The UK government a number of times last year reiterated its commitment to build 40 new hospitals by 2030, for example with a dedicated mention in the 2022 Queen’s Speech in May. While there has been some criticism over the pace, there are clear signs that progress is being made. This confirmation of commitment comes at a time of unprecedented backlog on NHS waiting lists, estimated to require up to seven years to be cleared, and patients experiencing more than 10-hour waiting times in A&E departments, partly due to the lack of space to admit them. More adequate facilities are urgently needed, and offsite modular is ideally positioned to play a major role.
Building projects in the healthcare sector are generally highly complex, requiring specialised technical knowledge and high standards to meet the unique needs. To add to this, the Government has indicated a preference for the latest construction methods, while leveraging digital technologies and meeting stringent sustainability considerations. Modular construction approaches are now wellestablished, but the breadth of offerings available masks the opportunities offered by those employing the most advanced methodologies. What can now be achieved is much further-reaching than generally recognised.
Multi-fold advantages
The fundamental advantages of the offsite modular approach are multi-fold. Standardised designs built in the factory setting and delivered to sites enable better design, faster delivery, and waste reduction, accompanied by cost savings. Despite perceptions, such designs don’t limit flexibility of use. On the contrary, buildings can be future-proofed by allowing adaptation to meet changing needs in the decades to come, without the need for substantial new construction work. The offsite modular approach has already helped deliver facilities in a timely manner, but we are only at the beginning. An era of new construction approaches is upon us, with digitalisation and collaboration at the core.
Widen the scope with modular: digitalisation and collaboration
According to McKinsey data, construction is one of the industries with the lowest levels of investment in innovation and digitalisation. Novel ways of working which help lower costs are often (mis-) understood as bringing compromises on quality or other aspects, rather than improving efficiencies and providing advancement over traditional methods. This is, however, a short-term view.
Digital solutions, such as BIM modelling, are increasingly used by the sector, but often only to replace drawing boards or 2D software, without exploring the advantages that they can bring to in terms of quality and timelines – factors that are essential for the healthcare sector.
Improving timelines
Construction projects involve long processes of ‘to and fro-ing’ between the various parties, including healthcare estate managers, architects, the construction business, and more. Taking a collaborative approach from the outset of the project can significantly improve timelines and outcomes. By prioritising an all-party approach from the design creation stage onwards, an outcome that meets all the individual needs of teams is more likely. This approach can also reduce the need for re-configuration or significant alteration requests at a later stage, avoiding costly delays.
As an example, Merit worked on the Northumbria Healthcare NHS Foundation Trust’s Sterile Services Facility, where regular collaborative workshops drove the project forward from the early stages, and this enabled an approximate six-month time saving compared with traditional methods. During the workshops, the Merit and Trust teams worked closely on developing design innovation in order to maintain technical functionality within budget constraints, for instance to establish superior infection control, at affordable costs. The early engagement also allowed costs to be agreed on and fixed in only three weeks. Digital platforms are essential to the success of such a collaborative approach, providing everyone with seamless real-time access to the latest plans and designs. Although such platforms are already widely available, they are significantly under-used.
Tailored to the healthcare sector
Employing Modern Methods of Construction also enables innovation, which is beneficial for the healthcare sector, and results in facilities that are more suitable for current and future needs, be it improved infection control, or meeting NHS Net Zero targets. The high ratio of hospital-acquired COVID infection cases during the pandemic has shown that infection control should be an utmost priority in all healthcare facilities. A recent report by the National Engineering Policy Centre (NEPC) has urged the improvement of building health and the imperative of buildings enabling adequate infection resilience. It has been reported that proper infection control can save £23 bn in ‘annual societal costs’ for the UK. Modular designs offer a response to such needs from the building phases onwards, and can be in place to allow better response to any future healthcare scares.
Cleanroom experience
As an example, Merit built on its indepth cleanroom experience learnt from biopharma projects. The aim was to provide the highest level of infection control for healthcare settings, including the use of recirculation systems with HEPA filtration or air socks to provide access to fresh air. A patented design platform supports pressure cascade optimisation, which allows rooms occupied by immunocompromised or patients with serious infectious diseases to be isolated from adjacent areas
With buildings representing a significant proportion of the NHS’s carbon emissions and impact, and with the Net Zero commitments gaining increasing importance, modular designs can enable healthcare settings with lower impact from the onset. Merit has implemented a core strategy of not offering fossil fuel as part of any project delivered, replacing natural gas with heat pumps and smart heat recovery systems.
Such considerations can also have wider impacts for building projects, as in the case of the new Berwick Hospital project that Merit was recently awarded. Here, distributed POD energy centres will be incorporated into the roof, eliminating the need for a space-hogging Energy Centre and improving the green credentials of the building.
Why not modular?
From looking at a range of recent projects it is clear that novel approaches can significantly improve the outcome. The timeline for the UK’s first CAR-T cell therapy manufacturing facility in Stevenage has been shortened by 24 months by leveraging modern approaches, while the approach for the Berwick project should deliver a time saving of over a year to the Trust.
Modern Methods of Construction have already shown their benefits over traditional methods, but the evidence is mounting that leveraging and tailoring digital solutions, as well as working in a collaborative way, can provide significant further benefits to the healthcare sector. It is important to note that these advantages are universal, and can be enabled by contractors with vast experience in a variety of sectors and industries, not only healthcare. In reality, innovation often derives from applying existing knowledge in new areas, which can change longstanding approaches fundamentally, be it via faster delivery, lowered carbon emissions, or better infection control. The healthcare system faces enormous challenges in the coming years, but embracing innovation and innovative modes of construction, in line with the government’s approach, could help accelerate progress in one key area.
Tony Wells
Tony Wells is CEO of Merit, which he took over in the North East of England in 2002. At that time it was a £2 m turnover piping company, and was re-purposed to focus on self-delivery of mechanical pipework and cleanrooms, a decision which has led to the company’s success today.
Tony Wells’ focus on innovation, new technologies, and productivity, has resulted in the company designing and building the most complex of facilities with offsite techniques. Most recently, he has applied his extensive experience in creating ‘a unique’ zero carbon emissionbased offsite manufacturing approach to delivering biopharma and other clean technology facilities, including Government flagship projects in mRNA vaccines, cell and gene therapy, and Li-ion battery manufacturing. He formed Merit Health in 2020 to focus on the new hospital build programme, and ‘to bring a much-needed step change in building healthcare facilities quicker’.
Tony Wells’ focus on innovation, new technologies, and productivity, has resulted in the company designing and building the most complex of facilities with offsite techniques. Most recently, he has applied his extensive experience in creating ‘a unique’ zero carbon emissionbased offsite manufacturing approach to delivering biopharma and other clean technology facilities, including Government flagship projects in mRNA vaccines, cell and gene therapy, and Li-ion battery manufacturing. He formed Merit Health in 2020 to focus on the new hospital build programme, and ‘to bring a much-needed step change in building healthcare facilities quicker’.