SEPTEMBER 2023 | £8 Carbon reduction EV charging points support energy efficiency Furniture Colour and material choice key to supportive environments Catering How hospital food services can support carbon reduction efforts Inside this issue: Work begins on Portsmouth hospital revamp
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Editor’s Letter APRIL 2023 Letter header goes here Letter header goes here After years of lobbying by mental health providers and charities, the Government has finally unveiled plans to inject more than £150m into mental health services, including improvements to the buildings from which care is delivered and creating new facilities across the country. The investment, up to April 2025, includes £143m of capital funding for 150 projects. It will be invested in providing and improving a range of spaces, including new mental health urgent assessment and care centres and the redesign and refurbishment of existing mental health suites and facilities including in emergency departments, creating spaces outside of A&E, and the expansion of crisis lines. Programmes will also focus on preventative measures, including improvement of sanctuary spaces and community mental health facilities. This focus on improving the estate offers a range of opportunities for contractors, architects and product manufacturers working within the sector. In this edition of mhdf you can read about some of the latest capital projects, including a new inpatient facility in Liverpool and a crisis café in Ealing (p5). Features include a focus on dementia-friendly lighting solutions (p8) and the impact of sensory rooms on people with mental health conditions (p13). In the next edition of mhdf we will focus on interior design and outdoor spaces. If you can help contact [email protected] Editor Jo Makosinski Sales director Julian Walter Production Nicola Cann Design Mary McCarthy Managing Director Toby Filby In this issue: 5 PROJECTS The latest mental health and dementia projects 15 DESIGN Exploring the benefit of sensory rooms in mental health settings 16 LIGHTING How smart lighting solutions are helping to support people living with dementia Cover image: Description and credit Best Wishes Jo Makosinski EDITOR [email protected] healthcaredm.co.uk 3 Editor’s Letter SEPTEMBER 2023 The journey to net zero The NHS has set itself a target of becoming the world’s first net-zero health service, with a deadline of 2040 for emissions it directly controls and 2045 for those it has influence over, for example within its supply chain. However, there have been suggestions there is still much to be done to keep on track with this ambitious timeline. The Climate Change Committee recently said of the Government’s Carbon Budget Delivery Plan (CBDP): “Policy development continues to be too slow and our assessment of the CBDP has raised new concerns. “Despite new detail from Government, our confidence in the UK meeting its medium-term targets has decreased in the past year. “The increased transparency embodied in the CBDP is welcome, but a key opportunity to raise the overall pace of delivery has been missed.” Among NHS trusts, attention appears to be shifting from small-scale interventions such as LED lighting upgrades and insulation improvements to more-energy-intensive technologies such as heating systems and energy centres. But funding for these improvements continues to be a major stumbling block for healthcare providers. In this edition of hdm, we look at some of these challenges, in particular the role EV charging stations and electric vehicles will have on reducing emissions and tackling climate change (p18) within NHS trusts. We also showcase work being carried out at Bridlington Hospital to make it one of the most-sustainable medical facilities in the country (p21). And, with catering services playing a key role in emissions generation, we also take a look at the measures being taken to reduce the impact on trusts’ overall carbon footprints (p31). In other areas, in our furniture section (p25), we look at how colour and material choice are increasingly being used to enhance the patient environment; and how infection control requirements are impacting on the design of healthcare facilities (p8). In the next edition of hdm, we will be focusing on infection control, utilities, and lighting. If you can help with these features, email [email protected] Editor Jo Makosinski Sales director Julian Walter Production Nicola Cann Design Mary McCarthy Managing Director Toby Filby Jo Makosinski EDITOR [email protected] Queen Alexandra Hospital main entrance redevelopment. Image, Stepnell 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. Publishers Stable Publishing Limited, SBC House, Restmor Way, Wallington, Surrey SM6 7AH, England. t. 020 8288 1080 f. 020 8288 1099 e. [email protected]
In this issue.... SEPTEMBER 6 NEWS Health Minister, Lord Markham, visits New Hospital Programme schemes across the North West to mark progress as part of commitment to building 40 new hospitals by 2030 8 DESIGN Looking at how infection prevention and control measures can be enhanced by improvements to the way healthcare facilities are designed 11 PROJECTS The latest health sector construction projects, including work on a new critical care unit at Barnsley Hospital, completion of a sustainable new medical centre in Rochdale, and the revamp of the main entrance at Queen Alexandra Hospital in Portsmouth
18 CARBON REDUCTION We look at how the NHS needs to up its game by introducing more electric vehicle charging points in order to drive carbon efficiencies, plus Bridlington Hospital on track to become one of the most-sustainable healthcare facilities in the UK 25 FURNITURE Exploring how healthcare furniture manufacturers are increasingly using colour to create more- therapeutic environments for staff and patients 31 CATERING How improvements are being made to NHS catering services as part of carbon net zero efforts
investment that will give us the opportunity to transform how health and care is delivered in Lancashire and South Cumbria. “This is our chance to shape our services to meet the needs of our patients, staff, and local communities, to enhance their experiences, and, of course, to create hospital facilities that our present and future generations deserve.” Lord Markham also visited the new North Manchester Hospital site, which will include a new acute hospital, mental health facility, and a multi-storey car park, as well as affordable homes and accommodation for hospital staff. He said: “We are investing in new NHS facilities across the country so patients can access high-quality care in state-of-the-art hospitals, both now and in the years to come. Health minister goes on the road Health Minister, Lord Markham, has visited three hospitals across the North West as part of a summer tour to discuss the Government’s plans to build 40 new hospitals by 2030. During his visit he saw firsthand how the new Leighton Hospital will implement clinical, digital, and environmental innovations to enable the trust to tackle inequalities and meet the needs of a growing and ageing population. Patients and staff will benefit from safe, state-of-the-art new facilities and improved care as Leighton Hospital is part of the Government’s commitment to rebuild six hospitals in the region. Patients and staff at Royal Preston Hospital will also benefit from modern hospital designs, making use of the latest technology, digital innovation, and sustainability to improve the overall patient experience and provide a better working environment for staff. The Government has provided over £11m in funding to support the trusts in the progress of both hospitals to help find suitable locations that will meet the needs of staff and patients in Lancashire and South Cumbria. Jerry Hawker, director of transformation for NHS Lancashire and South Cumbria Integrated Care Board and senior responsible officer for Lancashire and South Cumbria New Hospitals Programme, said: “We were delighted to welcome Lord Markham to Lancashire and South Cumbria for the national New Hospital Programme roadshow. “We look forward to continuing to work closely with the national New Hospital Programme team and the Department for Health and Social Care, as well as our local NHS, council, and wider partners to deliver our plans to offer the absolute best in modern healthcare and address significant problems with the current ageing hospital buildings.” Kevin Lavery, chief executive of NHS Lancashire and South Cumbria Integrated Care Board, added: “The New Hospitals Programme is about more than just buildings – it is a once-in-a-generation “The North West will benefit from six new hospitals and I’ve been visiting some of the sites and speaking to patients, staff, and local leaders across the region about the plans and progress. “These will help to improve care and allow patients to be seen more quickly, which will help to cut waiting lists – one of the Government’s top five priorities.” Underpinning the delivery of these projects, he added, are the Government’s new standardised designs, which mean hospitals can be rapidly replicated across the country. 6 healthcaredm.co.uk NEWS Lord Markham is visiting hospitals around the country as part of the New Hospital Programme roadshow He spoke to staff and patients about the plans
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Shraddha Badoni, Senior project co-ordinator and architectural technologist Pick Everard 8 healthcaredm.co.uk DESIGN Shraddha Badoni, senior project co-ordinator and architectural technologist at Pick Everard, explores the techniques to improve infection control through better design of healthcare facilities – focusing on key elements including ventilation and patient flow. Since the pandemic, it would be impossible to deny the existence of a new approach to infection control. The NHS estate was challenged to the ultimate test, leaving the lessons learnt and newfound priorities to continue influencing decision-makers today and into the future. Some of those decision makers include construction leads, architects, health and safety designers, and mechanical and electrical engineering specialists. And the physical design of a hospital continues to evolve in response to the demands of the medical world. This is being seen in both new hospitals that are exceeding current healthcare Materials used in healthcare facilities must comply with the appropriate hygiene performance rating and include easy-to-clean surfaces Improving infection control through better design standards, and older hospitals that are being retrofitted, refurbished, or renovated. However, while some of the design choices are clear to the naked eye, and can be easily retrospectively added, there are others that are less obvious and require careful consideration. But they all play a role in minimising the risk of infection transmission and maintaining more-efficient healthcare estates. PATIENT FLOW Understanding the way people interact with their environment is a critical design consideration in each and every project and impacts spatial planning to a huge extent. In the health sector, each building, its patients, its visitors, and its staff, have a tailored journey from entry to exit and spatial standards can be improved through creative modelling. Our work with hospitals could not be complete without thorough consultation and engagement sessions, which help us understand exactly how different facilities are used and the architectural limitations to consider. Ways to control patient flow, with infection control in mind, include limiting the number of entrances and providing adequate social distancing space in waiting areas, corridors, hallways, and stairways.
healthcaredm.co.uk 9 DESIGN The ultimate goal is to maintain a predictable flow in order to make other design decisions, such as the location of hand sanitisers and associated facilities, more effective. VENTILATION Enhanced ventilation, whether natural or mechanical, can effectively decrease cross infection risk of airborne pathogens. Variance in air pressure and distribution is critical and it is essential to consult ventilation engineers early in the design process to determine the air flow pattern required, without causing discomfort to occupants or affecting the function of the department the system is serving. For example, an infectious disease isolation room requires an air pressure of minus five pascals, whereas a critical care area requires an air pressure of 10 pascals, so ventilation designs must always be co-ordinated with the designs of other disciplines, notably architects and structural engineers. For positive air pressure regimes, advising the architect of maximum air leakage rates from an operating theatre will inform their design of wall linings, lobby locations, pressure stabilisers, and air transfer passages. Advising a structural engineer early of plant loadings and locations will also inform their design, and this is especially important on refurbishments where the location of proposed plant may have constraints due to the existing strength and structure of the building. Ventilation designs are rigorously reviewed by teams of experts prior to issue and construction. Then, at the construction stage, the installation and system performances are validated with numerous tests and exercises to demonstrate the design intent has been achieved. Once in operation, the ventilation considerations do not stop, though, and it is important to monitor the resilience of systems so any faults with equipment can be prevented. SHAPES AND SIZES All spaces and rooms in a healthcare facility must be carefully considered to minimise the chance of infection spreading. Minimal inside corners, with rounded solid surfaces, ensure cleaning can be completed more thoroughly. And horizontal surfaces, such as ledges and shelves, are being reduced as part of new design best practice to help prevent the build-up of bacteria. MATERIALS Materials used in healthcare facilities must comply with the appropriate hygiene performance rating and include easy-toclean surfaces. This covers everything found inside a space, from handrails to furniture, and is reinforced by technical standards and guidance found in the NHS’s Health Building Notes. Antimicrobial materials are ideal for healthcare environments as they prevent micro-organisms from growing on surfaces. There is value in material flexibility, too, so look at removable privacy curtains, for example, as these can be replaced more easily and cleaned offsite if required. Though some materials are better than others, the key is to ensure that spaces are managed through a thorough long-term cleaning strategy. TACTILE FEATURES Possibly the biggest change since the pandemic is the reduction in the need for physical touchpoints, a benefit for both patients and hospital staff. No-touch technology, like motion sensors, are delivering significant improvements in risk reduction, while building patient and staff confidence, through touchless doors, lights, taps, and hand dryers. Conversely, high-touch surfaces like enclosed cabinetry are being dispensed in favour of no-touch alternatives. Staff hand-held devices create concerns about cross contamination and are being increasingly kept away from patient surfaces, such as overbed tables. And we are seeing designated ‘staff-only’ stations, provided in accessible locations, to store equipment safely and make obvious to cleaners which surfaces run greater risk of containment accumulation. HAND HYGIENE Regular handwashing is recognised as a key practise to control infection and reduce contamination. Where possible, individual handwashing stations are being provided in patient rooms, general wards, and all clinical rooms. To make this effort common behaviour, extra attention is directed to distinct visual cues that enhance desired behaviours. The stations should then be designed to accommodate recommended handwashing procedures, including features such as long-arm taps that enable elbows to be used to operate water flow. Handwash sinks are also being positioned away from staff work zones to prevent splash and cross-contamination, while examination gloves, alcohol-based sanitisers, and bins are placed in easily-accessible positions when entering and exiting patient rooms. CHALLENGING THE NORM As humans, we continue to evolve, and our healthcare facilities must continue to meet our needs. While some modern innovations and ways of thinking are born out of unexpected events, like the pandemic, we must all continue to invest time and resource into healthcare betterment, trialling different healthcare designs that have the potential to improve the experience of patients and staff alike. www.pickeverard.co.uk
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healthcaredm.co.uk 11 PROJECTS Ambulance hub reduces the pressure The ambulance hub is designed to be fully net zero carbon in operation Following the recent opening of a new ambulance hub in the West Midlands, Assura has started work on a second facility in Bury St Edmunds. The £11m, 2,900sq m unit, which will take 14 months to build, will provide East of England Ambulance Service NHS Trust with a crucial central reporting hub. It will also house training facilities and space for over 30 ambulances, with onsite vehicle maintenance and preparation services. Following the launch of the Assura Net Zero Carbon Design Guide, the building has been designed to be fully net zero in operation, combining an array of smart technologies to meet the site’s expected energy demand. The hub will have over 1,000sq m of photovoltaic (PV) panels, with all expected energy demand being met through the renewable energy generated on site. These measures will radically reduce the carbon emissions and footprint of the facility, with the scheme designed to achieve BREEAM sustainability rating of ‘Excellent’ and an EPC rating of A+. The hub is the second to be delivered by Assura for the NHS, following the opening of a centre in the West Midlands. Jonathan Murphy, chief executive of Assura, said: “This fantastic project in Bury St Edmunds will help East of England Ambulance Service NHS Trust to deliver an efficient and essential service to the local population and forms part of our continued purpose to develop quality facilities that improve health services in a community setting, while reducing pressure on hospitals and the NHS.” Tom Abell, chief executive of East of England Ambulance Service NHS Trust, added: “Staff will move from outdated stations to benefit from modern, fit-for-purpose facilities – including a gym and wellbeing centre. “The development of the central reporting hub will also allow rapid and efficient preparation and deployment of our frontline teams to provide consistent, high-quality care to our patients. “Sustainability is vital to our organisation and I am very pleased that the hub will be the first of its kind in England to be net zero.” www.assuraplc.com Facelift for A&E unit Willmott Dixon Interiors has begun work on the first phase of a project to expand and refurbish A&E facilities at the Royal Sussex County Hospital in Brighton. The contractor has commenced demolition works at the hospital’s Millennium Wing. The 18-week project will pave the way for the phased delivery of an acute floor expansion, which will provide modern healthcare facilities and significantly increase capacity to support critical patients in A&E. www.willmottdixoninteriors.co.uk
healthcaredm.co.uk 13 PROJECTS The new facility will help to address the surgical backlog Modern Methods of Construction have enabled faster and more-efficient completion of a new general surgery operating theatre at Yeovil District Hospital. The single-storey unit includes a theatre suite with recovery rooms, reception and waiting areas, office space, and a dedicated staff facility. Delivered by MTX Contracts, offsite-fabricated steel sections of the external shell were craned into position on the prepared site of a former car park at the hospital before concrete screed floors and premanufactured walls were installed. Once the structure was complete, the MTX team began installation of mechanical, electrical, and plumbing elements, and fitting out including furniture and specialised equipment. A plant equipment enclosure located on top of the building accommodates air handling units and electrical supply panels to serve the self-contained 420sw m building. Modern Methods of Construction (MMC) are increasingly being chosen by NHS trusts because they meet Government requirements for adopting offsite construction techniques. They also provide additional facilities more quickly, with time on site reduced by up to 50%, reduced costs, and a greener build, with offsite construction reducing waste by up to 60%. The new theatre will principally be used to help to reduce waiting times for patients needing day surgery procedures including breast surgery, dermatology, plastic surgery, and other general surgery. Caroline Osborne, a consultant breast surgeon at Somerset NHS Foundation Trust, which runs Yeovil District Hospital, said: “We are MMC delivers new operating theatres so pleased to have opened our new day theatre, which means our team of surgeons can perform many more operations at Yeovil. “With the theatre located away from the main hospital building, it has freed up space in our main hospital theatres for the more-complex procedures, helping us to reduce the waiting times for patients across Somerset who need operations.” She added: “There has been a real change in the way we perform many operations in Somerset, with some specialties able to offer day surgery, where patients can be assessed, treated, and go home on the same day, rather than staying overnight in hospital. “We have had great feedback from patients on this approach.” MTX worked on the project with Simply Serve, a wholly-owned subsidiary of Somerset NHS Foundation Trust, which provides a broad range of services to the hospital and other organisations, including management of capital projects. MTX managing director, David Hartley, said: “Proven expertise in employing MMC enables us to quickly deliver high-quality new hospital facilities cost effectively. “The operating theatres and other facilities we create for NHS trusts are specifically engineered for medical use, with ventilation systems designed to optimise clean air flow and meet modern clinical needs. “And offsite construction takes place while the site is being prepared, enabling the two activities to be carried our concurrently.” www.mtx.co.uk www.simplyserveltd.co.uk
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healthcaredm.co.uk 15 PROJECTS The new main entrance will include an M&S Food store and a StockShop clothing outlet A new main entrance is being built at the Queen Alexandra Hospital in Portsmouth. As part of a wider redevelopment of the hospital site, contractor, Stepnell, has recently begun work on the entrance revamp and extension. The project will create a new accessible toilet and Changing Spaces facility, a lecture theatre, and a new M&S Food store and clothing store. Rob Speirs, director at Stepnell, said: “Taking advantage of our wealth of experience and expertise in healthcare projects, we are helping Portsmouth Hospitals University NHS Trust to create a functional and appealing main entrance to the Queen Alexandra hospital that meets the needs of hospital staff, patients, and members of the public.” To accommodate the works taking place on the live hospital site, Stepnell has created a temporary side entrance and erected hoardings around the area of construction, closing the main door at the existing entrance. Mark Orchard, chief finance officer at the trust, said: “This is a fantastic new development which will help improve the experience of those visiting our hospital site. “It is another step in a number of significant improvements to the QA site, including improved green spaces. “These plans will help us continue to deliver high-quality services in efficient, well-maintained, and well-designed buildings.” Stepnell and the trust will be delivering the main entrance project alongside Noviniti, a developer with experience delivering on the QA Hospital site, having built the North car park in 2022. The work is expected to take a year to complete. www.stepnell.co.uk www.noviniti.co.uk Making an entrance The project is part of the wider redevelopment of the hospital site The work is due to be completed next year
16 healthcaredm.co.uk PROJECTS A fabric-first approach has helped to increase the energy efficiency of a recently-completed new medical centre in Rochdale. Caddick Construction has handed over Milnrow & Newhey Medical Centre, which is operator United Healthcare Development’s most-sustainable healthcare facility to date. Earning a BREEAM ‘Outstanding’ sustainability rating, the new facility has an integrated ventilation system and will be net zero in operation. Spanning a floorprint of over 4,470sq m, the three-storey building has rooms for consultation, examination, treatment, and meetings. And the work also included development of a secure car park for staff, patients, and visitors; a paved area; and new lighting and landscaping to create a high-quality outside space. Paul Dodsworth, construction group managing director at Caddick, said: “Ensuring that sustainability is implemented throughout our operations, from design and build right through to the supply chain, is really important to us, which is why we’re aiming to become a net-zero business by 2040 and are committed to embedding environmental sustainability specification into all of the projects we work on. “The Milnrow & Newhey Medical centre brings a fantastic facility for the community and it is with testament to our expert team and the vision from United Healthcare Developments that we were able to bring this build to the community with a BREEAM ‘Outstanding’ rating.” www.caddickconstruction.co.uk www.uhdl.co.uk Sustainable health centre set to open Work has been completed on a new £7.3m critical care unit (CCU) at Barnsley Hospital. Contractor, I&G, has finished building work on the facility, which is located in a former courtyard surrounded by active hospital buildings. The challenging construction project involved the demolition of an existing facility and the creation of a new CCU, increasing the number of beds from seven to 16. And the work was accompanied by a host of logistical challenges, with three internal levels being constructed simultaneously. All construction materials, equipment, and miles of cabling had to be brought in through a 2m x 2m doorway – an achievement compared by workers to being like building a hospital ward through the back of an ambulance. As well as difficulties around getting materials onto site, the build was also taking place in a live hospital environment, with access to operating rooms and the emergency birthing route needing to be maintained around the clock. Despite all these issues, the build was completed on budget, with no accidents, and with no loss of service. As well as doubling the number of seriously-ill patients who can be cared for in the department, the new facility also has more space, with extra privacy for patients, better lighting, and more space for physiotherapists to conduct bedside consultations. And it is nearer the surgical high dependency unit, so patient transfers are easier, with an additional area for patients’ families to stay overnight also created. The facility is also pandemic-ready, with eight extra escalation bays which can be brought into service overnight if needed. www.iandgltd.co.uk CHALLENGING PROJECT REACHES COMPLETION
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18 healthcaredm.co.uk CARBON REDUCTION Taking charge We look at how the NHS needs to up its game by introducing more electric vehicle charging points in order to drive carbon efficiencies ...the infrastructure needs to be in place to support hospital staff and visitor needs In just seven years’ time the Government will impose a ban on the sale of new petrol and diesel vehicles in favour of a fully-electric road transport system. But, in order to meet this deadline, and achieve the associated carbon reduction targets, a complex network of electric vehicle (EV) charging stations will be needed. In 2022, EV specialist, Connected Kerb, published a flagship report – How to meet the UK’s EV charging needs by 2030 – which called on the Government to lead the charge towards public sector electrification by installing convenient, affordable, and reliable charging infrastructure across one of the UK’s most-prized assets – the NHS. It states: “The NHS is an obvious place for an ambitious EV infrastructure project. “It has over one million employees, a large fleet of vehicles, and operates nearly half a million parking spaces where chargers could be installed. “A deployment of this scale would be the largest in the world and provide a blueprint for other projects.” THE CLOCK IS TICKING Asif Ghafoor, chief executive and co-founder of charging infrastructure provider, Be.EV, adds: “The 2030 ban on new petrol and diesel vehicles is looming and the infrastructure needs to be in place to support hospital staff and visitor needs. “From first conversation to working chargers can take two years and the clock is ticking – but burying their heads in the sand is not an option.” Currently, NHS England alone operates around 436,900 parking spaces across its hospital sites, but recent figures suggest that only 60% of sites have at least one EV charging point available, while 24% of trusts say they have insufficient electrical capacity for the number of units they forecast they need. The Connected Kerb report states: “The potential to make the NHS the standard bearer of public sector electrification is huge and the starting gun has already been fired. “However, like with many public sector projects, aside from funding, the only limiting factor is ambition.” MEETING THE CHALLENGE And it calls for a target deployment of EV chargers in 25% of all NHS staff bays, with 50,000 made available within five years. But there are hurdles to overcome to realise this ambition. Firstly, trusts need to find the space to install charging units. Then they need to ensure they have the electrical infrastructure available without disrupting the mains supply. And they need to find the funding to support investment. The report sets out three main funding routes for the NHS: • Privately funded: A deployment funded by infrastructure investors who recover costs by charging drivers • Lease: The NHS pays an annual cost for the charging infrastructure and operating costs to the lease provider. They then choose the tariff to be applied • Government funded: Government funding covers capital investment with the option for full or partial cost recovery from user charging Ghafoor said: “Charging infrastructure can be provided for free, including power upgrades. “They are also a revenue opportunity that hospitals can benefit from, with chargers paying for themselves over the course of their service life. Illustration: Tippawan Sookruay from Noun Project Asif Ghafoor Chief executive, Be.EV
healthcaredm.co.uk 19 CARBON REDUCTION “Many suppliers will offer a revenue share, which incentivises them to ensure chargers are always in good working condition, and this provides steady income for hospital estates.” To help NHS trusts overcome some of these barriers, companies like Connected Kerb are offering turnkey solutions covering everything from choosing the right technology and site selection, to maintenance and funding applications. Earlier this year, as part of its Green Plan, Central London Community Healthcare NHS Trust installed EV charging stations across a number of its sites in London and Hertfordshire, which will be managed by EB Charging under a three-year contract. And NHS Forth Valley Health Board has rolled out 16 chargers in patients and visitor car parks at Forth Valley Royal Hospital, bringing the total number of points across its estate to 36. The publicly-available EV points are part of the Charge Place Scotland network, managed by SWARCO on behalf of the Scottish Government, and operating on a metered pay-per-use basis. EDUCATION, EDUCATION, EDUCATION But, to move forward, Ghafoor said NHS sutainability leads need to be educated on the benefits and challenges associated with EV charging provision. He told hdm: “There’s a surprising lack of education and trusts are paralysed by the number of options available to them. “With a range of patients and varying staff shifts, a mixed charging solution is the best approach. “Fast (all day dwell), rapid, and ultra-rapid chargers (10 minutes charge) will all serve a different purpose, allowing every type of visitor to charge their car effectively. “Staff can plug their car into a fast charger to charge throughout their shifts, for example, while rapid chargers are perfect for patients coming in for an X-ray or routine check-up. “But hospitals don’t need to rush to install all their charging infrastructure at once. “We suggest a phased rollout as trying to install too many chargers at once can see hospitals hitting power constraints, and empty charging spaces will frustrate non-EV drivers. “ And, once installed, the chargers need to continue to work 24/7, 365 days a year, with clear maintenance plans. Ghafoor concludes: “There’s a lot of ‘wait and see’ from hospitals. They’re holding out to see how the EV market plays out, but the influx of EVs is inevitable. “It’s only a matter of time until staff and patients start asking about charging facilities, and hospitals need to start moving quicker to make sure they don’t miss the EV opportunity.” www.connectedkerb.com www.be-ev.co.uk www.swarco.com www.blinkcharging.co.uk It is believed that only 60% of NHS sites have at least one EV charging point Central London Community Healthcare NHS Trust has installed charging stations across a number of its sites Be.EV is urging NHS trusts to opt for a mixed charging solution to meet the needs of all users
SOLUTION Key Entrances For the Main Entrance, Ambulance Entrance and the Entrances between the Rapid Assessment & Treatment and Resuscitation departments we installed five Doorson Automatic Telescopic Door Sets. Treatment Rooms We installed a Manusa Hermetic Door for its airtightness, hygiene, space-saving, and ease of access. This automatic sliding door offers various operational modes to suit specific needs and can be specifically design-adapted to best suit each space. Consulting Bays We designed and installed 14 sets of our own, award-winning Flo-Motion® Telescopic Manual Sliding Doors. The two sliding leaves of each set are connected by a sequencing device ensuring the primary leaf (fast door) reaches the fully opened or closed position at the same time as the secondary leaf (slow door) reaches its pre-set position. OUTCOME • More efficient & effective working • A lighter, more spacious department • Improved patient experience • Improved work environment for staff CASE STUDY CLIENT: Walsall Healthcare NHS Trust PROJECT: New £40m Urgent & Emergency Care Centre at Walsall Manor Hospital CONTRACTOR: Tilbury Douglas Construction ARCHITECT: BDP OUR BRIEF: To provide & install doors for Key Entrances, Treatment Rooms & Consulting Bays Photo credit: BDP Axis understands and delivers to the high standards expected and needed in a healthcare environment Leigh-Anne Schofield - BDP
healthcaredm.co.uk 21 CARBON REDUCTION Hospital on the path to net zero Work is continuing to make Bridlington Hospital one of the most-sustainable healthcare facilities in the UK. Vital Energi is working with York and Scarborough Teaching Hospitals NHS Foundation Trust on a multi-technology energy project which has seen air source heat pumps and solar PV systems installed to significantly reduce carbon emissions at the site. The energy efficiency of the hospital will be improved further through the installation of energy conservation measures, including thermal insulation, and modifying air handling units. The project also includes the optimisation of the heating and hot water systems across the estate, which will both reduce energy usage and improve the performance of the new heat pumps. Currently, the hospital’s heating and hot water is generated by 20-year-old gas-fired boilers and a gas-fired CHP system. The improvements will see the CHP being decommissioned and one of the boilers removed to make way for the installation of a 600kW air source heat pump system capable of supplying 100% of the heating and hot water demand. When coupled with the new 750kWp solar PV system, the heat pumps will provide zero carbon heat generation at the hospital. And the solar PV system, which combines over 1,600 panels both ground and roof mounted, will be capable of supplying 100% of the electricity demand of the heat pumps, meaning at times 100% of the heat demand of the hospital will be met via a 100% renewable source. The solar PV will also provide a proportion of the hospital’s electricity requirements. Through these measures, the hospital’s energy-related carbon emissions will be reduced by over 50% compared to current operations and, as the national grid continues to decarbonise electricity generation, these savings will increase further. Steve Black, Vital Energi’s account director, said: “We set out to design and deliver a solution which would enable the trust to fully transition from gas-fired heat generation to a more-sustainable system, which we had to do while ensuring the project did not increase the trust’s annual energy and operational costs. “We have achieved this and are delighted that we have given the trust a system which means it is no longer reliant on burning fossil fuel and which is capable of being 100% carbon zero.” The project received a £4.7m grant from the Public Sector Decarbonisation Scheme (PSDS), which is administered by Salix Finance on behalf of the Government’s Department for Energy Security and Net Zero (DESNZ). The fund aims to replace old gas-powered heating and hot water systems with low-carbon systems while reducing the heat requirement through energy efficiency measures such as increased insulation. www.vitalenergi.co.uk www.salixfinance.co.uk A drone image of the Bridlington Hospital site Illustration: Fran Couto from Noun Project A 750Wp solar array will provide electricity for the hospital
22 healthcaredm.co.uk CARBON REDUCTION Laboratories - a good place to start The recent energy crisis has added new urgency to the ongoing drive towards carbon reduction in hospital and healthcare sites. Laboratories and testing facilities are a particular concern, as their energy consumption is often more than three or four times that of offices on a square metre basis. And this can mean that laboratory buildings are responsible for between 50%-80% of the total energy-related carbon emissions of research-intensive teaching hospitals. Improving environmental performance of laboratory spaces is therefore a matter of urgency, but energy efficiency projects in these spaces require careful consideration. It is essential that the health and safety of staff, researchers, and other building occupants is not compromised by inadequate air management. The integrity of testing and research outcomes also relies on the correct environmental conditions being maintained. Effective measures implemented in these high energy consumption spaces, however, can make a major contribution to carbon reduction and cost savings for the site as a whole. TACKLING ENERGY WASTAGE An immediate priority is to identify unnecessary energy consumption when laboratories are unoccupied. It may be possible to set the Building Management System (BMS) to reduce air change rates overnight or at the weekend and local overrides can be used to ensure that, if personnel should be working outside of usual work hours, the air changes can be re-established at times when the BMS has put the building into reduced mode. A review of air change rates across the site as a whole will also identify if the settings of different zones are appropriate for the activities carried out in each space. TAKING CONTROL Another priority is to investigate the operation of fume cupboards, as these are responsible for a significant proportion of laboratory energy consumption due to their higher-than-average demand for conditioned air. A 900mm-wide fume cupboard with a maximum sash height of 500mm and face velocity of 0.5 m/s would extract approximately 225 l/s of conditioned air from the room. And this demand for conditioned air has a significant knock-on effect across the site, driving up the energy consumption of air conditioning system components such as air handling units, chillers, and fans. Firstly, it is vital to ensure that all fume cupboards are capable of variable air volume (VAV) operation, as this reduces extraction automatically when the sash is closed. For the example above, this figure drops from 225 l/s to just 55 l/s when the sash is down, reducing the conditioned air requirement by 170 l/s. Transitioning fume cupboards from constant to variable air volume has significant energy-saving potential. Next, consider minor changes to the day-to-day operation of fume cupboards that could unlock further energy savings. Sashes are often left open when individuals are away from the fume cupboards, resulting in unnecessary consumption of conditioned air. Ian Thomas, product manager for LabControls at TROX UK, reveals how effective measures can reduce laboratory energy costs and carbon emissions while maintaining safety and air quality
healthcaredm.co.uk 23 CARBON REDUCTION A retrofittable passive infrared (PIR) sensor can identify that no one is present at the fume cupboard and, after a set time, a visual or audible alarm is triggered to indicate that the sash have been left up. An auto sash closer can then work in conjunction with the sensor to close the sash automatically, preventing unnecessary extraction of conditioned air. It is also quite common for fume cupboards to have additional control features that are already resident, but not currently configured for operation. Contact the manufacturer, or a lab air management specialist, to investigate whether existing hardware has additional energy- saving features that could be brought into operation. ROOM AIR MANAGEMENT For the most-significant carbon reductions and energy savings, though, install a room air management system. This will provide automatic control of all input and extract air for the laboratory, ensuring the required ventilation strategy and levels of safety are maintained while optimising energy efficiency. If the fume cupboards are open and extracting air, there is not the same requirement for the room system to carry out this process. The TROX EASYLAB system, for example, scales down room exhaust air extraction automatically in line with fume cupboard extraction. This prevents energy wastage associated with over supply of conditioned air and improves environmental performance significantly (see Figures 1 and 2). www.troxuk.co.uk Fume cupboards are responsible for a significant proportion of energy usage in laboratories Figure 1 Figure 2
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It has long been known that colour can affect our wellbeing – and increasingly this is being recognised in the design of modern medical facilities. But it is not just the colour of the walls that can have a positive impact on patient and staff wellbeing. Furniture also has a role to play in helping to create a more-relaxing and less- institutional environment. “As experts on the psychology of colour point out, when we are feeling stressed we need to reduce visual noise and surround ourselves with tranquil colours that reconnect us with nature,” said a spokesman for medical furniture manufacturer, Ocura. PROMOTING WELLBEING “The growth in recent years of evidence-based design highlights the need to enhance patient wellbeing, not just through clinical care, but also through the environment, and choosing the right colour for the right environment is now understood to play an important role in optimal wellbeing. “And, as healthcare design inevitably becomes more sophisticated, the importance of the effect of colour on wellbeing is steadily gaining recognition. “This means the choice of colour is now a significant consideration in the purchasing process for healthcare furniture. “The days of bland and uninteresting hospital décor are gone. What we now have is an opportunity to create an attractive, colourful, and well-balanced environment that is entirely supportive of optimal wellbeing for all.” Ramsay McDonald, director of Deanestor, adds: “The choice of colour plays a hugely-important role in the design of furniture for healthcare environments. THROWING SHADE “Colours need to be light to promote good hygiene practice, so it is easy to identify soiled areas for cleaning. “Colour is also important for patients with visual impairments and in patient areas to help create a more-welcoming and less-clinical feel and an appearance that promotes wellbeing and healing.” The best colours for hospitals and other health and care settings are those that complement or contrast with walls and floors. McDonald explains: “The only elements of colour in a healthcare environment are typically the furniture and fittings, and the palette tends to be consistent throughout a healthcare building or hospital. “Colour strategies are currently favouring lighter palettes which are conducive to health and wellbeing and mean that hygiene standards are easier to maintain. “Lighter hues and soft, natural tones for inpatient rooms and waiting areas, such as in emergency departments, have been shown to have a calming effect on patients and their relatives when facing stressful situations. “The age of the patients is also a factor when considering colour, with children’s hospitals and paediatric wards often colourful, bright, and fun in their design to help young patients feel at ease during their stay. “With elderly patients, though, their vision changes and deteriorates with age, so more contrast is needed to help guide them through their rooms, for example towards seating areas and grab rails. healthcaredm.co.uk 25 FURNITURE SHOWING THEIR TRUE COLOURS In this article we explore how healthcare furniture manufacturers are increasingly using colour to create more-therapeutic environments for staff and patients The importance of the effect of colour on wellbeing is steadily gaining recognition Image, Knightsbridge Furniture
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