efficient environments but often the sustainability gains are overlooked.
According to the World Green Building Council, construction and buildings in use are responsible for 39 per cent of all carbon emissions in the world. This is broken down into two elements with 11 per cent being linked to the manufacture of materials and construction processes known as embodied carbon emissions and 28 per cent associated with operational emissions caused by heating, cooling and lighting systems when a building is in use.
The challenge is therefore two-fold. Whilst there has been a drive to reduce operational emissions through the implementation of government legislation such as the changes to Part L of Building Regulations to improve the building fabric and the wider use of innovative technologies – little has been done to address the carbon inefficiencies in the construction process.
Compared to traditionally built projects it is easier to control energy use in factory settings than in an open construction site. On average 67 per cent less energy is required to produce a volumetric manufactured building and up to 50 per cent less time is spent onsite, resulting in up to 90 per cent fewer vehicle movements which is less disruptive for the healthcare facility whilst also reducing carbon emissions.
Volumetric modular buildings are less susceptible to poorly specified manufacturers’ products as time can be taken upfront to validate the correct specification of materials. Designs are digitally constructed and virtually tested before they move onto the manufacturing phase. This process eliminates waste and achieves highly accurate and airtight building envelopes designed and manufactured to higher sustainability requirements. This allows NHS estate managers to have confidence in the quality and performance that they can expect from their new building.
Not only is the actual construction of the building ‘greener’ but volumetric manufactured buildings are also more energy efficient – reducing carbon emissions and ongoing operational energy costs for the lifetime of the building.
With the NHS facing an unprecedented backlog in patient care and building maintenance, the British Journal of Healthcare Management recently published a series of papers exploring how modular facilities help healthcare services overcome these challenges. Setting out a case for the use of modular infrastructure solutions to help healthcare services to increase their capacity to overcome them stating ‘innovative solutions to increase capacity in NHS hospitals have never been more sorely needed.’
Modern volumetric modular methods of construction are providing rapid, agile solutions to the healthcare crisis and the reusability of the facilities enables NHS trusts to move towards a more sustainable infrastructure, contributing to the net zero goal by 2040.
The Modular and Portable Building Association leads best practice protocols, the development of standards and is represented on many government committees for the benefit of members. The association collaborates with specialist technical advisors to enhance innovation in the design and manufacture of volumetric modular buildings. These can be designed and manufactured from timber or steel in any size and shape to meet individual client needs while ensuring full compliance with Building Regulations.
Photo Credit: Premier Modular – King’s College Hospital, London. The image depicts the new outpatient services building at King’s College Hospital, which is being constructed offsite by main contractor Premier Modular in a £21 million contract.
Healthcare is evolving through digitalisation and widening network capacity whilst simultaneously collecting a greater range and depth of data. The NHS is the largest integrated healthcare provider in the world with a supply chain consisting of more than 80,000 suppliers. The amalgamation of different estates, the multiplicity of legacy systems and the diversity of technology, people, processes and culture makes it a hugely complex environment. This is also vulnerable to Cyber Security attacks including data breaches where sensitive patient records may be attained for extortion, disruption or resale on the dark web. The current heightened political tensions and state sponsored cyber-crime only add fuel to this already challenging mix. In this evolving environment, it is imperative UK health organisations recognise the need to proactively manage and constantly review their Cyber Security posture as widely advocated by the NCSC for all the CNI sector.