Business Matters: An offsite approach can transform the future of healthcare | Blogs

Neil Orpwood of HLM Architects, Associate Director – Healthcare, and Mohammed Ul-Haq, Partner – Healthcare, discuss government approval for greater use of offsite manufacturing in healthcare and share their views on how to carry out successful projects and achieve goals.

The UK government has called for greater use of off-site manufacturing in delivering healthcare projects, requiring all new schemes to target a 70% pre-engineered value. Since government approval, we have seen the emergence of more frameworks specifying off-site construction, such as the NHS Shared Business Services Modular Buildings Framework, which covers NHS Trusts and public sector organisations. Recognizing the scope of MMC (Modern Methods of Construction) to complete public sector projects in a faster, greener and cheaper way, this is a hugely positive and exciting development.

However, the need for a wide range of unique spaces and the importance of minimal disruption during construction arguably make healthcare one of the most complex sectors to design. To achieve the ambitious new goals and successfully complete offsite healthcare projects, one of the most vital steps is to build strong relationships with MMC manufacturers.

HLM Architects has long championed the many benefits of the offsite approach, leading to the development of our own Think: Offsite initiative. Over the past 17 years, we have cultivated long-term relationships with several MMC manufacturers and been involved in the evolution of their systems and products. We see firsthand how MMC’s potential is now pushed further than ever before. Our first off-site healthcare project at Hull & York Medical School, from 2004 to 2007, used a more basic modular solution, while in 2009 we were able to reuse existing volumetric units at Hull Royal Infirmary.

More recently, our team explored how we can apply the MMC/offsite methodology to more specialized builds. Using experience gained across multiple industries, including education, we worked with a modular contractor to design and deliver a new diagnostic imaging suite for the School of Health and Rehabilitation as part of of our continued work at Keele University. This extension of an existing building used prefabricated modules, which we had to ensure were plumbed and heavily maintained to facilitate installation and use of an x-ray machine. Being able to use modules for this type of building, with complex and complicated needs, shows considerable progress, since the modules were previously only used in environments where only a minimum of maintenance and connectivity were required.

Innovative approaches to address industry challenges

Further critical research is underway on the development of offsite construction in the healthcare sector. For example, the Construction Innovation Hub (CIH) is a collaborative healthcare “sandbox” of over 600 companies, industry bodies, academics, and more. Equipped with a real-world functional physical research and development project aligned with a virtual model, participants have a unique opportunity to experience the different components of the spaces, with an emphasis on developing a group of juvenile operating theaters procedures and use of seclusion. This may reduce the need for greater use of theater and subsequently alleviate some of the pressure on the NHS by shortening waiting lists. Operating theaters are complex, so developing more basic, easily repeatable spaces that can accommodate smaller procedures will free up traditional operating theaters for major operations. The objective of the hub is to create a “kit of parts” that will enable the assembly of these spaces in new and existing buildings, maximizing the potential for reuse of healthcare facilities. Think, full-size Lego operating room delivered in a box and you wouldn’t be far off the mark.

With the pressure on the NHS in mind, we are also developing a temporary accommodation initiative, primarily for GP units, which will be factory completed and installed on site. These units would be adaptable to other types of health care requirements, again helping to reduce wait times. Together with a modular contractor involved in the delivery of the UK’s first Passivhaus GP surgery in 2021, this innovative project will also allow us to take a big step towards achieving the NHS goal of reaching net zero carbon by 2045. Additionally, this solution can provide a model design to be replicated in other industries, including education, where base units are very similar in terms of connectivity required.

Health care is rich in sub-specialties, which makes standardization more difficult. However, by harnessing the advanced technology available to us, the opportunities to design healthcare buildings in new and adaptable ways and to utilize multiple variations of MMC and off-site fabrication are greater than ever. As an industry, we must educate, collaborate and think outside the box, continuing to improve our capabilities in the future to deliver efficient and sustainable buildings through innovative and proven methods of MMC and off-site fabrication.

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