A range of pandemic-prompted innovations have changed industry practice for good. Josephine Smit talks to those who led the way

CREDIT- Christian Smith - Nightingale Hospital Manchester 3

Source: Christian Smith

The Nightingale hospital in Manchester was just one of the pandemic projects where contractors adopted more collaborative methods to cut programme times

From 鈥淏uild back better鈥 to 鈥淣ever let a good crisis go to waste鈥, politicians and business leaders have no shortage of aphorisms and slogans to apply to new ways of working in the wake of the pandemic. While for many, changes in the way they operate have been driven by two years of abnormal trading conditions, enforced lockdown closures or large-scale working from home, some working in construction had a very different experience to draw on.

They are the consultants, contractors, specialists and suppliers involved in delivering pandemic-related facilities like Nightingale hospitals and testing facilities. While others temporarily slowed or halted operations, these businesses and individuals found themselves working harder and faster than ever to respond to the emergency. Within the common and familiar foundations of the ProCure22 framework and NEC3 contract, project participants excelled and innovated in their processes and practices to deliver what was needed.

The resulting projects have, in many cases, already been dismantled, but the ways of working adopted to deliver them have left their mark. Some project participants have developed new practices, while for others the experiences have confirmed the value of approaches promoted through reports ranging from Sir John Egan鈥檚 Rethinking Construction to the government鈥檚 current Construction Playbook. At the same time, projects have highlighted the gap between the everyday and best practice, giving the broader industry much to think about.

What鈥檚 best for the project?

With six Nightingales to its credit, interdisciplinary design consultant BDP was more involved than many in pandemic projects. The ProCure 22 framework meant the practice found itself working with partners it already knew from previous projects. 鈥淪o straight away there was almost an alliance approach, with people bringing the right skills to projects,鈥 explains Nick Fairham, chief executive of the practice and lead on its Bristol and Cardiff Nightingales. 鈥淲e knew how we worked, how the framework worked, we had a track record and a pre-formed team, so could hit the ground running.鈥 With the supply chain on board early, the architect could identify any challenges and design around them from the outset.

Nick Fairham 2

Nick Fairham

BDP鈥檚 Nightingale at the ExCeL Centre, in London, was the first of its kind and demanded prototyping to evolve requirements for medical processes such as 鈥渄onning and doffing鈥 鈥 putting on and taking off PPE. The practice prototyped the standard components for the London project and rolled successful options out across others.

The wider use of this kind of prototyping has been accelerated by the Nightingale projects, and is helping clients understand their options, as Fairham outlines: 鈥淎 client might say a bed space needs to be a certain size. We could say that would deliver 100 beds in a hospital but a compromise could deliver 150, and demonstrate that through prototyping. Suddenly you are in a dialogue where you are adding value through knowledge and innovation.鈥

This prototyping approach goes hand in hand with the practice鈥檚 use of technology to help people engage with design, which saw the company create QR code-accessible drawings of the 4,000-plus rooms of its new Grange University Hospital in Cwmbran.

Straight away there was almost an alliance approach, with people bringing the right skills to projects

Nick Fairham, BDP

Fairham describes the design and delivery process for the Nightingales as seamless, and something that is being enabled through digital engineering and Revit. The practice created a standard cubicle design, taking on board factors including space standards, work sequencing, materials specification, the equipment inside cubicles and their users. Now the firm is going further by looking at standardising processes and design components for new hospitals, taking on board efficiency, sustainability and whole-life value. Fairham explains: 鈥淲ith a digital engineering approach, 80% of a building is standardised 鈥 and that creates time and space to focus on the other 20%, the elements that have more engagement with the users and more risk.鈥

NHS Nightingale Emergency Hospital - Excel London

On the very first Nightingale, at the ExCeL Centre in London, BDP developed a prototyping approach that has now become more widespread in the industry

The practice is developing a suite of rooms via the New Hospital Programme, with the aim of ultimately creating around 70 standard rooms covering key elements. 鈥淚t鈥檚 a performance-based specification, so doesn鈥檛 preclude market competition,鈥 adds Fairham, who hopes this will ultimately become a tool for the industry.

With a digital engineering approach, 80% of a building is standardised 鈥 and that creates time and space to focus on the other 20% 

Nick Fairham, BDP

Above all, BDP鈥檚 experience on these projects has given it a new mantra in the question: What鈥檚 best for the project? 鈥淚f you think about that, it helps foster collaboration and innovation, and drives value for money. It鈥檚 something we鈥檙e using a lot more in terms of our terminology,鈥 says Fairham. The projects saw unified teams working towards common goals. 鈥淥ne lesson we鈥檝e learned is to have empathy for other people鈥檚 targets within a project,鈥 he adds. The shift towards NEC contracting is indicative of broader recognition of the benefits of collaboration, Fairham points out, and he sees that shift continuing with the NEC4 alliance contract, which is being used by the partners of Hallam Alliance 鈥 including BDP 鈥 on projects for Sheffield Hallam University.

Supporting stakeholders

Many of those involved in the pandemic healthcare construction projects talk of the unusual degree of empathy and collaboration engendered among clients and stakeholders, designers, delivery team and the supply chain. While the emergency situation and the intensity of working relationships were unique to the pandemic, the achievements have provided some food for thought for the construction industry. 鈥淲e always try to create a common goal, but working in the Nightingales gave a sense of purpose and buy-in right from the start of the project. The experience has made us more aware of the impact that can have,鈥 says Cheryl Parsons, health sector director at Kier Group.

Working in the Nightingales gave a sense of purpose and buy-in right from the start of the project. The experience has made us more aware of the impact that can have

Cheryl Parsons, Kier Group

Kier worked on the 300-bed Bristol Nightingale, created in a conference centre at the University of the West of England in just 20 days by a team also including BDP and Faithful+Gould. The contractor relied largely on familiar ProCure22 processes, templates and communication routes as the foundation of its working approach. 鈥淲e needed to fast-track every aspect of design and delivery, but underpin it with the certainty of tried and tested processes and procedures, to make sure we could deliver everything right first time,鈥 says Parsons. The firm brought in an experienced team and a supply chain with the right attitude and behaviours, because, she continues, 鈥淭he ability to problem-solve was key, to quickly assess solutions, particularly for their suitability for a clinical environment and their impact on the running of a live hospital.鈥

KIERNightingale Bristol Banner3 (2)

Source: Kier

At the Bristol Nightingale, Kier based its working approach on ProCure22 processes and templates so that it could fast-track every aspect of delivery while underpinning it with the certainty of tried and tested procedures

The Nightingales demonstrated the value of Teams and other digital platforms to provide ready means of communication and information-sharing, and to drive rapid decisions 鈥 which on the Bristol project often had to be made within an hour. 鈥淲e used digital platforms to ensure the whole client, design, delivery and supply chain had access to information immediately. As soon as a decision was made, everybody saw everything,鈥 says Parsons.

These tools are now helping not only to speed up decision-making but also to increase stakeholder engagement. 鈥淲e鈥檙e currently using the approach across a number of live schemes,鈥 she explains. 鈥淚t allows people to contribute at a time that suits them, which is important as our healthcare clients are often balancing huge pressures of delivering clinical services while making decisions on project designs.鈥

We used digital platforms to ensure the whole client, design, delivery and supply chain had access to information immediately. As soon as a decision was made, everybody saw everything

Cheryl Parsons, Kier Group

Parsons says Kier鈥檚 experience has given a deeper appreciation of client needs and so how to drive improved decision-making and solutions. 鈥淎 key lesson for us has been around supporting stakeholders so that they have the right level of information to make decisions and can understand their impact,鈥 she explains.

She sees many elements of the Construction Playbook in the approaches promoted to deliver the Nightingales, including the use of digital and technology, collaboration and early engagement and integration with the supply chain. With materials supply lines disrupted during the pandemic, early supply chain engagement became pivotal and allowed the contractor to pursue product-led design solutions. BDP鈥檚 standardised design for the Nightingale 鈥 and the how-to guide it created alongside this 鈥 was also a game-changer, paving the way for the contractor to add its own innovations, such as in establishing a near-site prefabrication area for services and bedhead trunkings.

In all, six contractors worked across the Nightingales 鈥 and they worked collaboratively with each other too. 鈥淲e were never in competition on individual programmes; we shared materials, managed the design team together and shared ideas. I鈥檝e never seen anything like that before,鈥 admits Parsons. 鈥淭he experience highlighted the benefits of the ProCure22 approach for delivery and is potentially industry-changing. I hope we can continue to build on it.鈥

Fundamentally changing the business approach

Pandemic projects have had a significant impact on modular solutions provider Premier Modular. 鈥淲e鈥檝e fundamentally changed our business approach and become a slicker business because of what we鈥檝e learned,鈥 says managing director David Harris. The firm was involved in two initiatives: the Nightingale Exeter and provision of 50 standalone covid test sites for locations from Portsmouth to Inverness. For the former, the firm worked with Bam Construction, Arup and T Clarke, providing a 1,700m2 modular building that wrapped around a former superstore to double its size.

Premier Modular Nightingale Exeter 0532

Source: Premier Modular

Working on the Nightingale Exeter caused Premier Modular to rethink its manufacturing flow, enabling it to produce about 20% more modules with the same capacity

To speed up manufacture for this and other projects during the pandemic, Premier increased work shifts in its production facility in east Yorkshire, recruiting an extra 50 staff, many of whom are still employees. The consequences of this and other changes were revealing. 鈥淲e now believe we can do about 20% more than we thought we could do through our factories, because we鈥檝e had to look at how we can change shift patterns and how we can change the manufacturing flow to give more output. It has given us further confidence in our capacity,鈥 says Harris.

We鈥檝e fundamentally changed our business approach and become a slicker business because of what we鈥檝e learned

David Harris, Premier Modular

Here, as in other pandemic projects, accelerated delivery also came from having clients and key stakeholders collaborating and empowered to make decisions on the spot, altering decision-making from a sequential to a parallel process. 鈥淥ne of the biggest issues for us is not the design but the people making decisions,鈥 says Harris. 鈥淚f you look at our business, we鈥檙e very flexible and well set up with lean manufacturing techniques, so once a decision is made we can manufacture very quickly. It is a matter of getting decisions early enough to get on and build.

Premier Modular Nightingale Exeter 2969-0151c

Source: Premier Modular

The hybrid build solution used at Nightingale Exeter showed how different skillsets can work together and the best solutions are not necessarily all traditional or all modular, according to David Harris of Premier Modular

鈥淭here鈥檚 no reason why this can鈥檛 happen in normal life. It鈥檚 less painful for everybody,鈥 he continues. The firm now uses this project example to promote the approach to clients, although this kind of streamlined decision-making, as advocated by the Construction Playbook, still presents challenges for many public sector clients, Harris believes.

I would say we probably secure 70%-80% of our work now at a much earlier stage than we would have two years ago 

David Harris, Premier Modular

Early engagement is critical for Premier and for offsite construction generally. 鈥淚 would say we probably secure 70%-80% of our work now at a much earlier stage than we would have two years ago,鈥 says Harris. It enables the company to add value in early design stages, which could include recommending a hybrid build solution, as used at Nightingale Exeter. 鈥淭hat showed different skillsets could work together and that the best solutions are not necessarily all traditional or all modular,鈥 Harris explains. 鈥淲e鈥檙e not precious about saying the whole scheme should be modular. These things have been quite eye-opening for us.鈥

Premier Modular Nightingale Exeter 0525

Source: Premier Modular

The Exeter Nightingale project highlighted the value of early engagement in offsite construction, which Premier Modular says enables it to add value in early design stages

Offsite construction has been given a boost by both covid and Brexit-related materials and labour supply issues. 鈥淚f you look back to covid, we didn鈥檛 miss a single day in the factory and all our sites continued. I think both clients and contractors have now realised the efficiencies they can get from offsite,鈥 says Harris. 鈥淭here has been a mindset change, where it is no longer about looking at traditional or modular construction, but at what delivers the best solution.鈥

Doing it right all the time

From design for manufacture to soft landings, the processes that were applied to deliver the Rosalind Franklin Laboratory in Royal Leamington Spa weren鈥檛 new, but they were best practice and, says Gary Clark, regional leader of science and technology at project architect HOK, they were done right all the time. 鈥淭he project has shown what is possible if everybody is putting their shoulder in,鈥 he says.

You need everybody to buy into it and accept there is going to be a no-blame culture 

Gary Clark, HOK

The megalab for processing covid-19 test samples was created in an existing warehouse by a project team that included Mace, WSP, Hoare Lea, GMP and Balfour Beatty, with the British Army Royal Engineers working with the NHS to facilitate delivery. Cutting a 30-month programme to less than a year meant accelerating the design and procurement process, with RIBA stages being overlapped. 鈥淣ormally it鈥檚 very difficult to broach that,鈥 says Clark. 鈥淵ou need everybody to buy into it and accept there is going to be a no-blame culture.鈥

HOK 2021-05-11_LabLines__210000-2

For this covid testing megalab in Leamington Spa, a 30-month programme was cut to to less than a year 鈥 this kind of accelerated process required adoption of a no-blame culture

A project charter set the culture, calling for openness and collaboration, as well as respectful challenging. 鈥淏ecause of the speed at which we were operating, you had to call out blockers 鈥 that could be people in terms of attitudes or the system itself 鈥 and there had to be root cause analysis to see what the blocker was. In the classic football analogy you had to play the ball and not the person,鈥 Clark explains. Root cause analysis and five-whys problem-solving were among the techniques deployed by Major Gary Jackson of the Royal Engineers to drive decision-making and were in themselves key lessons for Clark.

HOK 2021-05-11_WelfareSocial__20001

Root cause analysis and five-whys problem-solving were among the techniques deployed in developing the covid testing megalab in Leamington Spa

In practice calling out blockers was stressful, Clark recalls, but adds, 鈥淚t was a national emergency and that galvanised people to put aside personal issues.鈥 The levels of collaboration achieved on pandemic projects often proves more elusive within everyday construction, as Clark acknowledges. 鈥淚 start every project with the same mindset of being open and collaborative,鈥 he says. 鈥淏ut through the project everybody, especially in moments of stress, retreats into their own silos 鈥 and that鈥檚 where behaviours default and you end up in dispute.鈥 One solution, he believes, could lie in greater adoption of project-based insurance in the UK, to enable project partners, to 鈥渨ork together as a team, without having to worry about your insurance premiums鈥.

鈥淲e鈥檝e got to be honest and frank with each other,鈥 he continues. 鈥淲e did that on this project 鈥 we had a safe space to call people out and challenge each other in a collaborative way. Until we have open conversations where we can be constructive, we are doomed to repeat the same mistakes.鈥 It is perhaps the demonstration of interpersonal skills, such as empathy, openness and honesty, that provides the greatest lesson from the pandemic projects 鈥 and one that may also be most challenging to replicate in the future.

 

 

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