Refurbishment Project of the Year

Bradford Teaching Hospitals NHS Foundation Trust – Programme of Works

This project entailed the refurbishment of four existing facilities (£5.97m) which ran concurrently within a fully operational hospital during peak Covid-19 periods. This required early engagement and quick procurement (10-12 weeks from engagement to start on site) Tilbury Douglas achieved programme delivery across a multi-phased project consisting of multiple stakeholders on time in budget and was achieved whilst maintaining COVID compliance in one of the worst affected hospitals within the UK with ZERO RIDDORs.

Several of the schemes were COVID-19 related and the aim of the projects was to transform patient flow, staff working environment, enhance the experience and care provided to patients, alongside building resilience.

The schemes included:

• Wards 2-5 & Link: repurposing of storage and general wards to Same Day Emergency Care Wards (43 beds) providing urgent care to patients without admission. The unit houses a surgical assessment unit, acute surgical inpatient beds, a ‘hot’ clinic where recently discharged patients are reviewed by consultant surgeons.
• Emergency Department: refurbishment of the existing ED to bring up to current HTM’s incorporating eight negative pressure beds.
• Ward 10: Conversion of a bariatric ward to a hybrid ICU with ten beds.
• ENT Theatres: refurbishment of three existing ENT theatres, providing improved ventilation, lighting, new surgeons panels, UPS, LV distribution and fire alarm system. The project involved several innovative features utilising a Common Data Environment.

The latest surgeons’ panels were used, quick fit jointing systems for pipework including prefabricated and spooled pipework manufactured off-site. Pre-packaged skidded plant was utilised in addition to steam packaged heat exchangers and AHUs procured complete as plug and play units, the nurse call system was a HTM compliant wireless system utilised to assist in the speed of installation. We undertook initial trials of Uni-Stut cutting device and several Covid related helmet mounted glasses and face shields to combat fogging of safety glasses.

The project included the upgrade of all lighting to energy efficient LEDs, high efficiency motors installed for AHUs increasing lifecycle. BMS system upgraded with individually located stations for improving and checking energy usage feeding into the Trusts route to Net Zero Carbon plan, also had operational benefits, e.g., new high dependency units cater for multiple patients, temperature and humidity in the rooms are critical and can now be monitored carefully. Latest cooling refrigerants were used to improve efficiencies and water issues improved through installation of thermal circulation valves.

Air Source Heat Pumps for LTHW were also utilised in addition to low flush water cisterns, materials were all sourced within a 20-mile radius of the site within Bradford and Leeds in line with our ‘Buying Local’ policy. All measures had huge benefits within the lifecycle operation and maintenance for the Trust, greatly improving not only patient care but the way the Trust control their estate.

The project also dramatically contributed to the Trust environmental targets compared to what was there before. The scheme was delivered in budget and programme despite a significant number of client changes in a live hospital environment, across four separate projects, with three different design teams all with differing design philosophies and following strict COVID restrictions. The communication and flexibility of our team was commended by the Trusts representatives with handover, client demonstration and training identified as excellent.

Cleveland Clinic London Hospital – 33 Grosvenor Place

A refurbishment of an existing office building, this project provides a state-of-the-art healthcare facility in the heart of London. Alongside the Cleveland Clinic’s design studio, healthcare architects HKS worked together with PLP Architecture, Waterman’s civils and structural specialists and WSP’s MEP experts. 33 Grosvenor Place was originally built in the 1950s as the headquarters of an energy company and was further renovated in the 1990s.

In transforming the building into a 21st Century medical facility, the team sensitively worked with the existing facade, retaining it on three sides and rebuilding the remaining fourth façade in order to maximise the available floor area internally. New structure, floorplate and cores were inserted behind the façade while the majority of the existing concrete foundations were retained, further benefitting the sustainability credentials of the building.

A new mansard roof provides essential space for housing the plant room requirements for the building and it was designed in a manner that complimented the original intent of the building’s architect, Sir Albert Richardson. Delivering an exemplary patient experience was central to the internal arrangement of the building. The design of the inpatient units has been based on a clear separation of flows for patient, public and staff.

The patient bedrooms are all located around the perimeter of the building, benefitting from the views over the surrounding area. A spacious racetrack corridor connects all the bedrooms to the main vertical circulation points, reception and day spaces. Nurse bases are located at strategic corners locations to allow for maximum observation along two different directions. Clinical support spaces are located centrally on the floorplate with additional corridor connections between the different quadrants. There is no distinction in the level of finishes for the staff areas, they are finished to the same standard as the public facing areas of the building.

The interior design of the Clinic shows a carefully chosen palette of materials that promotes a relaxing and calming healing environment. Patient areas including bedrooms and waiting areas are filled with natural daylight, with timber joinery accentuating the spaces. The Cleveland Clinic curated and commissioned a series of artworks specifically for the hospital as art can enhance the patient experience creating a relaxing and contemplative environment.

The west façade of the building also features an external artwork, carved into the new stone façade. A comfortable patient and staff experience is supported by sophisticated technical solutions required for the specialist treatment spaces that are included in the building. Located in the lower floors of the building, the operating theatres, cath labs and imaging modalities, that typically require a high level of design and services coordination, have been designed to reflect the clinical excellence aspirations of the client while presenting a calm and considered environment to the patient users. Sustainability has been a key design consideration throughout the scheme, the building has achieved BREEAM Very Good and is targeting a LEED Silver rating.

Critical Care Unit Expansion Project, Aintree University Hospital

The Critical Care Unit (CCU) Expansion project is an extension to the existing 24-bed critical care unit as a part of the Urgent Care and Trauma Centre (UCAT) development. One primary focus throughout all stages of design was to ensure that the equipment and facilities were suitable to offer all admitted, critically ill patients the best possible care. To achieve this, staff were heavily consulted throughout the design process to ensure that the new facilities would enhance efficiency and enable them to care for the patients on the ward effectively.

A key consideration was the link between the new and existing unit which allows for the prompt, safe, and discreet movement of patients, staff and supplies. A separate entrance for visitors was provided at the alternative end of the unit, off the main hospital street. The new unit comprises seven single-bed rooms, all of which are fitted with ‘state-of-the-art’ facilities, including sliding doors and ceiling mounted pendants.

Two of the rooms are lobbied isolation rooms, to offer the capacity to limit the spread of infection between patients and for the protection of immuno-supressed patients. Staff touchdown bases are located to allow for effective patient monitoring through the use of glazed screens and doors, whilst patient privacy and dignity is maintained through specification of high acoustic performance doors and screens, fitted with integral blinds.

The design forms a therapeutic environment, a healthy workplace for staff, and a calm treatment space for patients. Input provided by the hospital staff during early consultation meant operational activities and day-to-day work patterns were fully communicated so a deep understanding of how the new facility would best operate, once complete.

Trust IP&C officers shared in these conversations to raise any health or infection risks that may have been unconsciously overlooked, prior to a Trust sign-off. Another primary objective of this scheme was the removal and replacement of the existing RAAC (reinforced autoclaved aerated concrete) plank roofing system. This project is the first RAAC roofing removal and replacement in-situ. The BAM team surveyed the structural integrity of the building cleverly designing around the existing frame to enable the installation of an improved structural steel frame. This replacement uniquely took place above a live hospital meaning a completely weathertight environment was formed, using a scaffold tent.

As a result of the trailblazing RAAC replacement works and methods used, BAM are already engaging with the RAAC Technical Lead for NHS E&I to share the knowledge and experience gained nationally, for similar schemes to the benefit the NHS and public sector buildings with RAAC in the UK. Retention of the existing building frame made use of existing building stock allowing redevelopment of the space for a state-of-the-art Critical Care department.

A fabric first design approach saw new insulation and roof covering installed, along with new fire rated glazing and façade, ensuring the CCU is an optimal temperature year-long, reducing the energy use. Energy saving LED lights, PIR’s, programmable taps and BMS were employed to further reduce the impact and energy.

GOSH The Sight and Sound Centre

The refurbishment of the existing Italian Hospital (Grade II listed) to provide a state-of-the-art outpatient and diagnostic facilities for children, providing clinical services such as Ear, Nose and Throat (ENT), Audiology, Ophthalmology over 5 stories. It is located over the road from the main GOSH hospital and it is the UK’s first dedicated centre for children diagnostics with suffering with hearing and sight lost. The whole centre was designed for these young children in mind.

The new centre opened in June 2021, to transform the experience and care of children and young people from across the UK. A first-of-its-kind for children in the UK, the Centre features state-of-the-art soundproofed booths for hearing tests, an eye imaging suite, a dispensing opticians and other testing facilities. There is also a sensory garden with plants that children can see, touch, smell and hear, and bespoke and engaging artworks especially commissioned for children with sensory loss.

Wayfinding: The centre has been designed so each of the floors are colour coded, on entrance there is a toy wall replica of the hospital (Dolls House) to help children find the way to go and what to expect next to the floor colour code chart – the overall aim to make the experience less daunting for them. The children helped to design the way finding on each floor. • Audiology (Lower Ground) – Dark Blue – 4 consulting rooms, 5 booths, 3 sound treated rooms, 1 lab and 1 hearing aid fitting room • Outpatient Services (Ground) – Green – Opticians, Eye Clinic Liaison Offices, Genetic Counsellor, imaging, courtyard garden, APOA Consulting & Interview, 3 EDT Labs & 1 Eye Movement Room • Ophthalmology & Upper Courtyard Garden (Level 1)- Purple – Valentine Sensory Garden, Toilets and 12 consulting/ exam rooms & 1 eye drops room • Ophthalmology and Toilets (Level 2) Light Blue – 10 consulting/exam rooms, 1 eye drops room, 1 lense fitting room • ENT, SaLT & OPD (Level 3) Yellow – 10 consulting/exam rooms and 2 scope rooms and 1 scope / VPI room and 1 MDT room.

£16.3m

June 2018 – June 2021

Refurbishment

Clinical Facilities
• Outpatient & Diagnostic Facilities
• Ear, Nose & Throat
• Audiology
• Opthalmology

Key Objectives for 2021-2022

  • Complete the refurbishment of the old Italian Hospital to provide a dedicate outpatient and diagnostic for children with rare conditions.

Design Team

Sonnemann Toon – Architects Troupe Bywaters + Anders – M&E Design Fairhurst – Civil & Structural Engineers Banyards Consulting – Commissioning

“More than 8,000 children and young people with sight and hearing loss come to the hospital each year … The Sight and Sound Centre will improve care by bringing clinicians supporting these children together in one place and vastly improve the patient experience by creating an environment tailormade to these patients’ needs.”

Dr Peter Steer, GOSH’s Chief Executive.

Tameside and Glossop Integrated Care NHS Foundation Trust – Women’s Health Unit

Traditionally, the Women’s Health Unit (WHU) at Tameside General Hospital has been located away from the other Women & Children’s services, mainly due to spatial constraints within each of the buildings which has prohibited co-location previously. The existing WHU was located within Hartshead North and has long been considered to be in a prime location which would benefit from being converted back into a ward area.

The Estate at Tameside is small and as time has progressed, an inherent need to improve patient flow in the hospital has been identified. The need was amplified by the COVID-19 pandemic in 2020 with the introduction of social distancing so a solution was much needed.

In 2020, an underutilised, non-clinical space on the ground floor of the Charlesworth building was earmarked to allow for the relocation of the WHU, to sit adjacent to maternity and ante-natal services located in the same building. Design and enabling works commenced in late 2020, but the remaining refurbishment was postponed due to the pandemic.

In 2021, the project was resumed with works commencing in November 2021, and completing March 2022. Working to a challenging programme, the project team required a dynamic and flexible approach to meet the deadlines set. Construction commenced based on a developed Stage 3 design, allowing for early progress to be made. While some hurdles were encountered, the team delivered a high-quality, bright feeling build, within programme and budget. This was achieved through strong collaboration between the Trust, their consultants and the contractor and included the implementation of an accelerated programme, detailed weekly site reviews and a truly committed, flexible ethos.

The unit comprises of two Colposcopy Rooms, four Consulting Rooms, Recovery, Scan and Reporting Rooms, Clean Utility, Dirty Utility, Nurses Station, Reception and Medical Records space. Additionally, a purpose-built Quiet Room was provided, with special design input from the nursing staff, so that there is a dedicated space with the unit for patients to take any time they need.

A new Air Handling Unit (AHU) was installed externally to provide the required HVAC requirements to comply stringently with the current guidance in HTM 03-01. This element alone presented a significant challenge as earlier inaccessible structural steel work resulted in the need for a meaningful redesign by the Mechanical, Electrical and Plumbing (MEP) consultant and contactor in order to accommodate the required infrastructure. The positive impact of the new WHU is felt hugely by the Trust, but more crucially, all Women’s Services are now co-located in the Charlesworth building.

The end users have been heavily involved in the design, layout and finishes of each of the rooms to ensure that they have a useable, comfortable and modern facility to work in. As a direct result of this project, the Trust is now progressing with the design for the refurbishment of the vacant space with a view to reinstating a 20-bed ward, which will ultimately increase bed numbers as well as improve patient flow within the hospital.