SEPTEMBER 2024 | £8 Also in this issue: Newcastle Health Innovation Neighbourhood Go-ahead for ambitious £500m project healthcaredm.co.uk healthcare design & management Harnessing heat from MRI machines Viridis Building Services supports first net zero CDC The Midland Metropolitan University Hospital A preview into this ground-breaking project The Building Safety Act 2022 How to navigate the regulatory environment for healthcare buildings
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healthcaredm.co.uk 3 Publishers Stable Publishing Limited SBC House, Restmor Way Wallington, Surrey SM6 7AH, England. t. 020 8288 1080 f. 020 8288 1099 e. [email protected] healthcaredm.co.uk Editor Helen Adkins Sales Director Julian Walter Production Nicola Cann Design Gemma England Managing Director Toby Filby The Newcastle Innovation Health Neighbourhood The publishers do not necessarily agree with views expressed by contributors and cannot accept responsibility for claims made by manufacturers and authors, nor do they accept any responsibility for any errors in the subject matter of this publication. healthcare design & management With the recent approval of the £500 million Newcastle Innovation Health Neighbourhood, we are witnessing a transformative shift in healthcare design. This development marks a new era where the design of healthcare facilities is evolving to address not just medical needs but also to integrate into the communities they serve. The focus has expanded beyond functionality to include enhancing accessibility, fostering community engagement and improving overall health outcomes. Modern healthcare buildings are increasingly envisioned as integral components of their neighbourhoods. The Newcastle Innovation Health Neighbourhood (p 12), spearheaded by Newcastle University, exemplifies this approach, integrating the surrounding communities and drawing them into the space. This design strategy incorporates community spaces, public amenities and green areas, as well as healthcare facilities and cutting-edge research to help people live longer, healthier lives. Similarly, the Midland Metropolitan University Hospital is set to redefine what a healthcare facility can be. Opening next month, this hospital will not only feature Europe’s largest A&E, but also the largest art gallery in a hospital, as well as a winter garden with social spaces, restaurants and meeting areas, and an outdoor green space equivalent to the size of a cricket pitch for public use. Such facilities go beyond traditional clinics or hospitals, functioning as comprehensive centres that merge medical services with community functions, all within a single, accessible location. Architects and planners are also focusing on environmental sustainability in these new healthcare facilities. Many designs emphasise energy efficiency and eco-friendliness, reflecting a broader commitment to the community’s wellbeing. This includes the use of sustainable materials, energy-saving technologies and spaces that promote healthy lifestyles. Overall, the evolution of healthcare buildings into community-centric hubs represents a significant shift in health and wellness approaches. By creating facilities that are both integrated into their surroundings and focused on accessibility, we are enhancing the quality of care and the wellbeing of the communities they serve. As this trend progresses, we look forward to the future of healthcare design that will prioritise spaces that truly meet the needs of their communities. Helen Adkins Editor [email protected] Editor’s Letter September 2024 The rise of integrated healthcare hubs
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healthcaredm.co.uk 5 IN THIS ISSUE... September 2024 16 27 7 News A look at new projects and hospital extensions, as well as a round-up of all the latest news across the sector 12 The Newcastle Health Innovation Neighbourhood As this ambitious £500m Newcastle University project gets the go-ahead – in partnership with Genr8 Kajima Regeneration Ltd – we speak to the architects about the plans and the challenges 16 Viridis Building Services The UK’s first fully net zero Community Diagnostic Centre (CDC) in Scunthorpe is set to open this year, aided by an innovative way of harnessing waste heat from MRI machines 19 The Building Safety Act 2022 for healthcare Chris Jones, building control business unit director at Bureau Veritas, explores the applicability of the act and offers advice on how to achieve compliance 22 The Midland Metropolitan University Hospital Due to open next month, we talk to the Glancy Nicholls architects about integrating the design with the surrounding communities 25 Comment Amit Vadgama, principal building surveyor at Pick Everard, outlines the everyday NHS maintenance that is contributing positively to our communities 27 Pyroguard Andy Lake, Pyroguard’s UK & Ireland projects director, explores the crucial role and specifications of fire safety glass 30 Swedoor We look at Swedoor’s recent contract to supply 2,300 high specification doorsets at the newly opened Lighthouse Hospital in Finland 33 Altro Flooring Altro’s safe, durable and adhesive-free safety flooring has brought a natural, biophilic design to Ipswich Hospital 22
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healthcaredm.co.uk 7 NEWS Ascom has won a tender to implement its Alerts and Notification Management System (ANMS) at the new children’s hospital in Dublin as part of the five-year partnership with Children’s Health Ireland (CHI). ANMS will seamlessly connect clinical and non-clinical staff with various alarm sources within the hospital. the tier one contractor will deliver refurbishment works in the current Emergency Department waiting and triage rooms to meet modern standards. The project is being designed and managed by Gleeds in conjunction with the NHS (Aneurin Bevan University Health Board), with the former involving Morgan Sindall at RIBA stage four. Early engagement and consultation via the SCAPE framework resulted in a quick, eight-month consultation turnaround. Throughout the construction, Morgan Sindall will utilise its in-house carbon mapping software, CarboniCa, to track and reduce carbon emissions on-site. Furthermore, the team will install Morgan Sindall Construction’s Cardiff team has been appointed by the NHS to deliver an extension to The Grange University Hospital’s Emergency Department (ED) in Cwmbran, near Newport. Procured via the SCAPE National Construction Framework, the team has since started on site with the phased work set to complete in April 2025. Additional amenities to the pre-existing facilities include a three-storey building with a ground floor ED triage area. The remaining floors will continue as open plan in order to the meet required needs of the hospital. Further to the extension, Morgan Sindall Construction appointed to emergency department extension Photovoltaic (PV) solar panels on both the new building and the roof of current hospital buildings. Rob Williams, area director for Morgan Sindall’s Cardiff team, said: ‘This is the first time we’ve worked alongside the NHS in this particular area. Given the strain facing services, we’re glad to be contributing our expertise to the local hospital and relieving wait times for the community.’ Architects are BDP, with Gleeds acting as the client PM. ■ www.morgansindall.com www.gleeds.com/en www.bdp.com Ascom signs five-year contract with Children's Health Ireland A critical component in emergency care, the alert management system will help to ensure that alerts are received by the right person, dealt with or escalated. For example, in a medical emergency such as a cardiac arrest, calls will be communicated and escalated using Ascom’s technology directly to the relevant staff’s mobile phones. This functionality is poised to make a significant impact on patient outcomes and hospital emergency readiness. Adrian Rath, chief technology officer with Children’s Health Ireland, said: ‘We are delighted to work with Ascom on this project, as they have proven their efficient delivery of alerts and notifications, seamlessly woven into clinical workflows. ‘We know that connecting the hospital’s systems in this way will empower healthcare professionals to make informed decisions promptly whilst also enhancing overall patient care.’ The new, digital national children’s hospital will provide care for children and young people who require specialised and complex care. This new system from Ascom continues CHI's digital transformation programme. ■ www.ascom.com/uk
8 healthcaredm.co.uk NEWS healthcare design. It is expected that more than 100,000 patients a year will be treated across 13 floors in the purpose-designed environments with clinical and support accommodation facilities providing a once-in-a-generation improvement for staff and patients requiring hospital care from across Sussex. BDP’s design provides major new facilities for multiple wards and departments and fits a large-scale hospital building sensitively into its historic context in a constrained site. The mass of the building is broken down into fingers, which contain the bulk of the ward accommodation. All the patient rooms face south with views over the English Channel, increasing a connection with the outdoors and sea. The interior design strategy at the building fosters connections between the hospital and surrounding communities and landscapes, celebrating Brighton, Sussex, the coast, and the unique character and cultures of the communities that live there. The design Architecture firm BDP has picked up three major awards at the 2024 European Healthcare Design awards. The Louisa Martindale building in Brighton for the University Hospitals Sussex NHS Foundation Trust building was the outstanding project of the ceremony and a double winner, collecting awards for the development over 25,000 sq m and also for interior design and arts. The Future Healthcare Design prize was awarded to BDP’s project at Great Ormond Street Hospital. The Lousia Martindale building represents the very latest standards in presents a new narrative – allocating a theme to each ‘finger’ of the new building. Each theme has an associated colour palette, artwork and wayfinding, providing legibility and transparency in navigating the building to help reduce stress for all users. The award-winning design for a Children’s Cancer Centre at the worldfamous Great Ormond Street Hospital presents a crucial, innovative and flexible building that houses wards, a cancer day care centre, new surgical theatres, an intensive care unit and an imaging centre. The design plays with ideas of ‘House’ and ‘Garden’, with conscious allusions to home life scattered throughout the building. It evolved from early-stage consultations with GOSH’s ‘Young Person’s Forum’, a group of young patients who chose ‘nature’, ‘home away from home’ and ‘indoor-outdoor’ as prevailing themes. BDP also received high commendations for its designs for the Christie Paterson building in Manchester, Wexham Park Hospital in Slough and the Oak Cancer Centre in Sutton. ■ BDP triumphs at European Healthcare Design Awards
healthcaredm.co.uk 9 NEWS Procurement organisation and social enterprise Fusion21 has announced the suppliers successfully appointed to its national Lifts Framework, worth up to £80 million over four years. A total of 37 specialist firms – 76% being SMEs – have secured a place on the framework which is now in its fourth generation and has been designed to deliver lift-related works and services to estates across the public sector, including healthcare providers. Offering geographical coverage across the UK down to a regional and local level, the framework supports the design, installation, servicing, testing and refurbishment works of passenger and The building has been made possible through the rigorous fundraising efforts across the UK and will be constructed using modern methods of construction, with structurally insulated panels (SIPs) being manufactured offsite and erected in position, allowing a quicker, more efficient and more environmentally friendly process than a traditional build. The design of the building is intended to create a sense of community and an environment that meets the needs of patients, families and staff. As well as clinical areas and treatment rooms, the building will include a central space where people can come together, along with reading and quiet spaces, as well as activity, dining and outdoor areas. I&G have a track record of delivering high quality schemes in live hospital environments and the project is the Yorkshire-based construction firm I&G, part of the wider Sewell Group, has been appointed by Leeds Teaching Hospitals NHS Trust to build the new Rob Burrow Centre for Motor Neurone Disease (MND) in Leeds; the first of its kind in the UK. The new facility, which will be located on the Seacroft Hospital site, will bring a much-needed resource to the region and see all MND services housed under one roof for the first time. Named after rugby league legend, Rob Burrow CBE, who campaigned for MND after being diagnosed with the condition in 2019, the new centre will be funded by Leeds Hospitals Charity who have been fundraising to bring Rob’s vision to life. next in a series that the company are delivering in conjunction with Leeds Teaching Hospitals Trust, which includes the new Seacroft Community Diagnostic Centre. Richard Noble, associate director Estate Strategy and Development at Leeds Teaching Hospitals NHS Trust, said: ‘We’ve worked with I&G on several projects over recent years and we know they have a track record of delivering high quality schemes at pace, so we can’t wait for them to get started and see this muchneeded facility come to life.’ ■ www.iandgltd.co.uk I&G to build new Rob Burrow Centre for Motor Neurone Disease goods lifts, stair lifts and lift consultancy services. Peter Francis, group executive director (operations) at Fusion21, said: ‘This framework renewal will support our members to manage and maintain both passenger and goods lifts compliantly, while also catering for the renewal and refurbishment of aging units and the service and installation of domestic lifts. ‘In addition to working with a team of technical procurement experts and a rigorously assessed and approved supply chain, Fusion21 members accessing this offer will benefit from a compliant and efficient route to market, flexible call-off options and greater cost efficiencies. Fusion21 announces suppliers appointed to £80 million Lifts Framework ‘As with all of Fusion21’s frameworks, the Lifts Framework will also support members to deliver social value they can see in communities, aligned with their organisational priorities.’ A list of the suppliers appointed to Fusion21’s national Lifts Framework can be found at www.fusion21.co.uk. ■
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healthcaredm.co.uk 11 NEWS 8-9 October 2024 Manchester Central Healthcare Estates Stay connected, keep informed, get ahead Healthcare Estates is the flagship annual event of IHEEM – the Institute of Healthcare Engineering and Estate Management – and is the UK’s largest event for healthcare engineering and estates management professionals. Staged at the Manchester Central convention complex in the heart of the city, and this year organised around the theme of ‘Embracing the Challenges’, the two-day conference and exhibition provides learning, engagement and networking opportunities for professionals of all levels in every estates and facilities profession. Delivered as part of IHEEM’s 2024 Key Events and Networking Programme, Healthcare Estates helps the sector `Stay connected, keep informed, get ahead’, in several important ways: • Enhance your CPD record Complete up to 10 hours of CPD, across the wide range of keynotes, conference sessions and technical seminars, and meet professional bodies' requirements for completing a variety of development activities. • Strengthen your professional network Build trust and understanding with clients, suppliers and peers through face-to-face connection; re-connect and share experiences with old colleagues; make new contacts to expand the pool of people you can call on for suggestions and guidance. • Address strategic challenges Identify, discuss and understand the critical subjects for the healthcare engineering and estates management sector; get ideas and inspiration for tackling the big challenges facing your organisation. • Share best practice Hear from experts with deep subjectmatter expertise and extensive experience; share your expertise and experience to support others' development and help drive progress in the sector. • Enhance market and product awareness Get an overview of the range and depth of products and services on offer in the market; see the latest equipment and products from 200+ suppliers, from big established names to innovative startups; discuss applications with company product experts. • Address specific product issues Identify alternative products/solutions to address particular challenges/ opportunities; find new equipment/ technologies; discuss problems with existing products. • Develop technical knowledge Attend presentations from the IHEEM Technical Platforms and other leading associations and organisations; gain the advice of experienced peers. • Access further training Explore IHEEM training opportunities. The Conference & Exhibition (Delegate) Pass gives access to everything on offer at Manchester Central, plus a range of on-site benefits such as inclusive parking, with a choice of one- or two-day attendance. That includes all keynotes, conference sessions, workshops (subject to availability), exhibition seminars, and the exhibition itself. The Exhibition-only (Visitor) Pass is free of charge and gives access to the exhibition, including keynotes and technical seminars taking place in the Exhibition Hall theatres. Direct employees of the NHS, IHEEM members and Architects for Health members enjoy ‘VIP’ status, allowing access the VIP Area sponsored by Wandsworth Healthcare. Register your place at www.healthcare-estates.com. PREVIEW
12 healthcaredm.co.uk PROJECT Newcastle Health Innovation Neighbourhood Cutting-edge research meets community living Work has started on the £500m Newcastle Health Innovation Neighbourhood, aimed at transforming a former hospital site into a premier centre for research and innovation in ageing and wellbeing Work has commenced on the Newcastle Health Innovation Neighbourhood (HIN), marking a major partnership between Newcastle University and Genr8 Kajima Regeneration Ltd. Designed as a transformative mixed-use development, this landmark project aims to integrate research, residential and work environments, along with education and healthcare. Spanning 29 acres, the development was spearheaded by the Newcastle University and will partly focus on producing innovative housing solutions, including specialised accommodations for individuals living with dementia and traumatic injuries. Building on Newcastle University's global reputation in healthy ageing research, the project will also bolster the city’s ambition to be a hub for innovation and a leader in the burgeoning longevity economy. The HIN, formally known as the Campus for Ageing and Vitality (CAV), will not only contribute to the city’s economy by creating local jobs and new homes, but also introduce new models of integrated care. The site of the former General Hospital will incorporate existing university and NHS buildings into a new community with a focus on health and wellbeing, rooted in research and innovation. The project will combine multi-generational living with a living lab concept, enabling researchers to access real life data from the latest innovations in digital homes. As a result, specialist ageing research will develop advanced infrastructure to support housing solutions that will promote longer, healthier lives. THE MASTERPLAN The masterplan so far includes 350,000 square foot of research and innovation facilities, 350,000 square foot of business employment and education space, 100,000 square foot of NHS and other health related facilities, and 1,250 new homes. Professor Chris Day, vice chancellor and president of Newcastle University commented: ‘This planned
healthcaredm.co.uk 13 PROJECT ‘One of the key things around the success of this development is making sure it doesn’t alienate itself from what’s around it’ health innovation neighbourhood is built on our world leading expertise in healthy ageing and it will be the first of its kind in the UK, tackling major health and social challenges, with the aim of identifying solutions that will benefit people here in the North and beyond. The goal is to develop solutions that benefit not only the local community but also have a broader impact.’ Jonathan Hunter, senior partner at GSSArchitecture, has been working on the project since 2020, when the firm was commissioned to look at a high-level outline master plan. Since then, a detailed masterplan application has been through the local authority planning process, with Kajima Genr8 Regeneration Ltd becoming involved as a development partner two years ago. The Newcastle upon Tyne Hospitals NHS Foundation Trust, Health Innovation North East and North Cumbria, and Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) – a health organisation providing mental health, learning disability and neurological care services – also have a stake in the development. Hunter explains: ‘So Newcastle University has got an international reputation for their research programmes in and around subjects associated with ageing, with research buildings and clinics already on the site, and all focused on innovations and how to fundamentally help people live longer lives. That's really the mantra that sits behind this development and is what has formed the basis for this vision. ‘This project is about producing a healthy innovation neighbourhood, where people can live, work, visit and play, and do so with fundamental building blocks that will help people to live longer, healthier lives. Whether that's medical intervention, whether that's creation of communities or the creation of healthy societies.’ The site itself is poised for significant transformation. In addition to the hospital, it was also occupied by old workhouses and a number of cramped, pre-fab buildings at the end of their serviceable lives. A temporary cataract clinic remains on part of the site still owned by Newcastle upon Tyne Hospital Trust, which will be developed in alignment with the overarching masterplan or incorporated into the plan through potential land swaps. Ideally, the integration of NHS facilities will occur throughout the development, blending seamlessly into the neighbourhood rather than being isolated in one area. >>
14 healthcaredm.co.uk PROJECT ‘Our approach includes innovative and forwardthinking strategies to ensure the development is both functional and future-proof – it’s very futuristic’ The Genr8 Kajima Regeneration Ltd (GKRL) partnership is a 50/50 joint venture between Kajima, the panEuropean real asset investor, developer and manager, and leading regeneration developer, Genr8 Developments. It is a leading regeneration specialist with an established track record. GKRL has already delivered over £130m of town centre regeneration, including Rochdale Riverside, a 200,000 sq ft retail and leisure scheme. In addition to the Newcastle Health Innovation Neighbourhood, the partnership is currently working on schemes in Huyton, Winchester and Telford. www.gkrl.co.uk LinkedIn: Genr8 Kajima Regeneration X: Genr8KajimaReg Genr8 Kajima Regeneration Ltd PRIORITISING COMMUNITIES The redevelopment will also prioritise creating vibrant communities, including residential areas and primary health care services, as well as educational spaces to engage younger individuals and benefit the wider community. ‘ The importance of creating communities is crucial,’ Hunter continues. ‘There will be primary health care facilities and GP services, but also an educational facility which can be used by the wider community, so we’ll start to get some younger people on site. There will be different types of residential, including later living and dementia care, based on some examples on what they’re doing in Holland, which does require a shift in culture and risk. It’s all about progressive thinking.’ Intergenerational living is an important element of the concept, as progressive community style developments have been shown to be as beneficial to older-years health as primary health care facilities. Integrating the surrounding communities, which are extremely rich and diverse in this part of the city (the material printed for public consultations was translated into 70 different languages) is also crucial. ‘One of the key things around the success of this development is making sure it doesn’t alienate itself from what’s around it,’ Hunter says. ‘This development has to be truly outward looking and inclusive, and encourage people to want to come in. It’s not about providing big wow ivory tower buildings, but about providing places where communities feel comfortable gathering and where people have a reason to dwell, because it's those personal connections that communities stem from. And communities are a big part of what drives healthy outcomes in later life.’ While the development will feature research facilities, NHS services and housing, the emphasis on the public realm will be significant, with this element clearly reflected in the design code. Vibrant community hubs will be designed for performances and gatherings, while there will also be retail options, dining establishments and social spaces, as well as parks and play areas. In addition to these amenities, the project will incorporate mobility hubs – strategically designed spaces for deliveries and transportation needs. While the development will not be entirely vehicle-free, it will be designed to be vehicle-light, promoting multi-modal transport solutions. Hunter adds: ‘Our approach includes innovative and forward-thinking strategies to ensure the development is both functional and future-proof – it’s all very futuristic.’ Securing funding has been a significant challenge as the firm work to advance the project, but further complexity has arisen as a result of the vast array of stakeholders involved, from developers, local authorities and the university to the numerous local resident and community groups. ‘Each group brings its own perspectives, objectives and targets,’ Hunter explains, ‘making it crucial to balance a wide range of diverse interests. Managing this process requires patience and time, with success hinging on effectively communicating a clear vision. ‘The volume of consultation and the time that has required has been for me, to date, one of the biggest challenges, but it’s something that can’t be rushed and we need to bring everyone along on the journey. But it’s an exciting development and to have played any part in this project has been fantastic.’ ■ www.gssarchitecture.com
16 healthcaredm.co.uk PROJECT NET ZERO innovation The UK’s first fully net zero Community Diagnostic Centre (CDC) is set to open this year, aided by an innovative method of harnessing waste heat from MRI machines. Here, we find out how Viridis Building Services, a company that helps organisations reduce their carbon footprint and energy costs, has devised a ground-breaking innovation as part of its work to deliver the UK’s first CDC. Scheduled for completion in this autumn, the £19.4m new-build project in Scunthorpe town centre is already on target to achieve net zero status, having been passed as such by Building Regulations and construction-stage EPC ratings. Viridis was tasked to achieve as close as possible to net zero with the scheme, but is confident that it will surpass expectations and create a building that will even be able to feed excess energy back into the National Grid. THE NET ZERO SOLUTION The firm, based in Collingham, Newark, has introduced a combination of natural and mechanical heating and ventilation using roof-mounted PV tiles and optimal lighting systems. As part of its problem-solving process, it has also pioneered a method for capturing the enormous amounts of rejected heat from the centre’s two MRI machines and feeding that energy back into the 2,000 sq metre building. This innovation alone could save the NHS millions of pounds in energy costs if the same method was introduced across its estate. Lee Marshall, managing director of Viridis, said: ‘The knock-on benefits to this unique breakthrough could be huge. Not only have we delivered the UK’s first net zero Community Diagnostic Centre, we have also achieved a solution with the MRI heat recovery process that could save millions in energy bills and make a significant contribution to the reduction of the NHS’s carbon footprint.’ Scunthorpe CDC is one of the 160 Community Diagnostic Centres that the previous Government pledged to deliver before the end of 2024. The centres, which are being located in highpopulation areas close to public transport
healthcaredm.co.uk 17 PROJECT networks to provide easy patient access and encourage a reduction in car travel, will provide non-invasive treatments such as MRI scans, CT scans, ultrasounds and X-Rays. Due to its strong reputation for delivering net zero buildings, Viridis was given a completely open brief with Scunthorpe CDC by Northern Lincolnshire & Goole NHS Foundation Trust. ‘We were told they wanted a ‘nearly’ net zero building, as part of the NHS Estate’s commitment towards eventually achieving net zero across its entire portfolio,’ said Marshall. ‘How we achieved that was effectively up to us. So we employed our usual process of combining each team member’s individual expertise in various disciplines to ask how we can exceed the brief and actually deliver a fully net zero building – within budget. ‘We do not stop short at only implementing what has gone before. We always challenge the norms and, like here, it often it pays off.’ ‘The use of MRI machines as energy providers rather than energy wasters had never been done before’ THERMAL EFFICIENCY The Viridis team working on this project comprised of experts in mechanical engineering and electrical design, renewable energy and the environment. The team’s first ideas focused on the thermal efficiency of the building – ways to contain heat and recover waste heat. They then began to look at various energy systems within the building, such as lighting, and came up with ways to optimise them to create maximum efficiency and minimum carbon emissions. But the major breakthrough came about when the team began to investigate the enormous quantities of heat that are traditionally rejected from MRI machines. The use of MRI machines as energy providers rather than energy wasters had never been done before. Heat produced by MRIs would normally be ‘disposed of’ through a fan to the outside atmosphere, whereas Viridis found a way to collect and re-use it with the use of heat pumps. A building like Scunthorpe CDC would typically have expected to pay around £60k-£65k per year for its energy. But with the Viridis innovations, it is expected to have zero energy costs and figures indicate it may be able to sell around £1k of energy back to the Grid. ■ www.viridisbsl.co.uk
healthcaredm.co.uk 19 BUILDING REGULATIONS Exploring the application of the Building Safety Act 2022 in a healthcare setting Exploring the regulatory environment for healthcare buildings, Chris Jones, building control business unit director at Bureau Veritas, looks at the applicability of the Building Safety Act 2022, and how to achieve compliance The Building Safety Act 2022 (BSA 2022) has been widely coined ‘the biggest change to building safety regulation in a generation’ and was introduced to enhance safety and accountability within the building industry. It established a new building safety regime and follows recommendations set out in the Building a Safer Future report by Dame Judith Hackitt. The Act and its 53 recommendations drive cultural change and safety improvements within the built environment, and were the first step in ground-breaking reforms to make homes and buildings in England and Wales safer. Much of the communication and narrative around the BSA 2022 focusses on the residential sector, with the healthcare sector seeing much less focus and attention. However, the need to achieve compliance within a healthcare facility is just as important, particularly when considering their vast size and scale, and the many vulnerabilities of those occupying hospitals and care homes, making building design and fire safety crucial. In my role working with several healthcare organisations, I have found a concerning number of duty holders in the sector misunderstanding the Act’s applicability to their projects and being caught out in not realising that hospitals and care homes that meet the height/ number of storey definition criteria are classed as higher-risk buildings. This is because the BSA’s relevance and application differs from that applied to residential buildings, depending on status of the building i.e. under construction or in occupation. HOW DOES THE BSA 2022 APPLY TO HEALTHCARE BUILDINGS? Due to other legal controls being in place on healthcare facilities such as hospitals and care homes, they are not classified as ‘higher-risk buildings’ once in occupation. However, as of 1 October 2023, the under-construction aspects of the BSA 2022 apply to both new healthcare buildings, and existing hospitals and care homes undergoing changes controlled by the Building Regulations, if they have an occupied floor over 18 metres, or over six storeys above ground (as detailed in the Building Act 1984 and Higher-Risk Buildings (Descriptions and Supplementary Provisions) Regulations 2023). These regulations do not apply to healthcare facilities which do not have at least one overnight bed space, such as GP practices. In the relevant cases, an application must be made to the Building Safety Regulator (BSR), and the necessary gateway requirements met before the work can progress and before the building can be occupied. For these healthcare buildings in the design and planning stage, it’s crucial for the client and principal designer to be aware of their responsibilities. As a still relatively new piece of legislation, many architects, designers, developers and duty holders are still finding it difficult to navigate the many intricacies of the BSA 2022, and its application beyond the well-understood 18m residential building requirements. MEETING THE REQUIREMENTS IN A HEALTHCARE SETTING The first stage of compliance to the BSA 2022 is understanding whether the facility is a Higher-Risk Building (HRB) >>
20 healthcaredm.co.uk BUILDING REGULATIONS or non-Higher Risk Building (non-HRB). Non-HRBs can be approved by either the Local Authority or a Registered Building Control Approver (such as Bureau Veritas Building Control UK) – the choice of which organisation provides the statutory Building Control function is down to the client. Meanwhile, for all HRBs the building control function must be undertaken by the Building Safety Regulator in the design, construction and completion phases. It’s vital to understand that where a new building is being designed and constructed, where a part of a building meets the HRB height requirements, all other parts connected to that building, even those below 18m/seven storeys, are still subject to the Higher Risk Building Regime. This could be other buildings that are connected via an underground car park, partition wall, or corridor or stairwell – if the foundations of those buildings are shared with the HRB, they are classified as a single building and therefore all parts fall under the BSA 2022 application. The choice of the correct route to be followed on existing healthcare facilities is more complex as the definitions and guidance introduce the concept of ‘independent sections’. An independent section is one that can be considered as sufficiently distinct and meets the criteria of an ‘independent section’. Where a part of the building can be treated as an independent section, any work planned is not required to be subject to the Higher Risk Building regime. NAVIGATING THE GATEWAY PROCESS Gateway 1 requires developers to submit a ‘fire statement’ within the proposed planning application to the local planning authority – setting out fire safety considerations specific to the work set to be undertaken. This may sound simple, but get it wrong and it could end up with delays at the planning stage. To progress further, the local planning authority must consult with the HSE to provide specialist fire safety input before they grant permission. It is therefore imperative that a principal designer considers all fire safety matters, which may require expert input. Gateway 2 signals a ‘stop/go’ point requiring approval from the BSR before relevant building work commences. A series of plans, proposals and specified documents are all needed to meet the approval of the regulator, who must be satisfied that not only the design meets the requirements of the Building Regulations but that the project team has the required competency to undertake the project. If the submitted application is deemed satisfactory, you will be issued with a ‘go’ notice, allowing you to commence the building work and progress to completion and Gateway 3. Gateway 3 takes place when the works have been completed. This is also a stop/ go point. If requirements of this Gateway are not met, the BSR will not provide final certification, resulting in the need to retrospectively correct non-compliant or defective work, or provide additional information to demonstrate compliance. Only when the BSR is satisfied that the new works meet all the requirements will ‘In my role working with several healthcare organisations, I have found a concerning number of duty holders in the sector misunderstanding the Act’s applicability to their projects’ they be signed off as compliant and a Completion Certificate issued. SUPPORT TO ACHIEVE COMPLIANCE TO BSA 2022 There’s no doubt that the Building Safety Act will revolutionise building safety, mitigating safety risks in the UK’s built environment stock and all future new buildings. However, it’s also clear that the Building Safety Act and the associated secondary legislation presents new challenges. Navigating the BSA and gateway process can be complex. At Bureau Veritas we’re finding more and more healthcare trusts approaching us to support their principal designers, contractors and project managers in achieving compliance with these regulations. Receiving expert help and support from a specialist, like Bureau Veritas, at the design stage of building works, ensures a smooth process and mitigates potential delays, which is even more crucial in healthcare buildings that often must continue to operate whilst work is ongoing. Supporting architects and designers in understanding the detail of the Building Safety Act 2022 and Gateway process, Bureau Veritas provides independent assurance to mitigate construction risk and demonstrate compliance through construction consultancy services. ■ www.bureauveritas.com Follow us on LinkedIn and X (@bureauveritas)
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22 healthcaredm.co.uk NEWS October opening for NHS ‘super-hospital’ The Midland Metropolitan University Hospital in Smethwick, a cutting-edge £750 million facility, is scheduled to open on October 6th of this year. We spoke with Laura CarraraCagni, founding director of Cagni Williams, and Pallavi Gupta, the project architect, to discuss the journey behind its development The Midland Metropolitan University Hospital is bringing together various services from Sandwell and West Birmingham NHS Trust into a single, ground-breaking facility. This expansive hospital will boast Europe’s largest A&E department with comprehensive acute medical services, 675 beds (plus expansion) and 13 operating theatres, as well as maternity and paediatric services. The facility contains 85,000sqm of clinical space sitting above 50,000sqm of covered car-parking and will include public open spaces and an art gallery situated in an elevated winter garden for patient wellbeing and the local community. The project began in 2015 with Cagni Williams as Architectural Design Lead (collaborating with HKS as Architectural Project Lead and Sonneman Toon as Architectural Clinical Lead) on a 17-acre site formerly occupied by abandoned industrial buildings, adjacent residential areas, and a disused canal arm located on the outskirts of Birmingham in Smethwick. Cagni Williams faced the challenge of creating a masterplan that would not only provide all the hospital functionality but also revitalise the area by turning a disused industrial site into an open and legible development. ‘The design principles really came from us,’ says Laura Carrara-Cagni along with Edward Williams, both founding directors. ‘We Laura Carrara-Cagni Pallavi Gupta engaged extensively with the community and internal stakeholders. We also had strong ideas about the kind of hospital we felt was appropriate, and were influenced by our previous work with Hopkins Architects who designed the Evelina Children’s Hospital and the Macmillan Cancer Centre. These hospitals both prioritised fresh air and daylight for patient wellbeing, moving away from the traditional, intimidating hospital environment – and they were incredibly successful. ‘To some extent, that’s why we say Midland Metropolitan University is more than just a hospital. I believe hospitals shouldn’t be fortresses; we should use the investment to regenerate the PROJECT
healthcaredm.co.uk 23 PROJECT ‘I believe hospitals shouldn’t be fortresses; we should use the investment to regenerate the surrounding area as well, for the benefit of the community’ surrounding area as well, for the benefit of the community.’ Carrara-Cagni adds, ‘It was crucial for us that the building be compact, simple and welcoming, serving the community not just as a hospital but as a positive presence in the area.’ Given the hospital’s location within a well-established adjacent residential area, the architects had to thoughtfully integrate such a large, distinct building into its surroundings. To address this, they used the unusual topography of the site. ‘The seven-meter height difference from south to north allowed us to embed the podium level of the building into the landscape and open up the southern side to pedestrians, creating a permeable site that draws people into the substantial green spaces and allows for future development,’ explains Pallavi Gupta. ‘This approach makes the hospital more inviting and accessible, reduces its visual impact, and fosters public and community engagement. The building’s design features terraces on multiple levels, creating a staggered appearance that blends with the surroundings and incorporates extensive planted roofs.’ On the hospital’s fifth floor, there is a vast 4,000m² area known as the Winter Garden – a transparent, glazed space offering a place for families to meet and socialise, and for non-infectious patients and the public to mingle. This will provide a unique community space, complete with landscaping, cafes, a restaurant and an art gallery. The Midland Metropolitan University Hospital is opening its doors on the October 6th, happening around the month of Diwali celebrations. ‘It will be a fantastic experience for all of us to watch the fireworks from high up on the terraces or in the Winter Garden,’ says Gupta. ■ www.cagniwilliams.com See next issue for full details on the completed hospital.
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healthcaredm.co.uk 25 COMMENT Updating the NHS Maintenance Estate Standard Amit Vadgama, principal building surveyor at Pick Everard, discusses the everyday NHS maintenance that is contributing positively to our communities, amid infrastructure spending concerns and hospital building delays Outdated, dilapidated and in need of investment – these were the challenges lobbied at the Conservative Government when it launched its Health Infrastructure Plan in October 2020. Since then, and through the weight of the pandemic, the construction industry has been tasked with tackling a rising NHS maintenance backlog, which currently stands at £11.6bn. Following a change of government, adding further to sector concerns is the recent announcement from Chancellor Rachel Reeves, which has placed the build of 40 new hospitals on pause, subject to government review. With 2,000 buildings on the NHS estate older than the NHS itself, and reinforced autoclaved aerated concrete (RAAC) still top of infrastructure concerns, tensions are heightened for patients and staff. While hospitals require urgent attention to carry out emergency work, there is also a clear mandate for the construction industry to attend to the vital maintenance services within local health centres and facilities. These are an important part of the required infrastructure overhaul and will arguably play a more central role to addressing the nation’s health while the £40bn hospital programme is placed on pause. Part of healthcare remits is to keep hubs of community health operational, particularly during times of urgent care. The pandemic only shone further light on how integral our medical professionals and healthcare centres are to this mission, often opening or working for extended hours, or adapted in times of need. As well as balancing this extra requirement of services with its everyday care, increased pressure and dependence was placed on components such as boilers, which are indispensable to the effective running of the facilities, while insulation and lighting maintenance were also key for extended operations. These systems continue to be the focus of work in the bid to help transform the >>
26 healthcaredm.co.uk COMMENT We must continue to engage with local authorities on their healthcare requirements, driven by an ambition to collaborate on maintenance improvements that ultimately drive value at the heart of our communities, and build a safe and healthy future for all. ■ www.pickeverard.co.uk NHS estate, while larger infrastructure changes are placed on pause. FUNDING SHORTFALL Historically, the biggest obstacle facing local authorities in the past has been cost. The latest Labour announcement will have no doubt raised further eyebrows in this area, but with a rising backlog, there is clearly an ever-present need to implement lasting changes where possible. Often, facilities require not just big component changes, such as boiler replacement, but also everyday improvements that make a huge difference to modern healthcare standards. Contractors must be aware of how they can make these improvements, but also undertake them in live environments, operating with a degree of flexibility and detailed pre-planning to ensure they maintain sterile conditions. Gutter cleaning, fire alarm replacement and window repairs are elements that often go unnoticed in this area but play a huge role in ensuring healthcare facilities remain operational. Changes are also being driven by sustainability remits, with elements like LED lighting helping to not only brighten environments and cut carbon, but also reduce overhead costs in times of need. SETTING REGIONAL STANDARDS Improvements also have an influential nature across local authorities. Switching to more efficient lighting and heating is not just positive PR, it creates a benchmark for other councils to follow suit. Cross collaboration or influence in this manner is only a constructive step on the pathway to a brighter future. We must also ensure no gaps are felt within communities, which can often feel aggrieved when funding is prioritised unevenly between districts, or in new areas of healthcare over existing, valued infrastructure. A COMMUNITY-FIRST APPROACH New facilities within the healthcare sector often attract the headlines, simply due their inherent ability to start from scratch and build with forward-thinking technology front and centre of design approaches. For example, many new healthcare facilities are incorporating green heating solutions, such as heat pumps, while no-touch technology has seen massive expansion from the lessons of the pandemic. However, with this now placed on pause, it is vital within the healthcare conversation that we do not forget about our local practices, and the hardworking professionals and patients they support. Incremental improvements add up to a greater sum of their parts, and by taking the time to fix leaking gutters or inefficient lighting, the sector is making small gains in the wider quest to overhaul ‘While hospitals require urgent attention to carry out emergency work, there is also a clear mandate for the construction industry to attend to the vital maintenance services within local health centres and facilities’ the NHS Estates catalogue. Importantly, the work acts as a cost-efficient stopgap while spending budgets are reviewed at a national level.
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