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Despite the billions of pounds ploughed into improving public services over the past 10 years, managing the budget continues to be one of the biggest challenges facing NHS Trusts up and down the country.

There can be no compromise in standards of patient care, so looking more holistically at ways in which they can manage their assets more effectively to achieve greater efficiency has become an important route to better financial health for many trusts.

In west Hertfordshire, a history of financial deficit going back to the early 1990s led to a reported deficit of 拢26.8m in 2005/6, with a total accumulated deficit at just over 拢41m. One of the main contributing factors to this deficit was inefficiencies caused by duplicating services across several hospital sites.

This financial situation and a drive to improve patient services led to a decision to centralise some services onto a single site.

Meanwhile, an ambitious NHS rebuilding programme means a new hospital will be completed at Watford General Hospital in 2014/2015.

The new Accute Admissions Unit (AAU) department at the hospital is a key element of both the centralisation programme and the redevelopment of the Watford Health Campus.

Due to open to patients in March 2009, the department has been developed using modular construction techniques that have not only ensured minimised disruption to the Watford Health Campus while construction was under way but also reduced the time and financial investment required to build this essential new facility.

Pod cast

In most circumstances, when the client requires a 鈥榖usiness-as-usual鈥� approach to managing a site while construction work takes place, even with creative scheduling of works, some disruption is inevitable. For Watford General Hospital however, the design-and-build scheme was developed so that the whole AAU Department construction programme entailed as little disruption as possible because the building was built not in Watford but in York.

Using modular building techniques, main contractor Yorkon prefabricated the department as 164 individual 鈥榩ods鈥�. The main fit-out work was pre-installed before the units were transported to Watford. Once the units arrived in Watford in early April, all that remained was for the construction team to bolt them together on site and complete the final fixes and finishes.

Fast and flexible

To carry through the time savings and financial efficiencies achieved by using modular techniques, the containment for the electrical installation was also completed off site in York. Two m&e consultants worked on the scheme 鈥� EDP for Yorkon and DSSR for the Trust.

However, the m&e contractor, Connect 2, was given free rein to select the most appropriate containment solutions to fit the brief, and it specified Cablofil steel-wire tray as the quickest and most cost-efficient method of cable containment available. This was used to contain the building鈥檚 voice, data, security, fire alarm and sub-mains cabling, alongside trunking and conduit containment for the unit鈥檚 general power requirements.

鈥淭he electrical services required in a modern health facility are complex,鈥� comments Phil Blackburn from Connect 2. 鈥淎s labour is often the biggest cost associated with any electrical installation, specifying a product that reduces the time the electrical contractor needs to spend on site can dramatically reduce costs.

Wire tray can reduce the time taken to install a cable management system by around one-third, as compared with perforated steel tray

鈥淚n our experience, wire tray can reduce the time taken to install the cable management system by around a third, as compared with perforated steel tray.

鈥淲hat鈥檚 more, because the product is flexible and can be cut, bent and fixed on site, the contractor doesn鈥檛 have to factor in additional time for delays while we wait for bespoke joins or angles to be prefabricated,鈥� says Blackburn.

Off-site solution

While the building was to be made up of 164 individual pods, these were open-plan structures, each 3.3 m wide, fitted together as entire floors rather than individual rooms. As a result, installation of the steel-wire tray had to reflect the scheme鈥檚 finished layout, while taking into consideration the need to transport the pods from York to Watford.

鈥淲hile we were working on installation of the containment in York the pods were erected floor by floor,鈥� explains Blackburn. 鈥淭his meant we were able to complete the containment work for each floor before moving on to the next.

鈥淲e had to ensure there were breaks in the containment at the same point as the divisions in the pods so that each floor could be broken down into pods and transported to Watford.鈥�

Cablofil was installed as vertical risers to carry services throughout the building, and on each floor the tray was installed in the ceiling voids. Connect 2 was able to standardise the product, despite differing ceiling void depths, by adjusting how high they set the runs of cable using Cablofil brackets.

鈥淏ecause we were using Cablofil tray to install a variety of services, we needed four runs of tray throughout,鈥� says Blackburn. 鈥淲e were able to install all four runs of the tray side by side within the ceiling voids using a single Cablofil bracket.

黑洞社区 for the future

With the pods prefabricated and the containment all completed before any construction work began on site in Watford, disruption to patients and staff at Watford General Hospital has been kept to a minimum throughout the project. The Connect 2 team followed the build to Watford, where the pods were reassembled in their permanent home in April.

All that remained for the contractor was the installation of all the wiring, and this meant that services were up and running by early September, leaving the way clear for final fixes and finishes and commissioning of the building.

鈥淚t鈥檚 been quite an odd way to work,鈥� adds Blackburn, 鈥渂ut it has made a lot of sense, especially for the Trust. In fact, the Trust is already thinking of commissioning an extension for the new building 鈥� and it鈥檚 not even open yet.

鈥淭he good news is that using a flexible system like Cablofil steel-wire tray means making changes to the containment to accommodate changes to the building will be one of the most straightforward elements of any future extension project.鈥�