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Modular Approach to Healthcare Buildings

Adrian Day, Managing Director of Terrapin, discusses how offsite construction ishelping to meet the ever more stringent requirements of modern modularhealthcare buildings. 

 “Innovation within offsite construction means it is now possible to offer greaterflexibility in the design of  modular buildings than ever before. Recent advancesinclude the development of corner-loaded modular units, which increase designflexibility and generate significant cost savings on site and throughout thelifetime of a building. The most recent project to use this type of construction isLewisham Hospital, for which we worked in association with Kier London. Thedesign for a new Outpatients‟ Suite at the hospital incorporated our Unitrexsystem to create a double storey permanent building, as part of an overall £12minvestment to extend and refurbish the hospital.

A Government survey found that hospitalbuildings had some of the highest averageCarbon Dioxide emissions and, as a result of this, the health sector is looking for ways toimprove its energy efficiency and reduce itscarbon footprint.

Offsite construction is becoming a popularchoice in the health sector, due to the fact thatit can deliver permanent, high performancebuildings, working within the constraints of 

short timeframes and the restrictions associatedwith access to site. However, due to majorinnovations in design and the development of hybrid systems, this means thatnon-standard units can be produced and sustainable technologies can beintegrated into the design.

Challenges

As it serves a large population in the London Borough of Lewisham andsurrounding areas, this busy hospital has restricted site access, which meantthat all deliveries had to carefully planned and agreed in advance with the client.Due to the hospital providing Emergency Department services, this meant it wasvital to have clear access at all times to these essential areas and therefore wehad to take extra care to ensure normal operations were not affected.

One of the reasons for the construction work being commissioned is thatLewisham Hospital is pioneering a new approach to Emergency Departmentservices, by adding a new Urgent Care Centre. This will mean that as the patiententers the Emergency Department, they will be assessed and triaged to theUrgent Care Centre if their injuries or condition were not believed to be lifethreatening. The most serious conditions would be treated as a priority in theexisting Emergency Department, therefore ensuring patients who are most in

need receive priority.

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For the Outpatients' Suite, which links onto the main hospital building, it wasvery important that it was completed within a very short timeframe, as the workwas scheduled in phases. This meant that as soon as the Outpatient Suite washanded over, it could be occupied by other services including children‟s and adultoutpatient services.

Design and build

Lewisham Healthcare NHS Trust was looking for a non-standard width for thenew Outpatients' Suite, which was perfectly within Terrapin‟s capabilities due tothe bespoke nature of its service.

The design of the Outpatient Suite incorporated timber and steel, with wallpanels throughout. There is also a three storey circulation tower, which links thenew and existing buildings. The tower is built with a concrete roof and floors andis designed so that hospital staff and patients can easily move between the

existing and new building at all three levels, providing greater convenience. Oneof the requirements of the building was to ensure that there was noreverberation between the floors adjacent to the corridors, which meant Terrapinprovided reinforced floors to reduce any sound or vibration.

The building has been designed to achieve BREEAM Very Good and thereforemeets all the requirements for air tightness, improving energy efficiency andreducing the carbon footprint. The architect provided an A-rated specification forall building components, as part of achieving the project‟s environmentalrequirements. A very visible display of the building‟s green credentials is that itincorporated a sustainable sedum roof, which will provide a haven for grass and

plants to flourish, as part of reducing the building‟s carbon footprint. As well asbeing of great environmental benefit, there were also aesthetic reasons for doingthis as the three storey building will be overlooked by a nearby seven storeyhospital ward, improving the outlook for patients.

It was important on this project to ensure that the new building complementedthe style of the existing hospital. This meant that cladding was selected to matchthe finish of the existing structure, which makes it virtually indistinguishablefrom the main building. Therefore Microrib cladding was specified in metallicsilver, which matched the modern external façade of the existing hospitalbuilding that it joined. To enhance its aesthetics, the ceiling of the Outpatient

Suite featured a light well – again a distinctive architectural feature.

The design of the internalswas carefully planned too,down to the detail of theintegrated plumbing system,which was included with aframe assembly to avoid theneed for site studding. Thiswas part of the hospital‟srequirement, as it speeds up

installation on site in order tomeet the rigid build schedule.

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 Modern offsite systems, like the one used at Lewisham Hospital, also offer thepotential to achieve the very highest „A‟ rated energy performance, byoptimising insulation and energy performance. With traditional building methods,it is more difficult to meet such high performance, without, for example,

incorporating extra wide cavities to accommodate more insulation and thenthere is the issue of achieving adequate airtight seals. This can come aboutbecause of a lack of a joined up approach between, say, the roofing and façadecontractor, which can result in a poor air tight seal between these two criticalbuilding elements and therefore lower thermal performance. Offsiteconstruction systems overcome this problem because the elements are pre-fabricated in quality assured production facilities, which ensures an excellent airtight seal site.

Summary

Research has shown that the return on investment of an offsite constructedbuilding has proven to be significantly greater than that of a traditional build.This is clearly demonstrating how modular building meets the needs of thehealth sector in many ways and not least due to the excellent lifetime values of buildings.

Lewisham Hospital‟s outpatient‟s suite is a very good example of offsiteconstruction working really well to meet both the building performancerequirements and the site access restrictions of the health sector. With a focuson affordability and good value, offsite systems are rising to the challenge of meeting healthcare needs. The introduction of flexible flat pack and hybrid

systems, but which have all the design freedom offered by traditional buildings,means the healthcare buildings of the future can meet all requirements forperformance, design, scheduling and cost.”  

 As a leading UK provider of offsite construction solutions, Terrapin has been in

the business of permanent and temporary solutions for 60 years. Off site

construction delivers fast, accurate and affordable solutions to permanent,

temporary and relocatable building requirements for healthcare, education,

developer and commercial projects.

Compared to conventional building methods, Terrapin’s modular solutions reducetime on site, cut the number of deliveries and are virtually unaffected by 

weather considerations. Importantly, for a site where disruptions must be kept 

to a minimum, the offsite construction approach creates much less noise and 

interference to the day to day operation of the site and its occupants.