How modular construction is helping local healthcare

Finding out what is wrong with a patient is vital to treating them as early as possible. Community Diagnostic Centres (CDCs) provide essential tests and scans to patients, allowing for faster and more accurate diagnoses. They are a crucial component of a modern healthcare system, providing patients with access to planned diagnostic care, closer to home. These centres were recommended following the 2020 review of NHS diagnostics capacity by Professor Sir Mike Richards, with the goal of improving patient experience and outcomes.

CDCs delivered using the latest offsite techniques offer much-needed, cost-effective diagnostic facilities with a short build time. They provide local communities with fast, flexible access to a range of checks, scans, and tests, reducing the number of hospital visits, and cutting waiting times. As a result, they play a vital role in improving population health outcomes by diagnosing health conditions earlier, increasing capacity in the diagnostic service, and reducing health inequalities by ensuring equal access to care for all individuals.

Additionally, CDCs support more ‘joined-up’ care across primary, community, and secondary healthcare settings. Thirteen new CDCs have already delivered 742,000 additional scans, tests, and checks a year, according to the Department of Health and Social Care.

Diagnostic test demand continues to increase

Despite the progress that has already been made, demand for diagnostic tests continues to increase, 
with more than 85% of NHS patients now requiring 
this service. This waiting list has been growing 
steadily since 2008, and — as of April 2023 — around 1.6 million people in England were waiting for a diagnostic test. Over the past 12 months, 24.6 million checks and scans have been carried out, and the latest CDCs have now contributed more than four million towards this target.

However, the national target is that 99% of patients should wait less than six weeks for a diagnostic test. The UK currently has less diagnostic equipment than comparable countries — with 8.8 CT scanners per million population, we rank 25th out of 28 OECD countries, and the numbers of MRI units and PET scanners are also below average. NHS England estimates that demand for CT scans will rise by at least 100% in the next five years.

Delivering high-quality permanent new buildings faster

With waiting lists growing far quicker than capacity, the NHS must find ways to deliver more with less. It’s clear that an innovative and cost-effective approach to developing new infrastructure is required. Modular, offsite construction offers a faster, more cost-effective way to deliver high-quality new NHS buildings, including CDCs, by maximising efficiencies at every level. Traditional construction methods can be time-consuming and subject to delays on site, including a shortage of skills. Ultimately, this leads to longer wait times for patients in need of diagnostic services.

At Algeco we have been supplying high-quality modular buildings to customers across a variety of sectors, including healthcare, for over 60 years. We work under various NHS modular frameworks, and our solutions are compliant with HTM, HBN, SHTM, WHTM, and HAI-SCRIBE standards. Lean manufacturing, and Design for Manufacturing and Assembly (DfMA), are central to our approach, and we have invested heavily in both, along with an extensive R&D programme.

DfMA focuses on reducing time-to-market and total production costs by prioritising the ease of manufacturing parts and simplifying assembly. By taking a DfMA-led approach and adopting the principles of lean manufacturing, such as process optimisation and waste reduction, our offsite construction methods offer a faster way to deliver high-quality new buildings. The methodology involves the design and fabrication of building components or ‘modules’ taking place off site in a factory setting, prior to them being transported to the construction site for assembly.

The ‘way forward’ for the NHS

Aside from DfMA, offsite construction in itself offers numerous benefits over traditional building methods, and there are many reasons why it represents the way forward for the NHS. Principally, offsite can deliver permanent healthcare buildings in up to half the time it takes for an on-site build, while the fact that most work is done away from the hospital minimises disruption to the care environment. By completing many of the construction stages off site, the supply chain can be optimised, disruption minimised, and the overall build time reduced by up to 50%.

Offsite construction also leads to a higher quality end product, better overall performance of the finished building, and better value for money due to tighter cost control. Compliance with Building Regulations is also easier to manage, because elements such as fire ratings can be verified and quality checked before the modules arrive on site, mitigating the need to commission a third-party fire consultant.

This level of factory completeness is measured by Pre-Manufactured Value (PMV), and for healthcare buildings, including CDCs, up to 85% PMV can be achieved. That means the majority of the building work is already complete by the time that the modules arrive on site, with the remaining 15% consisting of finishing and commissioning.

Standardised modular designs

As part of the industry-wide Seismic Consortium, we have developed a standardised platform for building modules, with the aim of further simplifying the design and manufacturing process. Designed in line with the Government’s Construction 2025 targets, this platform was developed to drive a major shift towards a more productive, better quality, and lower carbon, construction industry. Ultimately, its purpose is to deliver high-quality buildings that can be mass produced and delivered within shorter timescales.

The platform, which has now been added to the Construction Product Platform Rulebook, facilitates the design, procurement, manufacture, and assembly of buildings using standardised and interoperable components and assemblies. It uses a small number of repeatable base designs, which enable all modular manufacturers to work to the same specification when creating the basic building components, delivering significant efficiencies, as well as greater certainty for clients. It makes full use of the latest in digital and manufacturing technologies, delivering higher-performing and better quality buildings that can be mass produced, and delivered within shorter timescales. On a practical level, the platform design is a lightweight steel frame building module made up of standardised interoperable elements. In accordance with the Construction Innovation Hub’s Product Platform Rulebook, it provides unlimited configuration to enable the efficient construction of any building, regardless of its type or use.

Operational faster

In short, by utilising a platform-based design approach, CDCs can be up and running in a shorter timeframe, providing much-needed diagnostic services to patients as quickly as possible. The figures speak for themselves: the platform design approach can reduce construction costs by 33%, enable completion of projects 50% faster, and reduce emissions by 50%, all with zero compromise on build quality or safety.

In terms of sustainability, analysis shows that the platform design approach accounts for 581.3 kg CO2e per m2, which is well below the Construction 2025
target of 1,300 kg CO2e per m2. In addition, because the CDC modules we supply can be reused, either by relocating to other sites, or by refurbishing individual components and cassettes, this adds a 234 kg CO2e
per m2 clawback.

• Modular CDCs — an example

Our partnership with Hygieia illustrates exactly how modular construction is revolutionising the delivery of healthcare buildings. This collaboration has led to the development of a new range of standardised CDCs using our platform design modular construction system. Hygieia, a consortium of leading companies specialising in healthcare modular buildings, now offers three standard sizes for CDCs: small, medium, and large. These standardised formats provide a cost-effective solution for NHS Trusts and the private sector, allowing for rapid construction and delivery. The CDCs are offered with a full design, delivery, construction, and finishing service — a comprehensive approach that allows customers to start using their CDCs from day one, eliminating the need for separate contractors. They also incorporate all necessary servicing, including the specialised electronics needed for sensitive imaging equipment, further streamlining the implementation process.

Flexible financing is also available, to help with the increasingly constrained capital budgets across the NHS. This allows Trusts to increase capacity using modular construction with a highly flexible operating lease option. This funding solution has low set-up costs, and is accounted for as revenue expenditure, spread over the life of the lease.

Our ability to offer a full turnkey solution was achieved by partnering with some of the leading brands in the sector, such as Tata Steel, P+HS Architects, and CAD21, among others. The CDCs are fully compliant with HTM / HBN requirements.

With early engagement, our specialist healthcare team can support NHS Trusts at every stage — from preparing outline business cases, design, and planning, to groundworks, offsite manufacture, and fitting out.

A step change in healthcare provision

The introduction of modular CDCs has had a significant impact on the healthcare landscape, addressing the growing demand for diagnostic tests and scans, and significantly reducing the pressure on acute hospital sites. These centres have played a crucial role in reducing waiting times for patients, diverting them away from hospitals, and providing faster access to essential diagnostic services.

Modular CDCs provide a step change in healthcare provision by supporting the Government’s aim of delivering services directly into the community. This contributes to the reduction of health inequalities by ensuring equal access to care for all individuals. By bringing diagnostic services closer to communities, these centres eliminate the need for patients to travel long distances for essential tests, especially in areas with higher health risks.