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How healthcare providers can address the pressure on bed spaces ahead of next winter


Robert Snook, Director and General Manager of Portakabin Hire, offers some practical advice to help healthcare providers address the increasing pressure on bed spaces ahead of the peak period next winter.

We have experienced a significant increase in the demand for a range of fully-serviced interim healthcare buildings – surge wards to provide additional capacity during the peak winter months and for buildings such as surgical clinical decisions units to reduce the rising pressure on A&E departments. 

However, these buildings need to be strategically planned, with trusts anticipating their needs for the coming winter months well ahead, rather than looking at reactive solutions to crisis situations that so many hospitals had to face last winter.

How to Deliver Highly Serviced Buildings in the Shortest Possible Time

The biggest challenge in the provision of hospital buildings for short-term clinical use is the level of fit out required. These buildings are complex, specialist and highly serviced facilities.  However, the demand for health services and the pressure on existing A&E services continue to rise year on year.

Our experience has shown that it is vital we work with NHS trusts to develop strategic plans that ideally take a longer-term view. Buildings can still be supplied in just a few weeks once the necessary NHS approvals are in place but the procurement and approvals process can be protracted which puts additional pressure on the delivery programme and what can be realistically achieved prior to the peak winter period. This makes planning well ahead absolutely vital.

How Interim Building Solutions Can Help Mitigate Crisis Situations

Offices or other support facilities can be relocated into a single modular building to free up additional clinical space extremely quickly in a crisis situation.

This is useful because it can often be more cost effective and better for patient flows to upgrade an existing clinical area which will already have services in place or nearby such as air handling and medical gases, and then to relocate administrative or storage facilities to an interim building.

These units can be supplied from stock in sizes from as little as 7m2 up to 68m2 and are available with compliant access.

This type of solution can generate space elsewhere in the hospital for extra beds or to accommodate clinical services. Single modular buildings (SMBs) can be supplied in a matter of days and can also be used to create walk-in assessment units directly attached to A&E departments, enabling trusts to prioritise and reduce waiting times for more urgent cases.

Increasing Capacity without Compromising Standards

At the other end of the scale, off-site construction can give healthcare providers the opportunity to increase capacity rapidly without compromising standards. 

Complete, fully-fitted, bespoke buildings for wards, pre-assessment, consulting or treatment facilities can be delivered in a fraction of the time of a site-based construction solution. Critically, these buildings can also be installed with much less disruption to patient care because manufacture of the steel structure and a high proportion of the fitting out take place off site. 

A Flexible, Short-term Solution

Modular buildings which comply with the relevant HBN and HTM guidelines and have an independently-accredited 60-year design life, can also be hired to provide an interim solution which can remain in place from just a few months to five years.  These facilities can be delivered fully fitted out with nurse call systems and bedhead trunking, energy-efficient comfort heating and cooling, heat recovery ventilation, specialist furniture and fittings, security and fire prevention systems, data communications that are integrated with the main hospital IT systems, and access ramps.

Importantly, these interim buildings can be funded from revenue streams if there is a shortfall in a trust’s capital budget. This solution also gives healthcare providers the benefit of greater flexibility because the building modules can be added to or removed and relocated to another site as service needs change or while a permanent building is constructed – a highly sustainable option.

Buildings for short-term use can be stand-alone facilities or can be seamlessly linked to the main hospital to maintain patient flows. This means that a patient moving from one building to another would never know when they had entered an interim facility.

The versatility of a modular solution also means that they can be craned into completely enclosed courtyards, sited on steel platforms, on the roofs of existing buildings or installed on sites where site-based construction and access would be extremely difficult or disruptive to patient care.

Integrating Interim Facilities More Effectively on Hospital Sites

The addition of exteriors features and other amenities can give interim buildings a more permanent feel and help to create a welcoming healthcare environment. However, these options should demonstrate practical as well as aesthetic benefits and be suited to the needs of staff and patients.

The provision of smoking shelters at NHS hospitals remains a controversial topic. As in other sectors, if staff, patients and visitors are going to smoke, it is better to encourage them to do so in a safely-positioned, well-maintained and easy-to-clean area by providing shelters and street furniture – and that applies to interim as well as permanent facilities.

Other options and considerations for interim healthcare buildings include:

  • Large span structures to create welcoming entrances and by reducing the number of posts, you reduce obstacles in busy areas
  • Areas of soft and safety surfacing (commonly used in children’s play areas) to reduce serious accidents for patients who are more prone to trips and falls
  • Walkway post positions so as not to obstruct internal views of the outdoors
  • Canopies and outdoor furniture designed to feature colour, architectural shapes and tactile materials.  By incorporating these elements into the building design you can encourage access outdoors whilst providing shelter from the elements.  Research has shown that time spent outdoors can improve the mental and physical wellbeing of patients; reduce stress and improve rehabilitation.  It can also help reduce overcrowding in busy indoor eating and meeting places
  • Consideration should be given to designing out surface-mounted post fixings to reduce trip hazards.

The Need for Strategic Planning

It is easy to see how strategic planning well ahead of peak winter periods is essential. There are a number of building solutions and delivery times will vary according to the complexity of the facility required and the length of time it will need to remain in place.

Is there capital funding for a permanent solution or can interim buildings be hired out of a revenue budget? Will decant wards be required during a major redevelopment programme?  Can existing support services be relocated temporarily to address a crisis situation?

The range of modular options now available to help healthcare providers address the increasing demand for bed spaces particularly for emergency care, has broadened in recent years.  A good modular building partner will work with the trust to develop innovative and cost-effective solutions to best suit each situation.

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