The NHS is under pressure.
This is nothing new, particularly as winter takes hold and the demand for services increases once again.
But against this backdrop is the recent announcement by the Government of a £2.8billion capital development programme.
Building projects like these, and the added pressure of existing backlog maintenance, can traditionally dominate budgeting at a time when the cash could be better used for frontline services.
So, keeping costs down, and finding innovative ways to deliver capital schemes, is at the centre of discussions happening within the health sector.
The research and development in modular construction are such that there is a significant bank of best practice in place
And modular buildings, and the use of offsite construction methods, will likely be key.
Modular construction takes place offsite, with the only building needed onsite being the groundworks, which can be undertaken in a matter of months.
The modular design team would work with a hospital to create a design for rooms, whether they are for treatment, consultation or waiting. This is then produced in a factory-like setting, down to decoration, fixtures and fittings, and all the essential finishing touches, and then transported to site once ready for installation.
When the modular building is ready to go to the site it will take only a matter of days before it is available for use.
Speaking to BBH, Ryan Jones, an outreach assistant from modular buildings supplier, MTX, said: “We are long past the time when modular buildings mean those draughty prefab huts of the past.
“Many doctors and nurses are likely able to recount times when such a building was used long after its shelf-life.
“But modern modular construction offers structures that are pegged to last 50 years.”
And it’s not just build quality that is appealing to health trusts.
A high cost in a bricks-and-mortar construction approach is the structure of the workforce.
Typically, a trust would first hire an architect to produce detailed plans for its main contractor. It would then have to be involved throughout, signing off on different parts of the build to help get to the point where it can freely use the facilities.
In contrast, in modular construction, trusts work with a design team who will help make the choices for them.
“The research and development in modular construction are such that there is a significant bank of best practice in place,” said Jones.
For hospitals, this chance to save money could mean a new IT system that eases the congestion in the A&E department
“Therefore, although your choices may be individual to you; they will be selected from a bank of standard methods.
“The design team is a part of the modular construction company, and therefore not separate from your main contractor.
“This saving on an architect will allow you to fund more beds, pay more nurses, or hire more doctors.”
Reduced reliance on contingency funds
All build projects require a percentage of contingency on top of the budget set.
And this contingency on traditional bricks-and-mortar construction could be as much as 10%.
Therefore, any chance of reducing the use of such a contingency could save thousands upon thousands of pounds that could be spent on a new scanner or a new occupational therapist.
As modular construction is completed indoors, much of the chance of delay is reduced.
“The weather is a significant contributor to over-running costs on an outdoor build site,” said Jones.
“Also, as materials for the build are more often than not stored outside in conventional sites, there is a lot more wastage.
“A shortage of skilled subcontractors can also cause a delay and there may be periods where no work is taking place on the site because the main contractor is waiting for an electrician or plumber to become free.
“Again, any delay costs money and causes disruption to vital health services – and will create a high chance of the need for the contingency.
“Modular contractors have all the trades under one roof, and they are working continuously on projects provided by this contractor. Therefore, they are scheduled to be working on a specific project at precisely the time they are needed.”
Unlike draughty prefab buildings of the past, newer modular buildings are built to last for 50 years
Reduction in material cost
Managing a just-in-time supply chain is tricky.
There are two problems. Firstly, there is a chance of delay if the supplies are not available at a given time. Secondly, there are no savings from scale.
Builders in the outdoor space need to order for that project individually and often order more than they need – just in case.
Modular construction projects can work on a larger scale.
“Multiple projects are moving through the factory-like area at any one time,” said Jones.
The choice to use modular build methods will not only be quicker and offer more flexibility; but will significantly reduce the cost of the build
“And each of these projects will require standard parts that can be ordered in bulk.
“There is also no wastage, as whatever is not used on one project can be returned to the stores for use on the next one.
“And fewer materials needed means lower costs. For hospitals, this chance to save money could mean a new IT system that eases the congestion in the A&E department.”
But another often-overlooked advantage of this approach is safety.
Jones said: “A conventional construction site is a dangerous place in the best of situations.
“There are the potentials for falls from height, tool misuse injuries, as well as being a prime candidate for trips.
Added to this is the fact the site is serviced by a constant to-ing and fro-ing of heavy vehicle traffic.
“This creates a potential accident issue, but also decreases the quality of the air around a construction site.”
“Air quality is also compromised by the dust and dirt that is raised during this lengthy construction process.
“And the location around a hospital, particularly, is filled with the comings and goings of ambulances and helicopters. Therefore, adding construction traffic to the mix is a significant issue.
“The benefits of using modular construction, therefore, should be self-evident.
“Most of the work is done away from the site, thus reducing hazards in the hospital grounds.
“And the indoor environment of the modular construction site is also much safer for workers, as they can work in the dry without the added dangers caused by the weather.”
He concludes: “The choice to use modular build methods will not only be quicker and offer more flexibility; but will significantly reduce the cost of the build.
Any money saved in building the hospital will be money that can be used to save lives.”
