The development brief set out to centralise and modernise the acute services provided by Mid Essex Hospital NHS Trust, by integrating the new facility with the retained estate. The project doubled the size of the original hospital and created a building that provides first class health facilities for the county.
Our involvement comprised design and construction of a 43,000m2, 300 bed hospital incorporating five ‘day case’ operating theatres, three endoscopy rooms, an A&E department with 110 assessment beds, a maternity department with two operating theatres, a neonatal intensive care unit, a new renal unit and a dedicated Aseptic Suite.
The accommodation is set over five levels, connected to the existing hospital via the atrium and entrance foyer. A highly flexible clinical planning solution integrates existing with new to improve operational efficiency, providing clear separation of the internal routes serving clinical, visitor, service and supply functions.
The scope included installation of the network infrastructure and medical equipment. Two of the theatres are specially equipped for laparoscopic work and one for interventional radiology cases. Imaging services benefit from new x-ray and CT machines, and digital mammography equipment. There is also a new pharmacy and dispensary, a rooftop helipad and a 457 space car park.
Building in a Live Healthcare Environment
It was paramount that the existing hospital remained fully operational at all times. We worked closely with the Trust to develop the design from RIBA Stage 2 as part of the competitive dialogue process.
An extensive Stakeholder engagement process included end-user workshops to ensure that the key requirements of the brief, the services delivery targets and the continuity of healthcare services on the wider campus were incorporated into the design.
During Construction, safeguarding ‘business as usual’ for the existing hospital remained a critical priority. To address this, we:
- Adopted a collaborative ‘One Team’ approach including establishing a co-located office with the Client’s representatives
- Held regular open meetings for community residents and staff to keep them updated and informed as to progress
- Shared overall works planning and short-term look-ahead programmes. This allowed us to communicate easily with all stakeholders, address any concerns, make alternative arrangements where appropriate and incorporate constructive feedback into our daily work plan
- Gave Staff the opportunity to use ‘mock’ wards in order to familiarise themselves with the new building
- Gave hospital teams the opportunity to have a say in the selection of materials and the fitting-out of their new workplace
- Implemented specific control tools such as a ‘service and connection interface matrix’ which identified how systems such as medical gases, nurse call and PTS would be extended for the two buildings. This resulted in a single, common system for both parts of the hospital that could be managed simply and consistently
- Provided a 24-hour helpline service throughout the construction phase
- Issued a bi-monthly newsletter distributed to more than 1,200 local residents
- Organised Open Days that were attended by more than 130 neighbours and hospital staff
- Carried out in excess of 4,000 inductions to reinforce Health & Safety priorities on site, particularly in the context of maintaining ‘business as usual’ for the existing hospital
- Sequenced the works with the end user’s priorities in mind. For example, we made sure that the aseptic suite was constructed in advance of the rest of the build, particularly the installation, testing and commissioning of both the permanent power supply and the generator back-up. This meant that the suite could be fully certified in advance of the overall handover.
The site team achieved regular high scores under the Considerate Constructors Scheme, a consistent level of performance that culminated in the project being awarded the National 2011 Considerate Constructors Bronze Award.
Delivering a Sustainable Estate
We recognised that it was imperative for us to consider whole life costs in developing a design solution that suited the Trust’s long term operational requirements.
As part of the PFI arrangements Bouygues Energies & Services is responsible for the operation and maintenance of the hospital until 2043. Our obligations encompass planned, reactive and lifecycle maintenance, energy and utilities management, and the provision of soft FM services such as linen and laundry, catering, portering and a Help Desk.
This gave us a unique insight into the functionality of the hospital. At the preconstruction stage we undertook a detailed Life Cycle Cost analysis taking into account best practice and lessons learned from our other ongoing healthcare PFI projects. The results of this exercise were shared with the wider project team and informed decision-making.
Our Facilities Management teams at Bouygues Energies & Services were involved throughout the construction phase, taking an active part in the progressive snagging and quality assurance of each aspect of the works. This ‘shadow client’ approach ensured the quality of both materials and workmanship.
The result was a solution that not only provided the best clinical outcomes, but also took into consideration the long term requirements.
Addressing Key Interfaces
We recognised the need to establish clear protocols defining site responsibilities in relation to shared systems such as fire alarms and pneumatic tubes, as well as the physical links between the new and retained estate.
Our approach improved the hospital’s reporting mechanisms, aligned the facilities under a clear point of contact and provided added value by removing dual running costs. In order to enhance efficiency and safeguard the patient experience we established a centralised Helpdesk to deal with both Hard and Soft Facilities Management Services. You can read more about the ongoing services at Barnet by clicking here.