Leicester Royal Infirmary Hospital Emergency Department
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Location: Leicester
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Sector: Health
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Division: Regional Building, Engineering
This much-needed project consisted of the development of one of the “most efficient and up to date A&E facilities in Europe”. The unit is also the UK’s first ‘frailty friendly’ Emergency Department, meeting the rising demands of an ageing population. The project marked the first major investment of University Hospitals of Leicester’s five year, £320m strategic plan.
The project was designed to reduce pressure and lengthy waiting times and improve the patient experience on a heavily oversubscribed and under resourced A&E.
The previous A&E building only catered for 100,000 patients a year and was dealing with 180,000, whereas the new development can accommodate up to 270,000 annually.
- Improved efficiency with paperless records
- A single storey building with separate departments for children and adults, providing a better flow for patients and bringing services that the emergency team need closer together
- Dedicated ambulance lanes for more efficient patient transfer
- Bigger cubicles for patients.
At a glance...
£33.3m
Project value
April 2018
Completion date
University Hospitals of Leicester
Client
This project was procured through the LLR-FMC Competitive Framework through our previous facilities management division using the Principles of the P21+. We successfully delivered this full turnkey solution for the client. We led the Final Business Case to generate £5m cost savings from the original budget within just 29 weeks and progressed this scheme through to pre-construction with a seamless transition to the build process.
Tilbury Douglas already had a robust working relationship with University Hospitals of Leicester before the project began. We have completed 10 Major Works schemes and 18 smaller Property Services projects with a combined value of £64m for this client. We are also currently on site with the new Paediatric Intensive Care Unit.
The project also provided:
- CT and MRI scan facilities
- Integrated Mental Health Unit
- Drop off parking
Time, cost and quality improvements
15,000 (14%) man hours were taken off site through off-site manufacturing. Providing a pre-fabricated plant room reduced the programme by five weeks and saved £100k in costs. This improved quality and proved to be a safer method of working as fewer flash screens were required and fire risk was reduced. Furthermore, fewer deliveries were required, which improved our carbon footprint.
Pre-cast culvert boxes and standardised retaining walls reduced the programme by six weeks and ensured factory quality concrete finishes. We also provided a pre-cast concrete fascia.
BIM was utilised to model the corridors which allowed clash detection, faster delivery, lower costs, reduced risk, enhanced sustainability and an improved whole-life performance of the building. BIM also allowed the fabrication of ductwork penetrations – making it easier to provide fire protection.
We identified over 10,000 clashes at GMP stage and accelerated the programme by two weeks.
A fully-plumbed IPS systems omitted the need for excessive plumbing works and allowed us to ‘get it right first time’, improving quality with a factory controlled finish while saving time.
A complex array of service diversions and demolition works in the centre of a live hospital
Enabling works included co-ordinating and managing all HV and LV electrical services, gas, water and steam mains from a major proportion of the Hospital. This was completed without a single loss of service.
With just two night closures, we safely removed a 1930s concrete and steel link bridge, which was positioned over the main arterial route into the Hospital, with minimal disruption to the public and ambulance service. This route has a footfall of around 2,000 people and 350 vehicles an hour at peak periods. Approximately 50 of these are emergency service vehicles. Closing Infirmary Way during normal hours or for a long period was not an option.
We kept the East Midlands Ambulance Service well informed of the upcoming works and road closures. We allowed the ambulances emergency access into the Hospital, preventing them from having to take the longer diversion. They gave us a pre warning of ‘red calls’ in which case we had four minutes warning to remove all workers and materials from the road allowing the ambulances straight into A&E. This allowed the emergency cases to have priority and be in A&E in the quickest possible time, which will have no doubt saved lives.
During the night the works were halted on 14 occasions to allow emergency blue light ambulances unrestricted access to the A & E. Lighting towers were also provided by Tilbury Douglas Site Services. We also liaised with the Police and Fire department to discuss the works and agree the diversion. 2,000 operatives worked on this site (28,000 man days/ 280,000 man hours) – accident free.
Frailty friendly
We liaised with UHL, Capita, Age UK, Vista and Loughborough University to provide a patient friendly design which delivered improved patient care. Unique design developments include:
- Rubber flooring in the department rather than vinyl – this is harder to slip on and helps reduce injuries should someone fall – reduces risk by 30%
- The floor design lacks patterns which can prevent people with dementia trying to pick non-existent ‘bits’ off the floor which they can find distressing
- We used a bright colour scheme and LED frames to give clear demarcation between zones, floors and rooms to help reduce confusion
- We also thought about the equipment we use for these patients such as having trolleys that are lower and easier to get onto and ensuring
that monitors, wires and oxygen outlets are behind panels to stop people from harming themselves - We provided purpose built mental health rooms where patients are protected from harm while being assessed and treated
Our partners
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M&E Engineer: Capita (Redditch)
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Structural Engineer: Capita (Bristol)
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Architect: Capita (Cardiff)