Delivering NHS Nightingale Hospitals, UK
Archus mobilised rapidly to help safeguard each Trust’s ability to care for all its patients during the first wave of the COVID-19 crisis. Embracing a ‘one team’ mentality and focusing on outcomes, the Nightingale hospitals were built collaboratively, efficiently and at speed. We helped to project manage the build phase, and gave technical assurance that the hospitals were safe to open from a construction and hard facilities management perspective.
The hospital is a testament to a phenomenal team spirit, to bold and creative leadership, and to a coalition of partners that ensured the very highest standards were maintained in the midst of a chaotic and high-risk environment.
Professor Jonathon Gray, Director of Innovation & Improvement, Cardiff & Vale University Health Board
Safeguarding capacity and a ‘one team’ mentality
The delivery of the NHS Nightingale hospitals safeguarded each Trust’s ability to care for all patients during the first wave of the COVID-19 crisis. The new temporary hospitals overcame short-term but very grave capacity challenges by increasing bed capacity, optimising patient flow and providing active treatment.
To deliver these in practice, the key challenge was simply the tremendous speed at which all project teams had to work. A ‘one team’ mentality was vital amongst partners. Across sites, this was forged by co-location, seven-day working, long hours and personal sacrifices with some members isolating from young families.
Developing national guidance
We worked closely with partners to produce national design guidance for NHS England & Improvement, including taking learning from the Nightingale experiences. The technical guidance style publication, ‘Standard Operating Procedure design note for Covid-19 patients requiring intubation’ was shared as the basis for all Nightingale facilities. This UK design guidance has also been transferred to other countries wanting to adopt a similar approach to COVID-19 field hospital design.
Archus also led the Technical Assurance team to review the approach taken to design derogation at each Nightingale site, working with NHS technical leads to provide final sign off prior to patient occupation.
We have been asked by NHS England and Improvement to make representation on clinical design planning for both COVID-19 and Post Pandemic. This includes several design themes, which will go into NHS policy and guidance going forward; and will form the blueprint for health and pandemic resilient hospital design for the future.
Ysbyty Calon y Ddraig, The Dragon’s Heart Hospital, Cardiff
The second largest temporary hospital in the UK, the combined team built a brand new temporary hospital and supporting infrastructure within The Principality stadium in just weeks. It is a ‘step-up and step-down’ hospital with patients requiring rehabilitation and support as part of their recovery and sadly for some, end of life palliative care. The hospital also included full radiology, laboratory space, a CT Scanner in lead-lined room, mortuary and oxygen tanks. At its peak the programme involved over 50 NHS staff, 600 contractors on site, and over 30 different companies delivering over 250,000 man hours.
Our health planners kept a consistent focus on patient experience and staff environmental considerations throughout. We worked closely with clinical staff to design with them, with patient rehabilitation spaces and staff rest areas given equal primacy with infection control and maximised bed space.
NHS Nightingale at The Excel, London
On the request of NHS England and Improvement, Archus made resource immediately available to help deliver the NHS Nightingale at the Excel Centre, London, in just three weeks. We responded within hours of the request to be on site to support project lead, Mott Macdonald, in the project management of the rapidly developed field hospital. Archus conducted surveys to determine safe and efficient locations of key equipment such as CT scanners, oxygen cylinders, mortuary vans, and drop off and collection of pathology samples. We worked to design the right level of staff change facilities, ambulance parking, as well as the logistics of medical procedures which were challenging without bedside decontamination facilities.
NHS Nightingale Hospital Northwest, Manchester
In Manchester, we supported the delivery of NHS Nightingale Hospital North West, a 633-bed facility in just two weeks. We worked alongside Mott Macdonald as part of the client-side project management team to help link the contractor delivery team and NHS project board. With the fast pace of delivery, we dealt with issues and changes on the ground, put necessary governance in place and ensured adherence, and provided a high level of stakeholder engagement with internal and external stakeholders including the Trust Board, Armed Forces, Public Services, Statutory Authorities, Contractors. We also ensured the project remained focused on objectives and key drivers to achieve the tight completion milestone.
Technical assurance for all NHS Nightingale Hospitals in Birmingham, Bristol, Exeter, Harrogate, London, Manchester, Sunderland
Archus worked closely with NHSE&I and each host Trust to ensure an appropriate level of compliance was in place prior to patient occupation, especially when considering the short design and construction timescales. Focus was given to each design and all associated derogations, ensuring the rapid timescales to deliver did not compromise patient and staff safety, nor the quality of the end product.
We were also asked to review the assurance of all sites which were required to be operationally ready as part of the second wave pandemic response.
Mark played a key role after he was thrust into the project with little notice and limited brief. He brought a positive and pro-active approach and developed strong relationships, grasped problems and drove the solutions so that the project could continue in line with the rapid programme.
Martyn Frackleton, Lead Project Manager, Mott MacDonald
