Healthcare Estates Webinars

Hear from expert speakers in a series of live and on-demand webinars designed to help bring the content of this year's Healthcare Estates Conference to your screen.

Previous Webinars & On-Demand Content

Sameen Khan

Programme Manager for the NHS Programme, Salix Finance

Driving decarbonisation in the NHS through improved energy efficiency and renewable technologies

Salix is a not-for-profit organisation funded by UK Government. We support the public sector by providing interest-free loans across the UK to improve energy efficiency, reduce carbon emissions and lower energy bills. With significant potential for carbon reductions in the NHS our presentation will focus on discussing how investment in energy efficiency can support the decarbonisation of NHS estates. The key message we would like to share with delegates will be the benefits of investing in “no regret measures” to improve efficiencies as part of long-term decarbonisation plans. Salix has provided over £100.8 million to over 70 NHS clients for energy efficiency projects saving the NHS over £24.8 million and 108,090 tonnes of carbon dioxide annually. The presentation will take a look at how this investment has benefitted Trusts and demonstrate how far the NHS has come in achieving the targets set in the Lord Carter review. We will discuss funding opportunities and the new Salix Decarbonisation Fund available to NHS Trusts to support long term plans and reduction targets. We will look to discuss the massive challenge of decarbonisation of heat and potential solutions towards achieving net zero. This will be useful for NHS trusts who are seeking to create a carbon or long-term decarbonisation strategy for their estate. We will share knowledge on popular technologies, practical approaches and examples of Trusts gaining the most out of a Salix loan including a guest speaker (TBC). We will share best practice and lessons learnt to inspire delegates. We will also explore technologies of the future which could potentially help the public sector to reach to reach net zero targets. We will also introduce the Public Sector Network, an online forum for the public sector to share knowledge and ask questions to their peers.

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Alison Butcher

Programme Manager, Community Health Partnerships

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Mark Tribe

Employer’s agent, Fulcrum Group

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Andrew Gamblen

Digital Manager, Willmott Dixon

Tessa Jowell Health Centre - A Digital Construction Case Study

This presentation concentrates on the new Tessa Jowell Health Centre in East Dulwich, London and how BIM/Digital Construction has impacted on the project across the whole design, build, and handover lifecycle. It will provide 3 different viewpoints; That of CHP, Fulcrum Group, and Willmott Dixon to give a holistic view of Digital Construction and the impacts it has had, with important learning shared with those attending the presentation. Topics will include the use of Virtual and Augmented Reality, how the design models were used, and how the data generated will be handed over for use during the operational phase of the asset along with others to show just how much of an impact Digital Construction can have.

Emma Bolton

Emma Bolton

Area Director (Leeds / North East) Community Ventures (Management) Limited

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Claire Hennessy

Director of Estates and Facilities, Birmingham Community Healthcare NHS Foundation Trust

Louise English

Louise English

Capital Planning & Property Manager North Tees and Hartlepool Solutions LLP

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Duane Passman - Chair

Programme Director - Acute Development, West Hertfordshire Hospitals NHS Trust

How NHS Trusts Responded

In summary, the presentation will focus on three main areas:
1. The effect of the pandemic on space utilisation / using the estate differently
2. Wider strategic implications
3. Practical examples in Community and Acute Trusts

Supporting Information:

Gareth Banks

Regional Director, AHR

Tony O’Connell

UK Hospital Spearhead, Ramboll

Paul Astle

Principal Structural Engineer, Building Structures, Ramboll

How to achieve zero carbon in healthcare

Sustainability will dictate the future of our healthcare estates. Zero carbon buildings are increasingly declared as the solution, however, what does this mean for the healthcare sector and how can this be achieved?
Our presentation will explore the findings from our Zero Carbon Healthcare design exercise to provide an achievable route with which we can move forward.
We will cover:
- Research of notable examples from around the world
- An analysis of how a zero-carbon building interacts with current HTM and HBN standards
- How we can deliver zero-carbon within current cost envelopes and the SOC and OBC process
- The lessons learned that can guide us to achieve a zero-carbon ward block by 2025
Our aim is to uncomplicate the matter for the sector to provide actionable and practical strategies to meet these targets.
We will demonstrate a developed zero-carbon study of a typical patient ward block, including appraisal of new-builds, refurbishment and remodelling methods, whilst illustrating the opportunities and limitations of the current HTM and HBN guidance.
Our presentation will examine solutions from across multiple sectors and key areas, including Passivhaus, BREEAM and WELL.
Our study will showcase:
- Use of BIM and Revit to model, measure and assess environmental impact, including calculations of embodied carbon, daylight analysis and modelling passive of ventilation strategies
- Modern Methods of Construction (MMC) and innovation, identifying the benefits of different delivery methods
This will be showcased alongside net carbon zero's impact on capital costs, reviewing obtainable benefits it offers for maintenance costs, and how we can achieve zero carbon with value for money within current costs OBCs.
Finally, we look how we can maximise the lifespan and regenerative potential of our estates, including opportunities to implement wellness design to ensure our spaces positively add to our world.

Graeme Tucker

Sales Director, Power Control

UPS systems and their role in managing critical infrastructure risk

Power Control gives an insightful and technical presentation covering topics relating to uninterruptible power supplies in healthcare estates and how they are deployed within critical infrastructures.

Gerry Brannigan

Partner, HKA

Why Hospital Projects Fail

Healthcare construction projects are complex, use "state of the art" designs, involve multiple stakeholders and contracting parties. In these circumstances, expectations are often misaligned which results in defect and performance issues. In other words, notwithstanding the best of intentions, disputes arise.
Resolving disputes on these capital projects requires a breadth of expert forensic analysis to navigate the intricate web of many underlying issues.
Recent research (CRUX Insight 2019) draws on an unprecedented bank of knowledge to provide valuable insights into the most common causes of claims and disputes, resulting in delays and cost overruns, on major capital projects across multiple sectors around the world.
The presentation draws on the 2019 CRUX data and reviews the more extensive Crux 2020 research data into over 1100+ projects across multiple sectors including 51 healthcare facilities from 8 different countries. This research confirms there are fundamental issues which are within the control of the various project stakeholders. Also, we can see from the research that these issues are repeating themselves year on year which means that lessons are not being learned in the buildings sector.
If the industry is to break this cycle of repetitive disruption, delay and over-blown costs, employers and contractors need to understand, prepare for and manage the complexity of their projects.
This webinar delivered on behalf of the Healthcare Estates Conference considers the evidence from CRUX Insight research of 51 healthcare projects from around the world and identifies common issues resulting in a claim or dispute. How various project stakeholders can mitigate the number of claims arising is discussed and considered, and which would place all parties in a better position to settle any claims which evolve into disputes

Alex Emms

Operations Director, Kohler Uninterruptible Power

Neutral Earthing and Fault Clearance with UPS Systems

A practical insight to the often-misunderstood topic of fault clearing of loads and neutral earthing supplied by an uninterruptible power supply (UPS). Learn what the 18th edition regulations state, how a UPS operates in order to clear a fault, and things to consider when planning distribution. In this informative session Alex and KUP will cover:
Neutral Earthing
o The galvanic isolation between input and output
o 4 Pole Changeover
o Earth Leakage
o Solutions
Fault Clearance
o How does the UPS react to a downstream fault?
o Fault clearance with static bypass
o Fault clearance without static bypass
o Earth fault loops
o Inverter Specifications

Richard Mazuch

Director of Design Research & Innovation, IBI Group.

Maximising the HIP Plan.

Acoustic design is fundamental to the design of healthcare environments. Sounds affect us physiologically and psychologically. Noise increases heart rate, blood pressure, respiration and even cholesterol levels. Good acoustic conditions are key to healing, recovery, raising immune systems, improving patient privacy, dignity and promote essential sleep.
In terms of guidance the World Health Organisation advises that average patient noise levels should be about 30 decibels. The DOH, HTM 08-01 recommends between 30-40 db. However a recent study recorded an average hospital noise level of 48db and indeed noises in excess of 100 db.
So what are the sounds that inhabit most hospitals?
From a mother in labour crying, screaming and singing, to an infant's first cry, to neonates’ auditory experiences in bassinettes. From sirens, screaming, crying and shouting in A&Es, to beepers, pagers, buzzers and alarms in ICUs.
From Orthopaedic drilling, screwing and hammering to mortuary bone sawing.
From MRI units emitting 95-105 db, equivalent to "machine gun fire" to Audiology depts trying to achieve total silence.
From Renal Dialysis machine to respirators. From the sound of grieving families to the sounds of pain in Palliative Care to the ultimate "death rattle".
Today hospitals have become so noisy that the annoyance has topped all hospital complaints (Deordorff 2017). For more than 5 decades, hospital noise has seen a steady rise (Science Daily 2015). Recommendations resulting from our collaboration with Huddersfield University and Calderdale & Huddersfield NHS Foundation Trust will also be presented. There are clear interventions that can reduce hospital soundscapes. Some are simple and quick solutions. Others are low cost or have zero cost impact. Some are exotic and indeed some are more unusual.
"Shhh!!! Silent Hospitals Help Heal!"

Conor Ellis

Head of Strategy and Health Planning, Archus.

Maximising the HIP Plan.

Following many design reviews for Trusts in 2019/20 and leading the NHSI HIP review this spring means that I have seen projects across all parts of the Country, from initial PCBC to detailed OBC's from £10m to £1bl plus. The lessons on standardising performance and investment returns are tied up in delivering transformation through the business case and its link to the estates Strategy. Too often there is a disconnect between the clinical modelling, estate backlog and the link to detailed master-planning . In this talk I will focus upon
• Delivering the link between activity, transformation, FM, Backlog, risk and estate planning so that we avoid unforeseen capital growth increases above that forecast in the later stage of projects where such rises make audit of changes and management challenging and mistakes commonly occur.
• Delivering and maximising the transformation agenda, meeting modern heath facility requirements via standardisation and new ways of laying out clinical facilities- examples from the best of the NHS and elsewhere
• Structuring the project to meet NHSI checklist requirements
• Use of IT to report and progress projects that speed transactional inputs
• Provide insight into best practice and innovation in health and social care projects
• Practical tips to deliver value from using consultants whilst maximising public value for the NHS
Finally sharing some of the best practice across the NHS in the 26 projects that constitute HIP 1&2

Guenter Lang

Sales Director Europe, Thermal Energy International

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Sam Mawby

Director of Technology, Thermal Energy International

Modernisation of Steam and Hot Water Systems: An Introduction To The Steam and Condensate Loop

An introduction on the main parts of a steam and condensate loop including Boilers and CHP, steam distribution and heat exchange, condense return and hotwell, highlighting best practice and where non-standard technologies can provide an efficient alternative to removal of a system.
Also touching on funding streams available for improvements, and successful improvements made on NHS sites.

Supporting Information:

Adrian Hall

COO, Brandon Medical Co. Ltd.

Smart Operating Theatres.

Next-generation of surgical robots is ready to enter the market, or already has. Their design has been guided by the needs of patients, surgeons and surgical teams. It is now the task of Health Estates Managers and engineers to seamlessly and effortlessly integrate these technologies.
The Operating Theatre has been dramatically changed: Minimally invasive surgery means that more equipment has to be integrated and controlled than before, with complex audio-video solutions required, additional to Medical IT, UPS, gases, specialised carts etc.
Health Estates Managers and Engineers are facing challenges in integrating the new technologies whilst having to build-in efficiencies such as flexible use of operating theatres, instead of fixed, dedicated specialisms, all the while having to implement compliance such as HTM 06-01 in the UK and other current regulatory and recommendatory requirements, which continuously and rapidly change.
The sheer number of variables increases the risk associated with any operating theatre project. Compounding on the complexity of the project, the solutions need to be future proof, flexible in order to allow for various BMS platforms and development of new technologies, whilst delivering a user-friendly interface for the clinical staff: engineers cannot and should not be required during surgical procedures for troubleshooting - a nightmare scenario.
Whilst we agree on the above points, we need to consider and ask the question: is the integration of the operating theatre equipment with the building management system necessary, a nice to have or purely hindrance - and should be avoided at all costs?

Supporting Information:

Tim Gardner

Regional Manager, Langley Waterproofing Systems Ltd

Mitigating Fire in Flat Roof Construction.

What can we learn from the Hackitt Review? This presentation will look at Part B Compliance, Broof(t4) and independent verification in flat roof construction. The Independent Review of Building Regulations and Fire Safety, known as the Hackitt Review, has led to increased attention on fire safety. While much of this has been focused on high-rise residential properties, it is crucial that the specification of all building materials and systems adhere to current fire regulations and ensure the safety of building occupants.
Fire Regulations
The presentation will discuss one of the key sources of regulation and guidance in England - Approved Document B (Fire Safety) of the Building Regulations. In particular section B4, which relates to the resistance to the spread of fire from an external source (as opposed to fire from within the building) as well as resistance to fire spreading across the roof. Approved Document B provides guidance on mitigating fire risks in all areas of the building.
Testing and Certification
It will look to discuss the two main tests to comply with for flat roof construction, the National Test (BS 476 Part 3) or the European Test BS EN 13501-5 Standards.
Ensuring compliance
Followed by identifying some of the issues around system and/or product specifications. Even when there is an understanding of the type of system that is required, for instance, a torch-free application, it is crucial to interrogate the product information to ensure the selected solution meets the requirements and fully complies with the regulations. The primary and often most important source of information is the details published by the system supplier.
Presentation will finalise on other contributing factors including specification details, site controls, education of issues and summary on what facility managers should look out for when choosing a compliant flat roof system with fire regulations.

Leigh Preece

Sales Director, Power Electrics Generators Ltd

Impact on the Healthcare Sector of the Medium Combustion Plant Directive.

On November 25 2015 the European Parliament signed a new directive that regulates emission limits from medium combustion plants. Over the next two decades The Medium Combustion Plant Directive (MCPD) will begin to affect how the UK generates power.
The Medium Combustion Plant Directive (MCPD) will regulate emissions of SO2, NOx and dust into the air with the aim of reducing those emissions and the risks to human health and the environment they may cause. It also lays down the rules to monitor emissions of carbon monoxide (CO).Key principles of the legislation include: regulation of MCPs of between 1 and 50MW (equating to electrical output of between 330kW and 17MW), monitoring of (and potentially regulation of) CO2 levels and an Emissions Limit Value (ELV) based on the size and type of combustion plants. According to the European Commission, the emission limit values set in the MCP Directive will have to be applied from 20 December 2018 for new plants and by 2025 or 2030 for existing plants. This will be a continuation of this years Presentation and will offer an update on the impacts of the MCPD from the 1st January 2019.

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Peter Dyment

Technical Manager, Camfill

IHEEM Webinar: Air Quality and Filtration Requirements in Healthcare - Changes in HTM03-01 and Filter Standards.

Over the last 2 years there have been important changes to air filter standards and the classification system used to identify their performance.
Air quality is a hot topic, no more so than in the Healthcare sector and ensuring that healthcare professionals and their patients are protected from polluted air is crucial.
This presentation covers the changes regarding this subject that will occur in the re-written HTM03-01 in 2020, changes to International, European and British standards regarding air quality and filtration and guidance on how Healthcare facilities should be specifiying their air quality and filtration requirements.

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Dr Evangelia Chrysikou

Lecturer, The Bartlett Real Estate Institute, University College London

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Malcolm McFrederick

St Pancras Transformation Programme Director

St Pancras Mental Health Buildings Redevelopment: Using International Evidence, Best Practice and Experimentation for Supporting Multi-Stakeholder Dialogue.

Mental Healthcare services and especially outpatient and those integrated to primary care provide key components of early detection and continuous support. This project was initiated as an early stage of transformative building asset redevelopment of a mental health Trust. It aimed at challenging the concepts of delivering care towards an extrovert and holistic approach following extensive stakeholder consultation. That included patients, staff, governance, the wider community with the planning and design professionals. Therefore, it was essential to bring core recipients --staff and patients-- to a healthcare planning understanding level to maximise their potential to deliver meaningful feedback. It set to create an inclusive perspective involving the broader knowledge base with focus on international practise. The later would bring the out of the box thinking, exposure to strategies and solutions reflecting various policies.
Research followed a qualitative methodology gathering data on a) evidence base, b) best practice and c) experimental approaches in community mental health facilities globally. A literature review focused on health and mental health environments of all three categories. Case studies -mostly from literature and grey literature-- were analysed. Parallel, international experts were interviewed with a focus on different provision and design practices. Challenging approaches were included. The rationale was to penetrate the closed-circuit culture of psychiatric provision and enable integration with non-psychiatric health systems and potentially inverse-integration practices. This included even buildings with even experimental aesthetics or structures. Data -both visual and scientific-- were evaluated using the SCP model, an existing research tool developed for the evaluation of psychiatric buildings.
By treating design and place-making as a therapeutic tool we could challenge the way people view mental health buildings. Creating the means -review and inclusive consultation structure-- to disrupt a normally segregated architectural dialogue-- was essential to this process.

Christopher Roberts

Director and Healthcare Solution Architect, Schneider Electric

Driving Efficiency in Hospitals: from Old to New.

The healthcare technology marketplace is buzzing with the latest innovations in equipment and applications each promising to solve a niche problem. In the complex healthcare environment these specific solutions are great, but the wider challenge is how to integrate these connected technologies to provide a safe, efficient, and sustainable patient experience across the continuum of care.
New integrated technologies can now provide the platform for change, automation of mundane and routine processes driving greater efficiency, but unless we transform the delivery process the benefits will not be fully realised.
The healthcare construction value chain has operated in much the same way for the last 50 years. Often operational costs, future use, and integration with other relevant and complementary technologies are not considered in the construction phase. Global leading technology companies are learning from their international experiences across the world to improve the way hospital critical systems and infrastructure are designed, built, and operated.
Through early engagement in the design process, a focus upon the operational needs of the end user, and a proven total cost of ownership model it is possible to transform the construction value chain benefiting both contractors and end users alike.
This presentation will also visit examples of international healthcare organisations who are forward thinking and willing to adopt new technologies. They also plan for the operation of their facility at the outset and are truly transforming the traditional value chain and driving more efficient solutions during construction and in the operation of their facilities.
Working within highly secure cyber environments and taking advantage of the Internet of Things (IOT), together with machine learning and artificial intelligence we can now access greater insights and value from information than ever possible before.
It's time to change and the issues highlighted above are all addressed within this presentation.

Supporting Information:

Matthew Mears

National Healthcare Consultant, Bender UK

The Fundamentals of Secondary and Tertiary Electrical Infrastructure power for Group 2 Medical Locations.

When sizing power requirements for Group 2 medical locations as per BS 7671, regulatory and recommendatory compliance must be fully adhered to - ensuring the solution provides the highest levels of resilience and redundancy to eliminate the single points of failure and provide the highest level of patient safety.
The general principle follows the designer to follow some very straight forward steps:
- Sizing Medical IT power systems in accordance to the group 2 requirements
- Calculate Maximum Total Medical IT demand
- Calculate Maximum Standard TN UPS demand based on 40 watts per square meter, (If required) - centralised UPS systems
- Calculate overall total load system demand
- Correspond demand to correct UPS frame size
- Consider 2nd Fault Clearance requirements of UPS Inverter (Inverter Short Circuit) with respect to downstream protective devices
- Apply consideration to effects of loss of neutral/ neutral generation
- Put Medical IT systems into suitable frame size systems, to allow for sensible interleaving of final circuits (building resilience)
- Phase balance all loads to make sure of a balanced system and no poly-phases within a medical location
- Apply diversity factor if design requires Medical IT loads generally treated as "1"
- Split UPS units into N+N solution to provide diverse supply routes and to build UPS supply resilience
The final step to any Group 2 or Group 1 medical location is to design a robust earthing philosophy within the patient environment.

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