Comment

Flat-pack buildings could save our NHS

The NHS needs to regenerate its rapidly deteriorating estate – and fast. With time of the essence and budgets stretched, conventional capital building projects are out of reach for many trusts. Phil Davies, director of procurement at NHS Shared Business Services (NHS SBS), explains why modular building must be part of the solution.

The Naylor Review was pretty explicit – it’s out with the old and in with the new when it comes to NHS buildings. While replacing the “old and outdated buildings [that] are inefficient and costly” is essential for the sustainability of our health service, as ever, the solutions aren’t simple.

A 2017 report by NHS Digital found that the money needed to address the “high-risk” building and maintenance backlog caused by the NHS’s ageing estate had almost doubled, from £458m in 2014-15 to £947m in 2016. Creating new, fit-for-purpose buildings takes time and considerable amounts of money. And, quite frankly, the NHS is not awash with either.

Akin to medical care itself, early intervention is always better. As hospitals and other medical buildings deteriorate unchecked, the risks to staff, patients and the NHS increase. Poorly maintained buildings, for example, can lead to accidents and incidents that open the NHS up to litigation it can ill-afford.

This is an issue that needs tackling quickly. One increasingly popular solution is modular construction – pre-fabricated buildings that are created off-site. Indeed, the buy-in from government is already there, with a significant chunk of the recently announced £3.5m infrastructure fund for the NHS likely to be allocated for modular buildings. It’s not hard to understand why.

This building method has the potential to rapidly expedite the construction process. A completely new ward can be up and running in six months, around half the time of a typical construction project – and quality is not compromised. Buildings are fabricated under controlled plant conditions, using the same robust materials as those used in traditional construction projects, and with the same rigorous adherence to building codes and standards as conventionally-built facilities.

They also frequently offer better value for money. Modular buildings have the potential to yield savings of 10% to 20%, and standardised construction brings economies of scale, saving the NHS as a whole money. Because there is one standard design, there is less scope for unforeseen glitches or costly misjudgements. Costs and timescales are much more predictable, and the sort of disruption that could affect patient care is minimised.

Modular buildings also offer flexibility. What goes up can easily come back down again, with the possibility of leasing or even re-selling these structures when they are no longer needed. With the face of healthcare constantly changing because of factors as varied as technology change, advances in medicineand demographics, this also  means the NHS could have the capability to shape its estate to its changing requirements on a much more regular basis.

A new framework

With these considerable benefits driving increasing demand for modular building solutions – and the government’s ‘Construction 2025’ identifying the need for more scrutiny of whole-lifecycle costs and savings – NHS SBS has developed a framework specifically in the area of modular buildings.

Providing a fully OJEU-compliant route to market for any NHS or public sector organisation, our framework is made up of 21 carefully vetted companies capable of constructing a wide range of modular buildings, including hospital wards, operating theatres, outpatient clinics, accommodation blocks, and catering facilities.

Specifically designed to ensure that the public sector can access very specific expertise for the particular nature of its construction projects, the framework includes specific lots for healthcare, education, catering and bespoke solutions. It is divided into categories to cover both hire projects and purchases and leases, below and above £1m.

Suppliers are carefully vetted not just in regards to expertise and experience, but also financials. Only those capable of providing turnkey solutions are selected, meaning our partner organisations avoid being stung by the mark-ups and risk associated with sub-contractors. Those using the framework are also supported to award contracts in the way that best suits their needs, whether directly or through a mini-competition.

Appetite for the solutions offered by the framework has been considerable. In the space of just over a year, we estimate that it has already saved the public sector around £1m through its seamless procurement solutions and easy access to the best possible suppliers for the job.

But of course, while modular buildings may have the edge over traditional construction practices for NHS and public sector construction projects, there is only so much money in the pot for new facilities.

Another key survival strategy for our stretched public sector is prolonging the lifespan of its current estate through careful buildings management.

Again, this is an area in which NHS SBS has developed specific, free-to-use and fully compliant frameworks for the public sector. Our comprehensive estate and facilities framework portfolio – of which modular buildings is a part – also includes Agreements for Hard Facilities Management, Construction Consultancy Services and Soft Facilities Management.

Combined, these frameworks enable users to access the expertise they need in all areas of building construction, maintenance and management, from pest control and buildings management to civil engineering. They also include a range of suppliers, from local specialists and mid-size SMEs to the major players, all of whom are vetted using NHS SBS’s stringent criteria.

In essence, because of how rigorous the vetting process is for the businesses on our frameworks and the comprehensive support we provide throughout the tendering process, the NHS and wider public sector is supported in getting it right first time, every time.

The quality of the NHS estate is no superficial consideration. The best buildings, running in the most efficient ways, have the potential to be one of the most important tools in the NHS’s armoury, helping services run quicker and reducing the potential for life-threatening cancellations.

By maximising the value extracted from the NHS’s estates and facilities, our frameworks enable NHS leaders to manage their constrained budgets with a two-pronged attack, not only ensuring estates are functioning optimally, but also saving considerable sums – which can be re-allocated to frontline care – along the way.

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