Modular, mobile and off-site construction techniques are becoming increasingly popular within the healthcare sector, as trusts face the challenge of enhancing and futureproofing the estate, while at the same time keeping costs and disruption to a minimum
Traditional on-site construction methods are taking a back seat, as the healthcare sector embraces more-modern techniques in an effort to reduce costs, lower carbon emissions, and cut down on disruption to crucial services.
In many cases hospital capacity is exhausted and at periods of high demand there simply aren’t enough essential facilities, such as theatres and wards, to treat patients in a safe and timely manner
Increasingly common when operators are looking for a way to expand and improve the environment for delivering services; mobile and modular buildings have become more widespread, particularly helping to deal with winter pressures.
In the past five years the NHS has used off-site construction to provide much-needed extra capacity during the more-demanding winter months.
But its use has recently widened, with more and more trusts opting to ditch traditional construction approaches to deal with pressures on the estate.
Unprecedented demand
Steve Peak, business development director at modular build specialist, Vanguard, explains: “We are experiencing an unprecedented situation in British healthcare. The population continues to grow, people are living longer than ever before, and there is a rise in complex and chronic conditions, all of which places enormous pressure on the national healthcare infrastructure.
“In many cases hospital capacity is exhausted and at periods of high demand there simply aren’t enough essential facilities, such as theatres and wards, to treat patients in a safe and timely manner.
“Mobile and modular healthcare facilities offer the NHS and other healthcare providers the ability to quickly increase capacity to match the current level of demand.
and modular healthcare facilities offer the NHS and other healthcare providers the ability to quickly increase capacity to match the current level of demand
“At a time when health budgets are particularly tight, this option is, in many ways, more financially viable than traditional ‘bricks and mortar’.
“The offsite-constructed design of mobile and modular facilities means they require significantly-reduced capital investment compared to permanent structures. It is also certainly the case that the cost of hire can often be offset by the additional revenue produced. In fact, we find that many providers are able to create a surplus while improving access for their patients through the use of a mobile facility.”
Visiting hospitals
Where these types of facilities are proving particularly useful is in helping to streamline refurbishment projects.
Peak said: “Mobile healthcare facilities offer the unique advantage of being able to deliver care across multi-locations.
“With relatively-little enabling work needed to install a mobile theatre, clinic or endoscopy suite; care can even be delivered away from acute hospitals.
“We are increasingly seeing national treatment or screening campaigns enabled by this degree of flexibility – improving access to care in remote areas or at the heart of densely-populated communities.”
Over the past year, Vanguard has been working with Birmingham Children’s Hospital as part of a landmark modular build contract.
Under the agreement, the company has provided temporary facilities to increase access to key treatment areas.
Known as ‘visiting hospitals’, the facilities act as a standalone treatment and recovery centre for day surgery patients.
Linked to the main site via a bespoke corridor, one such example features an eight-bed ward and state-of- the-art operating theatre featuring laminar flow ventilation.
In a single year, the unit has enabled the hospital to treat more than 1,200 young patients and is now due to remain on site for another 12 months.
Built-in flexibility
Portakabin is also working with NHS trusts up and down the country, including Royal Stoke University Hospital, where it has provided a 4,200sq m ward and theatre building.
Delivered in less than four months, the 124-module unit is helping to meet an increasing demand for orthopaedic services.
The £13.5m building features clean air theatres, a recovery room, ward bays and single en-suite bedrooms.
Robert Snook, director and general manager of Portakabin Hire Division, said, “This project really changes perceptions about just what can be achieved with modular construction – in an extremely-short timescale and on a highly-constrained hospital site.”
The building has been designed to be used for five years and has built-in flexibility so it can be adapted for other uses in the future if needed.
At a time when health budgets are particularly tight, this option is, in many ways, more financially viable than traditional bricks and mortar
The company has also worked on the revamp of the Royal Sussex County Hospital, providing modular buildings that will act as decant facilities for services as building work progresses.
Steve Newell, general manager at Portakabin, said: “We are experiencing a clear sea change across the construction industry.
“Off-site solutions are being recognised as a mainstream method of building and, when clients and contractors visit our completed buildings, they are blown away with the build quality we are achieving on every project.”
Advantages of this approach include minimising the possibility of budget overruns and delays, accidents on site, and mitigating the impact of a volatile labour market.
Matthew Goff, UK operations director at Actavo Building Solutions, which has delivered an off-site solution for Cork University Hospital’s new €3.4m paediatric wing, said: “When you build offsite, you plan and construct with meticulous precision. Enabling works happen in parallel with the building’s construction, which is manufactured in a high-quality-controlled environment. It takes strategic thinking and rigorous co-ordination, but the prize is minimal disruption, which is particularly key in the acute care environment.”
Space limitations
The new wing took only 26 weeks to build on site using modular construction methods. This meant 80% of the build took place offsite, which reduced onsite construction by a significant number of weeks compared with traditional methods.
Tony McNamara, chief executive at Cork University Hospital Group, said: “With limited space, and a requirement to keep noise and traffic disruption to a minimum, a modular building was the ideal solution for the high-tech unit to be put in place while the existing paediatric department is being refurbished and extended.”
In the future, experts predict that offsite solutions will continue to dominate activity in the sector.
Peak told BBH Vanguard is already coming up with new solutions to meet up-coming demand from the healthcare market.
He said: “One of the most-significant resulting changes of the Government’s NHS Five Year Forward View has been the growing prominence of community-based healthcare services, fundamentally impacting not just how, but where, healthcare is delivered.
“With 14 years’ experience of delivering portable surgical health centres to the acute sector, we have developed a system we believe could allow some 40% of surgical and diagnostic procedures to be safely transferred to the community setting. We call this system Healthportability.
Estate utilisation
Off-site solutions are being recognised as a mainstream method of building and, when clients and contractors visit our completed buildings, they are blown away with the build quality we are achieving on every project
“This focuses on creating state-of- the-art community health centres with a modular central hub; housing everything from consultations rooms to recovery areas. Into this hub is built one or more ‘docks’ which would allow seamless integration with the growing range of mobile healthcare facilities already available to NHS providers.
“Essentially, at the end of the corridor of one of these facilities there may lie endoscopy suite one week, an MRI scanner the next, and a theatre the week after. This would create a truly-flexible community infrastructure, tailored to the prevailing needs of each local health economy.”
Vanguard is providing temporary facilities to increase capacity at Birmingham Children's Hospital
