Grange University Hospital

Delivering a new level of quality and value for hospital procurement.

Last updated: 4th January 2022

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A pioneering Design for Manufacturing and Assembly (DfMA) approach allowed Laing O’Rourke to deliver the new £350m Grange University Hospital four months ahead of the original schedule, on budget and with zero defects. In fact, 384 beds of clinical ward space were made available for use almost a year early in response to the Covid-19 pandemic. Alongside DfMA, digital modelling allowed all stakeholders to engage with the design early; identifying efficiencies and preventing errors while ensuring medical professionals had a state-of-the-art facility that allowed them to deliver the highest standards of patient care to a population of over 600,000.

Innovation type: Kit of parts, Offsite
Organisation type: Construction tier 1 contractors, Government client

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Project pioneers

International engineering and construction company, Laing O’Rourke, has been investing in modern methods of construction (MMC) through its pioneering offsite production approach, known as DfMA 70:60:30. This inhouse Design for Manufacture and Assembly (DfMA) capability sees 70% of construction conducted offsite, creating a 60% improvement in productivity and a 30% improvement in delivery times.

The problem

Onsite construction projects can be difficult to plan and predict, making defects and rework common. Manual methods of design review are time-consuming. Team members can be reviewing different iterations of designs because, without digital collaborative models, you can’t be sure you are looking at the most up-to-date information.


DfMA 70:60:30 results in a right-first-time assembly. Preparing the components offsite means any trial and error takes place in a controlled factory setting; ensuring they are ready for assembly onsite. This improves the speed, predictability and quality of the building while making the process robust, foreseeable and reliable in terms of cost, which is vital for public sector projects like this one. Alongside DfMA, digital modelling allowed all stakeholders to engage with the design early; identifying efficiencies and preventing errors while ensuring medical professionals had a state-of-the-art facility that allowed them to deliver the highest standards of patient care to the population of Gwent and South Powys. The Grange University Hospital project demonstrated a new level of innovation, quality, consistency and value for hospital procurement and construction.

Key Insight

In 2003, discussions began between the Aneurin Bevan University Health Board (ABUHB) and Welsh Government for a new £350m hospital, which would sit on the site of the former Llanfrechfa Grange Hospital near Cwmbran in South East Wales. In 2008, Laing O’Rourke was invited to join the ‘Designed for Life’ framework by Aneurin Bevan University Health Board (ABUHB), aiming to transform the care of Gwent and South Powys’ most vulnerable patients – serving a population of over 600,000.

First step

Laing O’Rourke is committed to applying DfMA 70:60:30 to large-scale public infrastructure projects. This approach to both modern methods of construction and digital modelling saw them secure the opportunity to bring the ambitious Grange University Hospital project to life.


Focusing on traditional methods of construction and design can limit productivity or obstruct the collaboration needed to create optimum facilities that help medical professionals deliver state-of-the-art care.

Process innovation

Working together, Laing O’Rourke and ABUHB influenced the overall Grange Hospital scheme through early engagement and design, taking a DfMA-led approach. This resulted in intelligent sequencing from the outset, using a supply chain that created offsite building components throughout. Early engagement also identified efficiencies and prevented errors. This included:

  • Moving the energy centre to another part of the site to allow it to progress rapidly, separate from the main hospital building in recognition of its place on the critical path.
  • Constructing the permanent site access roads at the beginning of the programme to enable more efficient logistics.
  • Locating tower cranes outside of the building to eradicate issues around watertightness.

Ultimately the DfMA approach saved 237,099 onsite labour-hours and resulted in a 23% saving against a comparable programme for traditional construction. Much of this was down to the use of prefabricated and precast DfMA components such as concrete columns, twinwalls, lattice planks, hollowcore slabs, delta beams, facade panels, bathroom pods, MEP service risers, MEP service horizontal modules, and plant skids. Standardised component ‘types’ developed with the architect sped up approval times and fast-tracked drawings to production.

Digital Innovation

All Laing O’Rourke construction components utilise ‘plug and play’ build onsite, so all the interfaces can be reviewed in their entirety in 3D. The team check that the components fit together in the model before anything happens on site – ensuring a right first-time installation. For example, all 774 of the sandwich panels and facade elements were digitally checked and approved before pouring 10% of the ground floor slab. Panel geometry of these insulated, precast facade panels - with integral windows forming both structure and envelope - was transferred seamlessly to manufacture from consultant design models. The teams reviewed the design data in 3D, communicating via BIMCollab with no need for any 2D exchange. This is a huge superstructure milestone and wouldn’t have been possible without a fully integrated 3D digital model. Monitoring the design and manufacturing progress of components took place via a live reporting feed from the factories; visually and graphically indicating any items on hold and also communicating when items had been despatched and installed. This enabled the team to quickly resolve any problem areas before they became programme critical. Numerous digital models from the design team, subcontractors and suppliers were combined in a single federated model and reviewed for clashes, minimising errors and safety risks on site. From digital logistics planning and design change identification to live component tracking and cost allocation analysis, this sophisticated model enhanced every aspect of the project. A focus on collaborative, digital design, promoted discussion on complex design issues. It provided a forum for debating design interfaces so all parties could contribute to the development of solutions. Importantly this included patient groups and the doctors and nurses who would use the building.


All the parties in this project played a key role in the design and construction of the Grange University Hospital: Gleeds (project managers and cost consultants), BDP (architects), WSP (civil and structural engineers), AECOM (mechanical and electrical services engineers), Arup (NEC supervisor), Bureau Veritas (building control) and Torfaen County Borough Council (the local planning authority). As well as performing their individual roles, it was the close collaboration and engagement of all stakeholders throughout the design and construction that maximised the efficiency of the process, while providing a state-of-the-art new facility.

  • Arup
  • BDP
  • Bureau Veritas
  • Gleeds
  • Torfaen County Borough Council
  • WSP

Lead support

The Transforming Construction Challenge has shifted public procurement towards whole-life value and modern methods of construction. In line with this, the Aneurin Bevan University Health Board and Welsh Government ran a process that recognised the better outcomes innovative approaches could deliver for this ambitious project.

Long Term Vision

Grange University Hospital showed that modern methods of construction combined with digital modelling can deliver a step-change in quality and value for hospital procurement.

Human Stories

As well as delivering a state-of-the-art facility to transform the care of over 600,000 people in Gwent and South Powys, and 384 beds of clinical ward space a year early in response to the Covid-19 pandemic, construction also created work for over 10,000 people. This included 94 short-term work placements, 117 full-time employment opportunities for local unemployed people, and paid employment opportunities to 35 ex-offenders released on temporary licence (ROTL). Laing O’Rourke, together with project recruitment partner Acorn Recruitment, took a targeted approach, putting a focus on supporting a marginalised group in ex-offenders. The project engaged with HMP Prescoed, Pontypool which was just 5 miles from the site and supported local people serving sentences at the Category D prison. The goal was to support low-risk offenders in their final year of sentence that were committed to change, had put their past mistakes behind them, and wanted to give something back to the community before release. The impact on the individuals was huge. Working whilst serving meant that they were able to send money home to support their families, pay for their children to travel to visit them, and save money to assist with rehabilitation on release. They went from being convinced that they would not get a job because they felt no employer would hire them, to regaining confidence and a real passion for construction work which led to immediate offers of full-time employment on release. The wider community now has individuals that are committed to being productive, working full-time and contributing to the local economy; rather than potentially being a cost to it through re-offending or claiming benefits. Part of their wages were levied into a victims support fund, on top of Tax and National Insurance contributions that each of these workers made.

  • 35 individuals were employed on licence from Prescoed at SCCC
  • 817 weeks of paid employment
  • £275,112 paid in wages
  • £47,398 paid into a victims support fund
  • 6 individuals offered full-time employment with Laing O’Rourke and our supply chain on release
  • 14 Individuals secured full-time work on release
  • 6 individuals still employed by Acorn across construction contracts South Wales
  •  9 individuals are still to finish their sentence but are back out working on ROTL projects “Laing O’Rourke, Acorn and the SCCC/Grange University Hospital project have had a huge impact on the lives of a lot of people here at HMP Prescoed. When an employment opportunity is offered to an individual and that helps them succeed on release it affects a network of friends, family, children, parents in a massively positive way. For every person employed you have probably created a positive wave effect for a further 20 so for Laing O’Rourke to have given 27 opportunities it's clear to see what a huge impact this has had.” Sonia Davies, Resettlement Team, HMP Prescoed

Powerful Processes

Laing O’Rourke's DfMA 70:60:30 operating model, based on in-house capability in modern methods of construction sees 70% of construction conducted offsite, creating a 60% improvement in productivity and a 30% improvement in delivery times.

  • July 2017 – breaking ground
  • November 2017 – the start of substructures
  • March 2018 – the start of the superstructure
  • February 2019 – structure complete
  • July 2019 – building watertight
  • April/May 2020 – early handover of 384 beds in response to the Covid crisis (11 months ahead of the programme)
  • November 2020 – hospital fully open (four months ahead of the programme)

Fascinating Facts

Grange University Hospital was identified as an ‘Exemplar Project’ by Constructing Excellence Wales due to:

  • a 42-week programme saving
  • the 237,099 onsite labour-hours saved
  • a 23% programme saving secured by using DfMA components compared to a traditionally constructed project 
  • the hospital opening 4 months early
  • 384-bed spaces being available 11 months ahead of the programme to support the Welsh Government's Covid response
  • 2,612 rooms being delivered with zero defects at completion
  • the project coming in £10m below the agreed target price


To attract more women into the construction and engineering industries, two female members of the project team visited Howell’s Girls School in Llandaff on their Employers Day and gave an inspirational keynote speech about women in construction. The project also hosted site visits for both the Women in Construction and Women in Property groups. Laing O’Rourke has since set a target to achieve a 50/50 gender balance by 2033.

The project achieved an 'Excellent' BREEAM (Building Research Establishment Environmental Assessment Method) rating. There was also a reduction in earthworks vehicular movements of around 16,000 vehicles.

The project has demonstrated a saving of 237,099 labour-hours and a 42-week programme saving of 23% against a comparable traditional construction.

Regional Balance
Major components were manufactured in the East Midlands near Worksop and also at Oldbury in the West Midlands for delivery to the hospital site near Cwmbran in South Wales. In addition, the project maximised the use of local labour - 69% of labour was sourced in Wales, with 38% coming from within 20 miles of the site.