The research team have triggered supply chain innovation by using the space sector as a comparison and drawing on wider inter-disciplinary experience and capability. The recent example of the NHS Nightingale Hospitals has shown this in action. They saw many contractors and suppliers working in a more agile and aligned way, and using expedient procurement processes, allowing these hospitals to be delivered in three to four months.
Bringing together specialist healthcare contractors with advanced design, engineering, asset management and manufacturing has also encouraged new interactions and created innovative delivery, sustainability, inflection and rapid deployment targets that were unconstrained by typical lowest cost tendering.
The team investigated the delivery of a more sustainable operating theatre, with a goal to lower emissions by 50%. To do this, they recommend decarbonising through innovations in local bulk gas capture, extraction and purification. It's critical to establish specialist supply chain alliances that are incentivised to, for example, mitigate the impacts of anaesthesia gas scavenging systems, because some gases are 2,540 times more warming than CO2.
The programme looked at how theatre infection control could be transformed through a standardised platform. The research explored the standardisation of requirements, design and assurance to reduce the risk of poor design, execution and operational errors. And although not empirically tested, the research suggested that a platform approach to Design for Manufacture and Assembly (p-DfMA) could address the significant cost of surgical site infection, the costs to the patient and the societal costs, such as antimicrobial resistance.
The research programme showed that only 5% of theatres procured currently use offsite manufacture. Yet if the number of planned theatres manufactured offsite increased from 33 to 250, it pointed to opportunities to increase the productivity of projects by 15%. From the team's analysis of 60 processes involved in the theatre delivery (conducted in collaboration with AML), they created guidance that will minimise design, procurement and onsite delays and potentially limit errors as a result.
The team is aiming for a 50% faster delivery time due to a reduction in parts fabrication, logistics and assembly. This would support offsite manufactured theatres being delivered in five months. However the researchers are working with the SEISMIC II team and Moorfields Hospital to investigate whether this could be cut to as little as four months with greater productisation of the processes.
As a result of this research, NHS England and the Department of Health & Social Care have stated that manufacturing-led construction offers the greatest opportunity to improve efficiency and productivity in health construction.
Martin Rooney, Estates Delivery lead at NHS England and NHS Improvement, confirmed that Modern Methods of Construction should be a critical part of the NHS Health Infrastructure Plan (HIP). And with £21bn worth of major projects planned for 2020 and beyond, this is a huge step forward in the purchasing of hospital buildings to ensure they have the highest levels of quality and customisation, as well as the greatest overall cost saving.