West Middlesex University Hospital

West Middlesex Hospital project provides a full range of hospital services to a local population of around 425,000 people and employs 1,900 staff. The new build element of the development features A&E, critical care, resuscitation room, operating theatres, clinical imaging, outpatients and patient suites, and has full specialist and technical equipment.

This PFI contract comprises the design construction and ongoing maintenance of a 19,000m2 new build, and 10,000m2 refurbishment of the medical blocks and Women’s OPD building along with enabling and external works.

Our vast experience in the sector ensures our core understanding of hospitals as dynamic live environments. Managing the impact of construction whilst delivering a Hospital project safely is our number one priority. Our priorities include active stakeholder management, communication, control of noise, dust and vibration and ensuring we take a holistic view even beyond finishing our part of the works.

We have extensive experience of the long term management and maintenance of built environment assets. This expertise has largely been gained via Private Finance Initiative (PFI) and Public Private Partnership (PPP) contracts, and the West Middlesex Hospital project is another example of delivering to our commitments.

Construction in a Live Environment

In addition to the new build element, the project involved partial demolition and refurbishment of the existing hospital premises.

Sequencing of the works involved complex phasing, which required us to collaborate closely from the outset with a number of the Trust’s key stakeholders including clinicians to ensure a successful outcome.

Throughout the engagement process we balanced clinical functionality with realistic technical requirements. A number of potential phasing options were presented together with the pros and cons of each, which weighed the number of phases against clinical availability so that the Trust could make informed decisions.

We also presented what tools and equipment we would use for certain activities in order to minimise disruption. These included using concrete nibblers rather than jack hammers in the refurbishment element which significantly reduced noise, dust and vibration. Similarly, we worked in the evenings and weekends in outpatient areas to limit the impact of the works and thoroughly cleaned them prior to service resumption. There were daily joint walk arounds with the Trust prior to handing a finished area back.

It was important to keep many services live in refurbishment areas, and we worked together closely to determine and test where these were located. Although a number of them were scheduled for subsequent removal we nevertheless had to take them into account fully when installing new works. Our drawings therefore reflected a phase by phase addition and/or removal of services.

We kept a multi-zone programme of works based on cycle and rotations to offer a certain degree of flexibility where in particular situations, for trauma centres for instance, the works may be required to be stopped as soon as practicable for operational needs.

Again, for inpatient areas, we provided fire watch in locations where the fire alarms were disabled and we maintained close liaison with both the Trust’s fire department and the London Fire Brigade to identify and agree alternate access to the building in the event of a fire at each phase of the project.

With Health and Safety being a number one priority at Bouygues, we also held a series of training sessions as the phases progressed to inform and update hospital staff about escape routes and evacuation requirements. We augmented this with revised wayfinding at the start of each phase to assist and provide clarity for patients and staff.

Risk Management

We delivered the project successfully by establishing and maintaining a detailed risk register from the early stages of preconstruction through to the site works activities.

Our Risk Management Process was based on principles which remain part of our corporate quality system today.

This approach resolved a number of risks namely:

• Busy inner-campus location
• Access restrictions
• Retained structures interface and connections
• Oversailing requirements
• Party wall interface, scoping, agreements

Supporting a Sustainable Estate

It is essential to consider the long term operational requirements of a healthcare premises at all stages of a development; from preconstruction, through the construction and handover of the works and on into the service delivery phase.

On West Middlesex, in addition to the requirements for regular preventative maintenance, we have addressed both essential maintenance and the need for reactive (unplanned) maintenance requiring an immediate response.

We have worked closely with the Hospital Trust to deliver:

• Capital investment of £1.6m with a five year payback period
• 15% savings and 15% reduction on carbon emissions
• £2m in net savings guaranteed over 10 years
• £12m in gross savings over 25 years

Through its energy performance contract (EPC) with Bouygues Energies & Services, the Trust has seen a reduction in its energy consumption of approximately 8m kWh. This represents a saving in energy costs in excess of 15% compared with the 2012 baseline.

The EPC is performing well against the targeted payback period with revenue savings now amounting to £0.6m. The second phase of the EPC is to achieve an additional 15% carbon emission reduction (against 2012 baseline). This will place the WMUH site in a favourable position to achieve a 29% saving and assist the Trust in achieving the NHS Sustainable Development Unit (SDU) 34% reduction target required by 2020.

Further opportunities identified for energy reductions include:

• Final installation and commissioning of a combined heat and power unit (c1MW) on the West Middlesex Site will further reduce energy consumption.
• Further upgrading to LED lighting

To read more about our ongoing maintenance at West Middlesex University Hospital, please click here.