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Reducing the Financial and Ecological Burden on the NHS

Richard Coe, Project Director at Kajima Partnerships, discusses how to build in flexibility and increase capacity in the NHS, preparing the health service as a potential winter crisis looms.


The pressure the pandemic has placed on the healthcare sector, particularly NHS Trusts, is severe. Indeed, 2.3 million fewer diagnostic tests for cancer were carried out in August last year compared to the previous year, and the recent lack of services could mean an extra 35,000 cancer deaths. The backlog of patients waiting for diagnostics, cancer care and elective surgeries is approaching critical levels. However, the cost of building the capacity to address this crisis in the NHS is huge. Thus, the need for design solutions to solve the unprecedented demand on our health services is crucial. One option to assess is modular construction, which offers an opportunity for NHS Trusts to flex up capacity and services without incurring significant financial costs.

Implementing modular construction methods across NHS Trusts more widely will allow our health service to construct at pace, saving greatly on energy usage, construction costs and ensuring our hospitals and clinics have the ability to adapt to changing and unforeseen circumstances in the future. These benefits will be especially useful as we continue to battle COVID-19 and prepare for a potential winter crisis.

Speed of delivery

With 50,971 patients now waiting at least a year for treatment, up from 1117 a year ago, the speed of offsite construction offered by modular is welcome. The NHS is facing an unprecedented backlog crisis in the wake of the pandemic but lacks the infrastructure to cope and does not have the funding to meet these demands with traditional building methods. Turning to modular can provide a cost-efficient alternative to flex up the NHS and begin tackling the significant patient waiting list.

Modular construction can deliver buildings at great pace. For example, using the modular method, 1700m2 of hospital space was delivered to Nightingale Hospital Exeter in just four weeks. This is a speed of delivery that traditional construction methods cannot match. Consequently, adopting modular construction methods could save the NHS significant amounts of money as more traditional construction methods have much lower productivity – indeed, recent estimates from the Construction Products Association suggest that construction site productivity fell by 30 to 40% during the first lockdown earlier this year.

Saving money and the planet

Although a swift response to this crisis is needed, we must make sure not to overextend our use of resources to the detriment of the environment. Our built environment contributes around 40% of the UK’s total carbon footprint. Modular structures can help reduce this footprint, with most modular buildings being required to run in compliance with the latest L2 Building Regulations governing thermal efficiency, meaning they deliver an average lifetime energy saving of 90% compared to traditional structures.

Moreover, with up to 67% less energy required to build, modular offers a welcome solution to the financial burden of high energy usage involved in traditional building methods during construction as well as over the life of the building.

Modular achieves this initial energy saving through building in a highly controlled environment. As the construction is conducted offsite in a factory setting, the process is far more efficient than its traditional counterpart. More control in building leads to more control in price. Furthermore, the installation and assembly processes require less vehicle traffic than traditional onsite methods. This makes modular an extremely attractive option for the NHS, reducing both the financial and ecological impact of construction.

Cost-efficient in the long-term

Aside from the immediate financial benefits of modular in tackling the patient backlog crisis, the positives it offers extend beyond a purely short-term solution. A great challenge faced by the NHS long-term is the need to be able to adapt to future spikes in demand for services and facilities, whether they are seasonal or unexpected. Buildings constructed using modular methods retain the ability to be repurposed as and when needed to meet changes in requirements.

This flexibility is particularly useful for the NHS as it not only must flex up and down with demand throughout the year, but also as it allows for the reallocation and accommodation of new and existing facilities as modular healthcare builds can implement the necessary modifications with ease.

Indeed, modular construction is being increasingly used to quickly implement facility updates outside the UK. For example, earlier this year a modular approach was used to deliver a new satellite radiology clinic in a hospital in Copenhagen, Denmark, in just two weeks.

At a time when the NHS is under severe stress, the faster time and improved cost-efficiency of construction and delivery, alongside the ability to redeploy and repurpose structures, means that modular could play a significant role in addressing the issue of the patient backlog crisis as well as help the NHS shape and adapt its services to meet ever-varying demand in the years ahead.

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