How COVID-19 has redefined the design and build of future hospitals
As the UK’s vaccine programme reaches more and more people, we can see the end of the pandemic, and start to consider what its long-term effect on our economy and built environment will be.
One of the most direct changes it could have is on how we design and build hospitals.
The hospitals of the future will be significantly more sophisticated than the buildings of the past. How radically healthcare will change and how quickly it will happen we do not know. But we need to future-proof our social infrastructure in order to make the most of advances.
Current best practice is to include flexible floor plates, modular service provision and standardisation of room content, providing structures that last while having layouts that can be repurposed quickly and cheaply.
What they need to look like
The increased use of modern methods of construction (MMC) and a focus on net-zero requires facilities that can be bolted together and then unbolted at the end of life and re-purposed. The digitisation of a building to create a ‘digital twin’ is also key, providing real-time data on which decisions can be quickly made.
The recent need to dramatically increase intensive-care beds and provide triage space during the pandemic was possible in part because elective activities were reduced, and outpatients became a digital service. This flexibility may become the new norm, so in future we will ensure that infrastructure elements such as oxygen supply and IT capability have an inherent over-capacity, allowing for a rapid response to unforeseen events.
Last year has shown that the future can be highly unpredictable, and we need to be flexible in our response to healthcare needs. With an ageing population we cannot afford to be complacent, and funding of the NHS and the wider modernisation programme must continue to be a priority for future governments and society in general.
Extra spending
Chancellor Rishi Sunak announced in last year’s Spending Review that a further £5bn will be made available to the NHS to help it cope with the extra demands placed on it. That includes an additional £2.3bn to its capital budget. But even before COVID-19, capital investment in the NHS was increasing. A new funding settlement, announced by Theresa May in June 2018, promised NHS England’s revenue funding would grow by an average of 3.4 per cent a year in real terms over the next five years – delivering a real term increase of £20.5bn by 2023/24.
This is not just about new hospitals, although the chancellor confirmed in November last year that at least 40 are planned. A further 70 will be upgraded as part of an ambitious programme of modernisation. A report by the National Audit Office in February this year pointed out that in the year ending 2017 (the last year for which figures are available) 46 per cent of the NHS estate by gross internal area was more than 33 years old and 14 per cent predated the formation of the NHS in 1948.
The construction sector clearly has a vital part to play in partnership with NHS trusts, who are focused on building world class facilities while spending money responsibly. Tilbury Douglas (formerly known as Interserve Construction) is proud to have built the NHS Nightingale hospital in Birmingham, a project where the first phase was completed in just 13 days.
Building a new facility during lockdown, under highly unusual working conditions, required imaginative solutions – including using MMC for bathroom pods, modular bed bays and dirty utility facilities. The oxygen supply for the hospital was delivered directly and not via bottles. To do this we created over 10 miles of medical grade copper piping, which at the time was believed to be the largest copper ring main in Europe.
Delivering the facilities, the NHS needed to fight the pandemic was a great challenge to our industry, but it was one we rose to. It will put us in good stead to build the next generation of healthcare facilities.
Craig Tatton is Chief Operating Officer at Tilbury Douglas.