Healthcare Property Issue 02 March-April 2024

03/2024
MARCH-APRIL 2024
The future of PFI — trusts told
to act now before it’s too late
NHS capital budgets must
double to protect the estate
Decommissioning medical gases
helps to drive carbon efficiencies
The evolution of healthcare
fencing design
HEALTHCARE-PROPERTY.COM

Comment
W E L C O M E
A new era for the
healthcare estate
Welcome to the second edition
of Healthcare Property magazine,
which comes at a time when the
spotlight is very much on NHS
budgets, particularly the lack of
capital in the system.
With a General Election
expected later this year, public
spending will be a key focus, and it
couldn’t come at a better time, with
recent ERIC data revealing the
cost to eradicate the current NHS
estates maintenance backlog is a
staggering £11.6bn — an increase
of 13.6% since 2021/22.
In contrast, the private healthcare
market has seen a growth in
admissions across all UK nations,
leading to increased investment in
real estate.
In this edition of Healthcare Property, we look at some
of the current trends, including coverage of Christie &
Co’s new Business Outlook 2024 report, which reveals
that rising operator optimism and increased activity are
fuelling interest in the sector.
And a new report from Knight Frank shows the
health and care property market is one of the fastestgrowing
across the globe, with private equity, REITS,
and institutional investors chasing the ‘strong, long
income’ generated.
You can also read about the Government’s pledge to
deliver more than 160 community diagnostic centres
(CDCs) as we ask whether these much-needed facilities
are having the desired impact on improving access to
healthcare services for patients.
According to the findings of the All-Party
Parliamentary Group (APPG)
for Diagnostics, there remain
key questions over their efficacy,
including concerns over location,
staffing, and data sharing.
Elsewhere, there is news of the
latest projects and information
on construction trends, including
digital adoption.
And features include work being
carried out to eradicate nitrous
oxide from hospitals, the evolution
of fencing design for healthcare
facilities, and the latest carbon
reduction efforts in the public and
private sectors.
The NHS is currently responsible
for 5.4% of total UK carbon
emissions, and with a net zero
target of 2040, work is underway to
improve energy efficiency and climate resilience.
This is driving a fresh approach to property
investment and development, as we head towards a
more-sustainable model.
With so many issues facing the sector, it is expected
that capital spending and real estate investment will
continue to dominate headlines, and this brings both
opportunities and challenges.
Throughout 2024 Healthcare Property will be
reporting on all of these issues, providing industryleading
insight and commentary, as well as showcasing
some of the innovations in products and services.
If you have any news or views to share with readers,
please contact joanne.makosinski@nexusgroup.co.uk
Jo Makosinski
Editor, Healthcare Property
About Jo: Jo is the editor of Healthcare Property, having
joined Nexus Media in November.
She has been specialising in design and construction
best practice within the health and care sector for the
past 14 years, working on the Building Better Healthcare
Awards and editing both Building Better Healthcare and
Healthcare Design & Management magazines.
She has a special interest in the design of mental
health and dementia care settings and in modern
methods of construction and energy efficiency.
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 3

Contents
Chief executive officer
Alex Dampier
Chief operating officer
Sarah Hyman
Chief marketing officer
Julia Payne
Editor
Joanne Makosinski
joanne.makosinski@nexusgroup.co.uk
Reporter and subeditor
Charles Wheeldon
Business development director
Mike Griffin
Advertising & event sales director
Caroline Bowern
Business development executive
Kirsty Parks
Sales manager
Luke Crist
Publisher
Harry Hyman
Investor Publishing Ltd, 5th Floor, Greener House,
66-68 Haymarket, London, SW1Y 4RF
Tel: 020 7104 2000
Website: www.healthcare-property.com
Healthcare Property is published six times a year
by Investor Publishing Ltd.
ISSN 3029-0627
© Investor Publishing Limited 2024
The views expressed in Healthcare Property
are not necessarily those of the editor or publishers.
6-9 News
We round up the latest big stories,
including new health and care
projects, the decision by the
Scottish Government to halt
hospital construction projects for
at least two years, and calls for an
increase in capital funding from the
NHS Confederation
10-11 Policy
Exploring whether NHS England’s
investment in 160 community
diagnostic centres is delivering on
its aims
12-19 Finance and
Property Deals
An overview of the key trends in
real estate financing for the health
sector, including new reports from
Christie & Co and Knight Frank,
plus we look at the future of PFI
as the health sector prepares for
contract expiry
22
20-22 Market Analysis
Architects and contractors turn
to technology to reduce the
environmental impact of projects
30-32 Estates and Facilities
Management
Special report on how making
improvements to medical gas
supplies can help hospitals to
reduce their carbon footprint
34
30
34-38 Environmental
Exploring the health sector’s net
zero carbon challenge and the
support available, including the
creation of Green Plans and the
expansion of the Swansea Bay
solar farm
@HCprop
linkedin.com/company/healthcare-property/
28
24-29 Building Design
Modern methods of construction
(MMC) underpin the creation of
the next generation of care homes,
plus we look at how the concept of
a ‘village campus’ is setting a new
benchmark for the future design of
mental health units
40
40-47 Products
How anti-bacterial surface
products are helping to reduce the
spread of infections in hospitals,
and why fencing design is evolving
to support safety and security and
enhance the healing environment
48-50 People
Staffing and people news,
including the latest appointments
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 5

News
Scottish government halts
healthcare construction
The Scottish Government
has ruled out new hospital
construction projects until
2026 at the earliest, it has
been reported.
NHS Lothian finance director,
Craig Marriott, said ministers
north of the border had told
local health chiefs they would
be waiting ‘at least’ two years
for any estates improvement
works, potentially putting jobs at
risk and severely disrupting the
supply chain.
Daily Business reports that
letters have been sent to project
managers, building firms,
and architects outlining the
clampdown, which will also
affect NHS activities and staff.
The decision follows cutbacks
announced in December’s
Scottish Budget.
Sources say a number of firms
and recruitment agencies have
been forced to withdraw job
offers made to candidates linked
to a number of developments
which will now not go ahead.
Daily Business contacted one
health board, NHS Lothian,
whose director of finance, Craig
Marriott, issued a statement
saying: “New construction
projects are dependent on
approval and funding from the
Scottish Government.
“Following the Budget
announcement in December,
the Scottish Government
advised NHS boards to
immediately stop any project
development spend as the
Scottish Government does not
anticipate starting construction
of any new capital projects over
the next two years at least.
“Staff and partners are being
made aware of the current
picture and will be kept
updated.”
But sources say that some
big developments, including
Image: 652234 from Pixabay
some that are well advanced,
will go ahead, such as the
new Monklands Hospital in
Lanarkshire.
A Scottish Government
spokeswoman issued a brief
statement on the health board
letters, saying: “This is not for
the Scottish Government to
comment.”
Kier to deliver £60m mental health hospital
Kier has been appointed
by the Sussex Partnership
NHS Foundation Trust to
deliver a new £60m 54-bed
acute inpatient mental health
hospital in Bexhill as part of
its Re-designing Inpatient
Services in East Sussex
(RIS:ES) Programme.
This is the first step in the
RIS:ES Programme, which will
bring all mental health inpatient
services across East Sussex
together on a single site.
The new 57,393sq ft facility
will replace outdated services
currently provided in the
Department of Psychiatry at
Eastbourne District General
Hospital.
There will be three 18-bed
wards, all with individual
bedrooms and ensuite
bathrooms, surrounded by
attractive and therapeutic
landscaped green space.
The new building will also
provide outpatient services
as well as training facilities
for medical and other related
professions.
And it will be fully electric and
highly insulated, with energyefficient
systems implemented
to reduce energy usage
and optimise environmental
performance, including solar
panels and a range of electric
vehicle charging pointspoints.
In addition, the car park has
‘rain gardens’ that collect the
surface water run-off, filtering it
into a storm water attenuation
tank before it is discharged
directly into the ordinary
watercourse.
6 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

News
Contractor appointed
for community diagnostic
centre project
Morgan Sindall Construction has been
appointed to create a new Community
Diagnostic Centre (CDC) at St Margaret’s
Hospital in Epping.
Commissioned under the ProCure23 (P23)
framework for the design and construction
of NHS capital projects, the CDC is the main
aspect of three streams of work the tier one
contractor is delivering for The Princess
Alexandra Hospital NHS Trust (PAHT).
This phase of the project is to be
completed in 2025, with plans for further
services on the site to be confirmed.
The work will significantly improve access
to important healthcare equipment and
skills, shortening the amount of travel time
for NHS patients in the area.
In phase one, Morgan Sindall will refurbish
and add an extension to a bungalow on the
St Margaret’s Hospital site.
PAHT has been allocated over £14m for
this project, which will enable the buildings
to house MRI scanning facilities as well as
outpatient services.
QUICKER CARE
This will be one of approximately 30 new
centres in the UK, which are part of a
government initiative following the COVID-19
pandemic to move diagnostics out of acute
hospitals and into community sites to provide
easier public access and earlier diagnosis.
As part of its Intelligent Solutions approach
to construction, Morgan Sindall will utilise
its digital carbon analysis tool, CarboniCa,
during the project. This will inform carbonrelated
decisions throughout the design and
construction phases to minimise emissions
and ensure the building is as sustainable as
possible.
By retrofitting existing buildings, rather than
creating new ones, PAHT is significantly
reducing its carbon footprint by avoiding the
materials, waste, and resources that a newbuild
development would incur.
Morgan Sindall will also be working with the
trust to deliver important refurbishment work
at The Princess Alexandra Hospital in Harlow.
This will include ward refurbishments and
upgrades to key areas, which will ensure
that the site continues to operate at a high
standard until it is replaced by the new
hospital.
Peter Whitmore, managing director for
Morgan Sindall Construction’s East region,
said: “The new West Essex Community
Diagnostic Centre will bring a wide range
of crucial healthcare benefits right to the
doorstep of the community.
“To ensure that this project provides as
much value as possible for the local area,
we have been collaborating closely with
The Princess Alexandra Hospital NHS
Trust to create a new facility that will meet
the multifaceted needs of the trust and its
patients.
SUPPORT
“Bringing our expertise in constructing
medical environments, as well as in creating
sustainable spaces and generating social
value, means that this new site will be helping
to support future generations in a wide
variety of ways.”
Michael Meredith, director of strategy and
estates at the trust, added: “The Community
Diagnostic Centre at St Margaret’s Hospital
will support us to provide modern, integrated,
and outstanding care to our local community.
“We will be able to provide quicker access
to diagnostic tests, closer to our patients’
homes and are focused on having our
patients at the heart of our services, with
new and enhanced ways of working and
providing care.”
Now in its fourth generation of NHS
England’s route to market for the provision
of design and construction services to NHS
capital projects, the P23 framework is part of
the CCS CWAS2 procurement framework.
This ensures that NHS capital works
adopt the principles of the Government’s
Construction Playbook, modern construction
on delivery, and a focus on sustainability and
social value.
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 7

News
Mental health boost
for Nottingham trust
Tilbury Douglas has completed
construction of Tall Trees and the Glade
at Highbury Hospital for Nottinghamshire
Healthcare NHS Foundation Trust.
This includes a refurbishment and
reconfiguration of Tall Trees, an existing
two-storey building, providing office
accommodation with meeting rooms,
breakout areas, meeting spaces, and staff
amenity/rest facilities for the trust’s mental
health crisis teams.
The second project, The Glade, is a
refurbishment and new-build extension to
provide a new mental healthcare outpatient
facility comprising consultation rooms,
group activity rooms, reception, a waiting
area, and staff facilities.
Works also include a new fenced garden
for service users.
And the handover also marks the first
anniversary of Sherwood Oaks Hospital, a
5,000sq m complex refurbishment project
with new-build extensions.
Spread across three blocks, two of which
house four wards and one comprising an
administration area, the new site provides
Mental health construction
reaches key milestone
A £29.3m mental health hospital for older
adults in Walsall has reached a significant
milestone in its build.
A water-tight ceremony has taken place at
the site of the new and improved hospital,
which is a tradition in the construction
industry to mark the point when the
building’s exterior has been completed and
is protected against the elements.
Staff from Black Country Healthcare
NHS Foundation Trust were joined by
colleagues from the project team, including
Kier Construction, Archus, and Gilling Dod,
who gathered to celebrate the important
milestone.
The project includes the construction
of two ground-floor wards with ensuite
accommodation, flexible therapy space, and
an outdoor garden area.
As well as providing a modern, safe
environment, the build also has a focus on
energy-efficient design and will have a small
number of electric car charge points, a first
for the trust.
Jeremy Vanes, chair of Black Country
Healthcare NHS Foundation Trust, said: “We
are delighted to have reached this important
milestone in the journey to move patients
and services to the new and improved
hospital.
“It is great to see our plans beginning to
take shape and see the progress that has
been made.
“This build is a significant investment in
modern health facilities for the care of
around 70 patients.
The Sherwood Oaks project generated
£6.5m of social value investment back
into the community, with particular
emphasis on skills and opportunities.
Alongside work placements and
employment for local people, the project
team engaged local businesses, with 64%
of the supply chain being sourced locally,
upholding Tilbury Douglas’ commitment
to enhancing local economy spend across
its projects.
older adult mental health services in Walsall
and will improve the care and experience
for patients in hospital and we are looking
forward to the final phase of the build and
developing plans for when we are ready to
welcome staff and patients safely on site.”
The hospital is due for completion in
summer 2024.
8 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Doubling the NHS capital budget
News
NHS capital budgets must double to
ensure the delivery of fast and moreeffective
patient care, according to
analysis from the NHS Confederation.
The organisation’s Investing to Save:
The Capital Requirement for a More
Sustainable NHS in England report claims
a further £6.4bn of capital funding must be
committed through all three years of the
next Spending Review — totalling £14.1bn
a year — in order to address the mounting
backlog maintenance crisis across the NHS
estate.
The money will also help with the
refurbishment of dilapidated buildings,
upgrading of equipment, and an increase in
staff productivity, the report states.
Chief executive of the NHS Confederation,
Matthew Taylor, said: “Some of our members
have parts of their estate that are barely fit
for the 19th Century, let alone the 21st, so
any future Secretary of State for Health and
Social Care must make the physical and
digital condition of the NHS a priority if the
health service is to reduce backlogs and get
productivity levels to where the Government
wants them to be.
“Lack of capital across different care
Image: Michal Jarmoluk, Pixabay
settings, covering digital and physical
infrastructure and mental and physical
health, is clearly not just leading to missed
opportunities to improve productivity, but
actively undermining it and causing patient
safety issues.
“Health leaders across England have
endless ideas about how capital funding
could drive large productivity increases.”
He added: “Equipping staff with the right
tools, and allowing them to operate in
safe, modern, optimised environments will
improve efficiency, meaning an increase to
the capital budget will help limit the need for
growth in revenue spend, relieve pressure
on wider NHS finances and services, and
put the NHS on the path to longer-term
financial sustainability.
“This will require a significant increase
to the NHS capital budget to make up for
years of underresourcing and repeated raids
on capital that has left much of the estate
broken.
“Based on the assessment of health
leaders, this will need to be an increase
of £6.4bn to take the capital budget to
£14.1bn for each year of the next spending
review in order to fully address the repairs
backlog and realise some of the innovative
transformation projects which have
previously fallen by the wayside.
“The next government must grasp the
nettle.”
Also identified in the report is the fact that
health leaders across the country have ideas
on how care can be improved. However,,
these innovative plans are being delayed
due to a lack of funding.
Planned care centre under development
Tilbury Douglas has been
appointed to lead the
construction of the East
Midlands Planned Care
Centre (EMPCC) on behalf
of University Hospitals of
Leicester (UHL) NHS Trust.
The centre is one of the
most-significant capital
developments at UHL in recent
years and comprises the total
refurbishment of the former
Brandon mental health unit,
a three-storey building on the
Leicester General Hospital site
which has stood empty for over
10 years.
Under the scheme the space,
dating back to 1977, will be
transformed into an exemplar
planned care hub to help the
trust tackle waiting lists for
planned procedures.
The project includes external
fabric upgrades, with new
wards, theatres, treatment
rooms, and support spaces
planned internally.
Partnering with Tilbury
Douglas Engineering, the
deliverables will include new
plant rooms and boosted
water tank installation, which
alongside a replacement roof
and more than 700 replacement
windows and doors, will
contribute to the building’s ‘net
zero carbon ready’ strategy.
Simon Butler, regional building
managing director for the
Midlands at Tilbury Douglas,
said: “We are proud to be
selected to deliver this important
scheme, which aims to provide
additional capacity for elective
procedures for Leicestershire.
“This should enable the
further reduction of waiting lists
within the region and allow for
improved patient care.”
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 9

Policy
In 2021 the Government announced
a £350m investment in 40 new
community diagnostic centres (CDCs)
across England, part of a drive to reduce
waiting times, cut down on the number of
patients having to visit hospital sites in the
aftermath of the COVID-19 pandemic,
and achieve earlier diagnoses for major
health conditions.
Initially proposed in Professor Sir Mike
Richards’ report, Diagnostics: Recovery and
Renewal, the one-stop shops for checks,
scans, and tests aimed to deliver 2.8 million
additional appointments in the first year of
operation.
The following year the Government
announced plans for an expanded network
of 160 centres, supported by the largest
central cash investment in MRI and CT
scanning capacity in the history of the
NHS.
And, in October 2023, the Department
Image: Dmitriy Gutarev from Pixabay
Care closer
to home?
Exploring whether NHS England’s investment in 160 community
diagnostic centres is delivering on its aims
of Health and Social Care revealed it was
on track to deliver the facilities a year ahead
of the 2025 deadline.
But, has the programme achieved what it
set out to do?
SHORTFALLS
In January of this year, the All-Party
Parliamentary Group (APPG) for
Diagnostics published the findings of
an inquiry into CDCs, and it raises key
questions about their efficacy, particularly
around location, staffing, and shortfalls in
technology adoption and data sharing.
The report reveals that NHS England
and the Government have made strides in
delivering the programme, so far approving
174 CDC sites and opening one in each
Integrated Care System (ICS).
However, it reveals concerns over
‘unequal’ geographic distribution and
funding constraints for future expansion.
NHS budget deficits,
high upfront costs,
and risks with
privately renting
retail spaces limit
CDC placement in
community hubs and
overcoming these
obstacles is crucial
for ICSs to make
the brave choice of
placing CDCs where
they can significantly
impact community
healthcare.”
“Analysis of CDC activity reveals a slow
pace, with only around five million tests
conducted since July 2021 against a target
of 17 million by 2025,” it states.
“Collaboration with the private sector
has expanded services, but persistent
high demand and limited capacity pose
ongoing challenges, emphasising the need
for continuous scrutiny and transparency
from NHS England to assess the impact on
patient outcomes.”
A major stumbling block has been the
location of the centres.
Initially, the aim of the programme was to
enhance diagnostic capacity in underserved
communities and enable access to services
outside of acute hospital sites.
CLOSER TO HOME
It was intended that the clinics would
be sited in a range of easily-accessible
community-based settings such as local
shopping centres and football stadiums.
But, in reality, a large number have been
co-located on existing hospital sites.
The APPG report states: “Questions
remain over how many CDCs are truly
community based, with 5.2% and 41%
of approved CDC sites located on acute
10 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Policy
Turner Diagnostic Centre, Colchester, Essex
hospital and community hospital estates
respectively.
“NHS budget deficits, high upfront costs,
and risks with privately renting retail spaces
limit CDC placement in community hubs
and overcoming these obstacles is crucial
for ICSs to make the brave choice of placing
CDCs where they can significantly impact
community healthcare.
One of the driving forces behind
the decision on location appears to be
workforce planning.
The report reveals: “Ongoing staff
shortages, demonstrated by shortfall figures
and reports of unmanageable workloads,
compounded by insufficient workforce
planning and funding, limit CDC
effectiveness.
RECRUITMENT
“Proposed workforce solutions include
acute/CDC rotation models, international
recruitment, ‘grow your own’ initiatives,
and private sector collaboration, each with
its own advantages and drawbacks.
“Ultimately, there is an urgent need to
expand the diagnostic workforce in line
with growing patient demand.”
The Royal College of Radiologists found
that 89% of CDCs are staffed by existing
trust employees and warned that rotating
staff between the CDC and acute hospital
sites may be diluting capacity in both
settings.
However, the study also found that,
positively, CDCs may also be contributing
to the retention of existing staff, with
feedback revealing CDCs provide ‘a
positive environment’ with ‘better working
hours’.
Responding to APPG report’s findings,
Charlotte Wickens, policy adviser at health
think tank, The King’s Fund, said: “The
programme has a wider ambition to deliver
diagnostics differently, in a way that tackles
health inequalities and moves access to
diagnostics into underserved and deprived
communities.
“This means the location of the CDCs is
also crucial.
“While it might make sense to co-locate
CDCs with existing NHS facilities, there
are also benefits to having these centres
embedded in the community.
“The Government’s announcement that
it will speed up opening 160 CDCs by
March 2024 is a good thing for capacity
in the NHS, but it is important that
this increased pace does not eclipse the
ambition for the new centres to improve
access for underserved communities.”
HIGH COST
She added that setting up CDCs outside of
the NHS estate is expensive.
“Upfront costs are high and there are
risks associated with using space let by
private landlords, while there is also the cost
of relocating and maintaining equipment,”
she told Healthcare Property.
“And, given the finite pot of funding
allocated for the rollout of CDCs, and with
all integrated care boards reporting deficits,
it is hard to see that the risk and long-term
financial commitment associated with
locations such as shopping centres could be
justified going forward.
“This may result in most CDCs being
located on existing NHS estate, potentially
preventing them from addressing health
inequalities and access issues as originally
intended.”
UNDER SCRUTINY
The type of services being delivered within
the hubs is also coming under scrutiny.
“CDCs provide essential diagnostic
services, encompassing imaging,
physiological measurement, and pathology
to meet high healthcare demand,” says the
APPG report.
“Additional services, tailored to meet
local needs, have, and should, be integrated
Image: Darko Stojanovic from Pixabay
to establish CDCs as true ‘one-stop shops’
for patients.
“Unfortunately, a lack of data and
research limits the assessment of the
programme’s effectiveness in achieving this
goal.”
Although the CDCs are equipped
with up-to-date diagnostic equipment,
the report calls for increased adoption of
technology to fully realise the ambitions of
the programme.
“Digital tools, such as the iRefer tool
and NHS App, are vital to streamlining
diagnostics, improving efficiency and
patient engagement,” it adds.
PRIVATE PROVIDERS
“Unfortunately, despite pilot projects
showing significant benefits, challenges
in basic infrastructure, data sharing, and
inconsistent digital advancements persist,
underscoring the need for additional
funding for robust digital infrastructure.”
In response to the criticisms, the
Government and NHS England has set out
an ambition to increase use of independentsector
capacity.
At least eight of the final wave of
CDCs, announced last August, will be
independently run, functioning like
NHS-operated facilities, but staffed by
independent-sector employees, with the
private provider also owning the building.
Companies signed up to deliver services
include InHealth, which is delivering
CDCs in a number of locations, including
Greater Manchester, Bristol, Ealing,
Bicester, Liverpool, Ipswich, and Milton
Keynes; and Alliance Medical, which
created the country’s first CDC and now
operates a network across the country. n
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 11

Finance and Property Deals
Life after PFI
Health trusts operating PFI-funded estates are being urged to act
‘before it is too late’ as the controversial contracts near the end of
their lifespan
NHS organisations operating PFIfunded
estates are being urged
to act ‘before it is too late’ as the
controversial contracts near the end of their
lifespan.
The Infrastructure and Projects
Authority’s (IPA) 2022 report, Preparing
for PFI Contract Expiry, recommended that
trusts take the next steps at least seven years
prior to contract expiry.
That means hundreds of organisations
will need to take action now to prepare for
handback and decide how they will fund,
operate, and maintain their estate moving
forward.
And, as many Private Finance Initiative
(PFI) contracts also covered the delivery
of hard and soft facilities management
(FM) services, there will also need to be
discussions on how these will be provided
in the future.
LONG-TERM VISION
Government figures from 2018 show
the value of the initial investments was
£12.8bn, but the Department for Health
and Social Care will have spent a total of
£80.7bn once they are all paid off.
The long-term contracts — which often
spanned a period of up to 30 years — were
signed between the NHS and a private
sector consortium, typically a specialpurpose
project company, and meant the
private sector designed, built, financed, and
operated the asset and related services.
Under the contracts, the private party
bears the risks associated with construction
and maintenance and management
responsibility, and remuneration is linked
to performance.
There are currently over 120 PFI projects
in NHS England, with contracts varying in
size, but most including the delivery of hard
and soft FM services such as maintenance,
portering, cleaning, and catering.
The first deal was signed in July 1997 and
successive waves followed until, in October
2018, the Government announced it would
no longer support the model.
PLAN AHEAD
But now trusts which have operational
PFIs need to begin planning for the future,
ensuring their estate is handed over in
tip-top condition and either finding the inhouse
expertise to take over operations, or
opting for a new public/private model.
The National Audit Office (NAO) found
in its June 2020 report on PFI contract
expiry that public sector bodies risk
underestimating the time, resources, and
complexity involved in managing the end of
PFI contracts.
Matthew Vickerstaff, deputy chief
executive of the IPA, said: “The expiry
phase of PFI contracts, including asset
handback and the transition to future
services provision, presents additional risks,
including potential operational disruption,
lack of service continuity, financial loss, and
reputational damage.
“The effective management of the
expiry process is therefore of particular
importance.”
The report adds: “The IPA expects that
senior leaders will commence planning for
PFI expiry at least seven years prior to the
contract end.
“Early, but cost-effective steps will need
to be taken to increase awareness and active
management of the contract in advance of
expiry to understand the assets, systems, and
people involved in the exit and transition
process, build supportive relationships with
other parties, and obtain information from
the PFI project needed to shape and plan
the future provision of services.
MANAGING RISK
“Significant risks will need to be managed,
diverse expertise and resources will need
to be applied, and additional budgets will
likely need to be made available.
“What is certain is that the whole
expiry process will require more, and
different, senior management support
than is currently being provided to the PFI
project.”
The IPA guidance is supplemented by an
expiry toolkit, which provides additional
tools and materials to support authorities in
managing expiry.
But what is next for these hospitals?
NEXT STEPS
Speaking to Healthcare Property, Alison
Martin, legal director and PFI specialist in
international law firm DAC Beachcroft’s
infrastructure and projects team, explained:
“For the past 30 years a large number of
hospitals have been provided via PFI and,
from 2030, a lot of those contracts will
expire.
“With the IPA guidance recommending
planning for expiry seven years out, now is
the time for those trusts to start preparing
for handback and expiry, and planning
what is coming next.
“This will be critical for the NHS in
terms of ensuring service continuity and
delivery of its healthcare estate.
She added: “It is not yet clear what a
successor model for PFI might look like.
It could be a centrally-driven standardised
approach, or trusts may be allowed more
flexibility to design their procurements at
12 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Finance and Property Deals
Alison Martin
a local level. It could also look at bringing
it back in-house, but this could present
potential resourcing issues in terms of
capacity and capability.
“In my view, the private sector will
continue to play a part in the NHS estate,
particularly in the provision of hard and
soft FM services — it’s just what model that
will look like.
“Certainly value for money will be key
and any replacement will have to be more
balanced and focused on value rather than
pushing the risk to the private sector.”
KNOW YOUR RIGHTS
Key to the handback will be clarity as to the
required condition of the buildings and the
respective rights and responsibilities of the
parties under the PFI contract.
Martin said: “The NHS can’t make
strategic plans for taking these buildings
back unless it knows what condition they
are in, what condition they are meant to be
in, and what is coming next.”
But, threatening to hamper this process,
are disagreements as to the condition of the
assets and the often-frosty relationships that
have grown over time between some NHS
organisations and their PFI providers.
Stan Campbell
Significant risks will need to be managed,
diverse expertise and resources will need to be
applied, and additional budgets will likely need
to be made available.
Martin explains: “A number of public
authorities have been accused by the
private sector of taking overly-draconian
enforcement measures under the PFI
contract — often in an attempt to maximise
the level of deductions that can be made
for poor performance under the payment
mechanism.
“In turn, concerns with the private sector
approach have been cited.
“Together, these are said to have driven
behaviours, antagonised relationships, and
led to a rise in disputes.
“A priority will be to restore those
relationships going into the handback
process.”
PUSHING ‘RESET’
She added: “We have seen a number of
NHS PFIs adopt the ‘reset’ approach
recommended in the recent White Fraiser
Report, with a view to restoring the
goodwill between the parties.
“The ‘reset’ approach gives them an
opportunity to improve and assure
performance of their PFI contract now,
rather than waiting until the contract is due
to expire.
“It provides for the carrying out of
an audit of the PFI contract (by way of
surveys), and gives the PFI provider a timelimited
period within which to rectify any
issues identified without threat of being
penalised under the contract for noncompliance.
“Despite its critics, there are some merits
to the PFI model, which have helped
transform the healthcare estate over the
years, albeit not without cost.
“But, ultimately, handback will be used
to measure its success and it will take
collaboration between the parties to agree
on what that ‘success’ looks like.”
CUTTING EDGE
Stan Campbell, partner and health property
lead at DAC Beachcroft, concludes: “Some
of the PFI hospitals are still very cutting
edge, but the perception of the associated
cost was a problem — stories of companies
charging £40 to change a lightbulb eroded
public opinion.
“Many also held the view that PFI
effectively privatised part of our beloved
NHS.
“Within the private sector, there appears
to still be an appetite for investing in the
NHS estate and a group of investors who
want to do well by ‘doing good’.
“We don’t quite know what the future
will hold, but to ensure there is sufficient
capital investment in NHS infrastructure,
the NHS needs to consider what will
replace the PFI model.
“It also needs to start conversations
with existing providers now to make
sure the estate it gets back is the one it
paid for.” n
Within the private sector, there appears to still
be an appetite for investing in the NHS estate
and a group of investors who want to do well
by ‘doing good’
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 13

Finance and Property Deals
Richard Lunn
The state of real estate
Christie & Co’s new Business Outlook 2024 report reveals the opportunities and challenges within
the health and care real estate sector
Rising operator optimism and
increased activity are fuelling
interest in the healthcare property
sector, according to a new report from
Christie & Co.
Its Business Outlook 2024 report reflects
on the themes, activity, and challenges of
2023 and forecasts what 2024 might bring
across key industries, including the health
and care sector.
And it reveals that 2023 was a year
of consolidation, with the majority of
operators reporting that occupancy had
returned to pre-pandemic levels.
Staffing issues eased slightly due to the
successful recruitment of foreign staff via
the sponsorship licence, although this may
be impacted by recent immigration policy
changes.
But the demand for bed spaces remained
high, particularly for dementia care places,
and fee increases predominantly kept pace
with inflation.
KEEPING PACE
The report also reveals that the
transactional market adjusted to an
environment of significantly-higher
interest rates, placing greater emphasis
on debt serviceability, with a 14% rise in
completions in 2023 compared with 2022.
However, wider cost pressures had a
significant impact on providers of smaller,
converted care homes which do not have
the economies of scale and are less energy
efficient.
This increased the rate of care home
closures at a time when demand for bed
spaces should be increasing.
Consequentially, the proportion of
closed care homes Christie & Co sold in
2023 increased to represent 19% of its deal
volumes, compared with 13% in 2022.
And this trend is interesting as new-build
developments are not keeping pace with
closure rates.
The number of distressed sales also
increased, with Christie & Co noting a 7%
rise in 2023.
Positively, though, the company did not
see a material deterioration in asset values
for going-concern deals — noting a 0.4%
decrease in its annual price index, and
the performance of the sector fared well
compared with other asset classes.
The development market faced stronger
headwinds due to construction cost
14 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Finance and Property Deals
Good levels of
demand and a
limited availability
of stock enabled
pricing to hold up
well and, moving
into 2024, we are
positive about the
prospects for the
year ahead
Image: Gundula Vogel from Pixabay
inflation and the availability of debt.
However, the need for futureproofed
care beds remains undiminished and the
underlying ESG credentials, together
with future bed demand needs, remain
compelling for investors.
THE SURVEY SAYS
As part of its annual sentiment survey, the
company surveyed healthcare professionals
across the country to gather their views on
the year ahead.
And 48% said that they feel positive
about the year ahead — a 14% rise on
survey figures reported in the previous year
— while just 9% feel negative.
When asked about their sale and
acquisition plans in 2024, 77% said they are
planning to buy and/or sell this year.
Demand for dementia care beds remains high. Image: Gerd Altmann from Pixabay
FINANCE
The care sector continues to be well
supported by both traditional and
alternative funders; with the level of
finance Christie Finance generated for its
clients having increased by 28% between
2022-2023.
Income potential and cashflows were seen
as particularly reliable due to the sector’s
needs-driven nature. However, there are
now more intense audits, assessments,
and monitoring from lenders around how
operators will manage the impacts of the
rising cost of living and increase in debt
costs on their business.
In 2024, Christie Finance is hoping
for a more-stable economic environment
which, when combined with currentlyreducing
inflation and the increased cost
of living mostly now absorbed by
operators, should lead to a more fluid
finance market.
PREDICTIONS
In 2024, Christie & Co expects:
• Capital values will remain stable with
strong occupancy levels and investor
demand offsetting higher debt costs
• Capital markets activity will increase
with a more-stable interest rate
environment
• An increased number of OpCo
transactions as operators seek to expand
their portfolios without tying up capital
in real estate
• Growing distress for smaller assets with
rising staffing and capital costs, largely
driven by the increasing minimum wage
• New-build development activity will
increase across broader geographical
regions as operators seek less-competitive
operating markets
• Ongoing rationalisation from larger
providers and third-sector providers
• Continued protractions and uncertainty
in the planning system will constrain
the supply of consented care home
development sites
Richard Lunn, managing director of care
at Christie & Co, said of the findings:
“Despite the undoubted economic
headwinds, the care sector remained
resilient through 2023.
“Good levels of demand and a limited
availability of stock enabled pricing to
hold up well and, moving into 2024, we are
positive about the prospects for the year
ahead.” n
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 15

Finance and Property Deals
Giving something back
Matt Small, director of T150 Energy, reveals his plans to pass energy
savings onto clients in the care sector
An energy broker is offering care home
operators the chance to recoup some
of their gas and electricity costs as
part of an innovative new ‘payback’ scheme.
Matt Small, director of T150 Energy,
has revealed plans to launch the initiative,
providing care sector clients with between
0.2-3.5% of their energy savings back.
Matt explains:
“Businesses could
receive between 0.2%-
3.5% of their annual
gas and electricity
costs, depending on a
number of factors.
“Now, I appreciate
that 0.2% as a
minimum does
not sound like a
Matt Small, director
of T150 Energy
lot. However, if
you consider the
average care home
may use 100,000 kWh — and I think this is
conservative — per year on electricity alone;
collectively, we could put a lot of money back
into the industry.
“There are 16,700 care homes in the UK
and based on the average usage of 100,000
kWh per year, this gives an average use of
electricity alone of 1,670,000,000 kWh per
year.
“If we could get even 1% of this number
onto our payback scheme this could be
between £17,000-£244,237.50 going back
into UK care homes on a yearly basis; and
that’s just the electricity.
“Based on the above figures, gas could
put between £17,000-£146,542.5 in payback
as well.
“And, if care homes have charitable status,
the payback amount could be given as a
charitable donation and would, therefore, not
be taxable. It’s a win-win situation!”
Staffordshire-based T150 Energy launched
in 2019, shortly before the Coronavirus
outbreak, and works across a number of
sectors, from care homes and educational
institutions to hospitality and manufacturing
businesses.
Coming from a background in telecoms
and a career in the Armed Forces, Matt
brokers energy deals between businesses
and some of the top energy providers —
including British Gas, Opus Energy, YGP,
I am well aware of how woefully underfunded
these sectors are and as I work with operators
I really wanted to give something back.
engie, Dual Energy, npower, Scottish Gas,
SSE, and Gazprom.
And, with energy prices continuing to soar,
and the care sector feeling the pinch, he is
keen to give something back.
The idea of the payback scheme came when
he attended The National Care Awards last
November, an event operated by Healthcare
Property publisher, Nexus Media Group.
Matt explains: “At the awards I was
speaking to operators and care home
managers and they were talking about the
work they are doing.
“The idea came to me that night and the
next day at The Care Managers Show, I was
wondering how I could help and what I could
do that is different.
“I work with partners who bring me
business and I pay them commission for
bringing me their clients, so I thought why
don’t I do the same for care homes?
“The following day I looked at a few figures
and started doing the maths.
“One care home operator I had spoken
to had 92 care homes. This would mean a
potential payback of £180,000 on electricity
alone.”
He added: “My goal for this year is to put
back £1m to businesses within the care sector,
including care homes and nurseries, as well as
other charities; and the only way I can do this,
is by being put in front of the right people.
“I want to start giving back more than
hopefully savings on their existing rates — I
want to give them part of the money we make
as a business.”
The health and care sector is particularly
close to Matt’s heart after he underwent
emergency brain surgery three years ago
following a diagnosis of a colloid brain cyst,
which was causing deadly hydrocephalus.
He said: “It was an interesting period,
coming out of COVID and leaving another
industry, then walking into the crisis in
the Ukraine, when energy prices rocketed,
putting many businesses in difficult times.
“I am well aware of how woefully
underfunded these sectors are and as I work
with care home operators I really wanted to
give something back.
“I want people to want to work with me
because, 1. I’m great to work with, and 2.
Because, where possible, I will give them
something back.” n
For more information on the payback
scheme, go to www.paybackscheme.co.uk.
Businesses could be paid back up to 3.5% of their annual energy costs
Energy Usage
per year (KWH)
Approximate
Annual spend
50,000 £13,322.33 £438.75
100,000 £26,423.98 £877.50
300,000 £78,830.58 £2,632.50
500,000 £131,237.18 £4,387.50
1,000,000 £262,253.68 £8,775.00
10,000,000 £2,620,550.68 £87,750.00
Potential ‘Pay Back’ from
T150 Energy Ltd
16 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Finance and Property Deals
Property investment
flows in healthcare
A new report reveals that the health and care property market is one of the fastest-growing
across the globe, with private equity, REITS, and institutional investors chasing the ‘strong,
long income’ generated
Knight Frank is the UK’s leading
healthcare property consultancy,
advising on more than £12bn worth
of property assets in the sector every year.
A multi-disciplinary firm, it offers a
one-stop shop for valuation and advisory
expertise, also providing development,
consultancy, and research services.
And, with the healthcare industry
remaining one of the fastest-growing
markets across the globe — with around
$38bn invested in care-related global real
estate in the 12 months to June 2023 — it
works with care homes and day centres,
independent hospitals, acute hospitals and
surgeries, dentists and pharmacies, and
supported living and retirement operators.
MAKING A CASE
Its most-recent Global Healthcare
Report reveals private equity, REITS,
and institutional investors ‘continue to
chase the strong, long income generated’
by the sector and that there is growing
interest in healthcare’s capabilities to
aid environmental, social, and corporate
governance (ESG) investing strategies.
“Globally, across the board, the
fundamentals that create the case for
investment flows into healthcare are
evident,” it adds.
And it highlights seven factors which are
driving this.
• Demographic shift: An ageing
population means increasing demand for
residential care, primary care, and acute
hospital services
• A secure income: Operator revenue is
reinforced by a healthy mix of self-funded
and publicly-funded care and income is
supported by high occupancy and patient
demand across the healthcare arena
• Long-term income: Weighted average
unexpired lease terms (WAULT) average
25-30 years in the residential care and
hospital sectors and leases are commonly
indexed linked to inflation
• Investment performance: Returns are
historically stable, offering investors
protection and diversification
• Demand for safe havens: Healthcare’s
long-term and often governmentsupported
income offers further defence
• Structural change in real estate: Real
estate investors are already de-risking
from traditional sectors such as retail
into alternatives like healthcare
• Social impact: The influence of impact
or ESG investing in real estate is growing
at a faster pace than ever with a new
range of investors now focusing on
social infrastructure investments, and
healthcare is part of this
PRIVATE CAPITAL
Julian Evans, a proprietary partner and
head of healthcare at Knight Frank, said
that location was a main consideration for
investors.
He told Healthcare Property: “ We
advise some of the world’s top health and
care investors and, when you take Bupa
as an example, it has 220 sites and a £4bn
portfolio of properties.
“When we value this estate, we get very
18 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Finance and Property Deals
Julian Evans
deep in terms of understanding the DNA
of the business and its strategy and we can
provide real value, sourcing development
sites which are the right ones.
“When we do valuations, we look at KPIs
and our research in order to produce live
data.
RESEARCH
“Give me any postcode, and we will have
valued an asset there and that research is a
really-powerful tool.
“If you have five care homes and you want
to build a new one, we would mandate a
feasibility study to see if there is support for
building a facility there.”
And one thing driving that decision is the
potential return on investment.
With care homes, in particular, recent
development has been stymied because
of Brexit, the COVID-19 pandemic, and
ongoing supply chain problems.
But the most-pressing issue is ensuring
any new developments are economical in
terms of providing a return on investment.
And this is pushing investors towards
only a handful of potentially-viable
locations.
Evans said: “When it costs £12m-£14m
to build an average care home, if you can
get £1450-£1850 in weekly fees, then it
becomes an attractive proposition.
“But it does not work going in areas like
Manchester or the West Midlands where
the local authority fees are £600-£700. It
does not make sense as you are not going to
generate enough income.
“Therefore, we are not seeing
development in challenging local authority
areas.”
THRIVING CITIES
Instead, private investors are concentrating
on locations such as cathedral cities, where
Survey in numbers
people are more likely, and able, to pay for
their own care.
“This is where data and feasibility studies
are really important,” said Evans.
Investors in medical centres, hospitals,
and other health facilities are less active.
Evans said: “Overall, the trends that
emerged within operator trading data in the
past year, have, once more, highlighted the
case for healthcare.
“The sector has been a topic of concern
with regard to its ability to weather
storms ahead, and this is something that it
continues to do tremendously well — for
example, steady improvements in average
occupancy year on year and the minimal
compression of EBITDARM margins.
“Staffing costs will continue to be an area
of focus, especially as we look to another
rise in the National Living Wage in the early
stages of 2024.
STAY OPTIMISTIC
“The extent to which fees can continue
to absorb higher operational costs
remains unknown and will be essential in
understanding the maintenance of overall
profitability.
“While inflationary pressures are evident
through rising utility costs, we are hopefully
through the worst.
Overall, the trends
that emerged within
operator trading
data in the past year
have, once more,
highlighted the case
for healthcare
“With the economy beginning to
compose itself, we seem safer from irregular
fluctuations and therefore hope to see
operational costs stabilise somewhat in the
coming year.
“We are, and always have been, optimistic
about the sector’s outlook.
“The structural drivers mean that the
sector’s demand remains strong. It will
undoubtedly be an exciting period for
healthcare.” n
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 19

Finance and Property Deals
Best-in-class development
sold to leading operator
Christie & Co has announced the sale of
an Aspire LPP-delivered care home site
in Fareham, Hampshire, to Barchester
Healthcare.
The site is situated in a prominent roadside
position on The Avenue (A27), a short
distance from the high street, and benefits
from planning consent for a 60-bedroom
care home which, once built, will form a part
of the local infrastructure and community.
This best-in-class development will
provide 60 beds with wetrooms and
communal amenities, all set within
landscaped gardens.
Michael Lucas, founder and managing
director at Aspire LPP, said: “Aspire is
delighted to have delivered this bestin-class
care home development site in
Fareham.
“This 60-bed care home represents one
in a pipeline of developments which Aspire
LPP is delivering to the market during 2024
and beyond.”
Julian Burgess, land buyer at Barchester,
adds: “We will be delivering the highest
quality of care here in a beautifully-designed
building and look forward very much to
becoming an integral and valued part of the
local community.”
First-time buyer
snaps up Derbyshire
care home
Christie & Co has also announced the sale of The Firs
Residential Home in Derbyshire.
The Firs is a ‘Good’-rated residential care home registered for 28
service users and occupying a two-storey, detached property with
25 bedrooms, six of which have ensuite facilities.
The home also includes a garden area with a covered pergola and
is located in the large Derbyshire village of Breaston, around seven
miles east of Derby and eight miles west of Nottingham.
It has been owned by Yvonne Dunbar for 17 years and was brought
to market to allow her to retire.
Following a confidential sales process with Rosie Turner from
Christie & Co, it has now been purchased by first-time buyers, Dr
Daljinder Bajwa and Gurpreet Singh Jassal.
Turner said: “Having built a relationship with Yvonne over the years,
I am delighted to have been able to assist her in the retirement sale
of her beloved home, The Firs.
“This is another great example of the demand that exists for
smaller homes in the East Midlands.
Commenting on the appetite among
investors for care home sites, Jordan Rundle,
director of healthcare development and
investment at Christie & Co, said: “Fareham
is a densely-populated residential area
of the south coast within close proximity
to the coastal cities of Southampton and
Image: HIA.
Portsmouth, providing significant underpin
for new futureproofed care bedrooms in the
catchment.
“Barchester will be in an excellent position
to serve the growing requirement for care
beds in the local area.”
The site was sold for an undisclosed price.
“While there are new challenges within deals, such as the interest
rate rises and wider economic factors, signs still point towards a
positive outcome for smaller going concerns within the region and it
also shows that a new operator with great experience and business
ideas, like Gurpreet and Daljinder, can still raise funding to acquire
their first home.”
20 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Finance and Property Deals
Welford Healthcare
buys established
Exeter nursing home
EXPRESSIONS OF
INTEREST SOUGHT FOR
ROOKWOOD HOSPITAL
Langford Park Nursing Home in Exeter
has been sold to Welford Healthcare
for an undisclosed sum, taking the
company’s social care portfolio to 20
properties.
The home occupies a former residential
building which has been significantly
modified and improved over the years to
accommodate up to 35 residents.
Located in an attractive, semi-rural location
in Exeter, the 35-bed home was previously
owned by Vision UK and was brought to
market to enable the directors to focus on
other business interests, both within and
away from the care sector.
Following a confidential sales process with
Simon Harvey from Christie & Co, and with
funding from Omega REIT, it was purchased
by Pete Madden of Welford Healthcare,
which owns 19 other homes across the UK.
Harvey said: “This sale is yet another
example of the strength and diversity of the
market in the South West, where appetite
continues from investor-backed operators
such as Welford Healthcare through to firsttime
buyers who remain keen to enter the
sector.”
Prestige announces
Yorkshire care home plan
Prestige Care Group has purchased a
1.2-acre site in Aiskew, North Yorkshire, in
a deal arranged by commercial real estate
firm, Colliers, for £1.1m.
The group, which already has seven homes
in the Yorkshire area, is seeking to build a
new 70-bed development which will provide
care facilities for the elderly in the region.
Having purchased the land in Blind Lane
earlier this month, work will start on site this
month and the home is expected to open its
doors to residents by June 2025.
Raj Singh, chairman of the Prestige Care
Group, said: “We’re pleased to have been
able to secure this site in order to develop a
new home for clients in this much-soughtafter
part of North Yorkshire.
“Our new home will provide essential,
good-quality care for residents from the
area, providing purpose-built modern
accommodation within a quaint village in
the unspoilt English countryside.”
Cardiff & Vale Health Charity, the official charity
of Cardiff and Vale University Health Board, is
working with NWSSP Specialist Estates Services
and property agent, Savills, around expressions
of interest for the sale of Rookwood Hospital as a
whole or in parts.
In 2020, the main part of Rookwood Hospital
closed when spinal and neuro rehabilitation
services were relocated to University Hospital
Llandough.
Currently, the artificial limb and appliance
services (ALAS), electronic assistive technology
(EATS), Wales Mobility Driving and Assessment
Service (WMDAS), the mass vaccination centre, and
occupational therapy remain operational on the
site and provisions have been made to ensure the
smooth continuation of these services during this
period.
With two Grade II listed buildings — Rookwood
House and the summerhouse — as well as the
site’s inclusion in Cadw’s non-statutory Register of
Landscapes, Parks and Gardens of Special Historic
Interest in Wales (Grade II) and the existence of
a large number of trees which are statutorily
protected by Tree Preservation Orders — the site is
no longer viable.
And, due to the restrictions surrounding the
estate, the property cannot become the type of
modern-day hospital that is required to provide the
best care for patients.
Rookwood Hospital was originally constructed in
the late 1860s for Col Sir Edward Stock Hill, though it
is believed that landscaping began as early as the
1770s when the grounds became part of the estate
of Thomas Edward of Llandaff House.
The house was first used for healthcare in 1917,
rehabilitating patients who had suffered paralysis,
and for the provision of artificial limbs, appliances,
and aids.
The beneficiaries of the sale of Rookwood Hospital
will be Cardiff & Vale Health Charity where the
monies will be used to support patients, staff,
visitors, and the community.
Expressions of interest
are open until midday on
Wednesday 21 February 2024.
Scan or click the the
QR code for more information.
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 21

Market Analysis
Image: Pexels from Pixabay
The construction
digital revolution
A new report reveals how architects and contractors are
increasingly using technology. But do they have the digital
know-how to realise the benefits?
NBS, the platform for connected
construction information, has
revealed the results of its 2023
Digital Construction Report, showing
that, while there has been an overall rise
in technology adoption, many fear the
industry is lagging behind when it comes to
digital know-how.
Focusing on emerging technology and
the construction industry’s approach to
digital transformation, the report offers a
snapshot of industry professionals’ various
views and evolving opinions.
And one of the most-hotly-debated
topics from this year’s study concerns
the industry’s rate of tech adoption and
whether it now excels in terms of digital
expertise.
Despite an overall rise in the use of
digital technologies, nearly half (47%) are
concerned the industry is behind the times.
Moreover, 36% of respondents said they
worry they will be left behind when it
comes to digital know-how.
FINDING THEIR FEET
However, around a quarter (26%) believe
this is an outdated view and is no longer the
case, and that construction has finally found
its ‘digital feet’.
With such a divided split, it could suggest
that digitisation is more prominent in some
areas of construction than others.
NBS also found that the use of digital
twins has increased by 50% since 2021 from
16% to 25%.
What’s more, just over half (55%) of
those that use digital twins do so to mirror
construction from other projects and to
create an ‘as-built model’.
And this could be evidence that
building safety and efficiency is now taking
precedence.
Figures relating to the number of
projects using elements of offsite
construction also showed an uptick, with
over half of professionals (57%) involved
in a project that used MMC in the past 12
months.
In 2021, this figure was hovering at
around 50%, so an upward trend is taking
place.
Suppliers were the most likely (70%)
followed by contractors (63%) and
consultants (58%).
The increased uptake of offsite
construction has also been reflected in
project data from Glenigan, with its
intelligence showing a value-adjusted
percentage of 11% of new-build projects
using MMC during the first nine months
of 2023.
And Glenigan predicts further growth
over the next few years, with nearly 9%
of new-build projects securing detailed
planning approval during the first nine
months of 2023 involving an offsite
element.
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Market Analysis
…we can see that construction
is shaking off old and tired
misconceptions and now relies
on all manner of digital skills to
produce building excellence
BECOMING IMMERSED
The study also flagged a growing appetite for the use of immersive
technologies, such as Augmented Reality (AR), Virtual Reality
(VR), and Mixed-Reality (MR) which are playing an increasinglyimportant
role.
More than one in three professionals (36%) are already using this
type of technology, and a further one in five (20%) plan to within
the next three years.
Overwhelmingly, its main use is for stakeholder engagement
(74%), where upcoming or ongoing projects can be digitally
generated to present detailed plans.
However, for two in three users (62%), immersive tech offers a
way to visualise design interfaces so they can better understand how
construction projects fit within existing surroundings.
Just over a third (35%) use it for marketing purposes, particularly
among suppliers (67%) who recognise its value when selling
products and systems.
MACHINE
LEARNING
Interest in Artificial
Intelligence (AI) and
machine learning has
also seen a sharp rise
within the past year following
the launch of ChatGPT and
other algorithm-based language
models.
Looking back to 2020, two in
five (38%) said they were unsure if their organisation was using it, of
those who did, just 9% were using AI.
Although the use of AI in construction is yet to take its grip
(43% said they have no plans to use it), signs of early adopters are
already visible.
More than one in five (22%) have already adopted AI, and a
similar number (20%) said they will do so within a year.
HEAD IN THE CLOUDS
Eight in 10 now also use a form of cloud computing as part of their
daily workflow.
While mainly in the form of storage, including Google Drive,
OnePoll, DropBox, etc; the study revealed that over 70% use it to
share documents and information with clients.
Three-quarters (75%) also use it to collaborate with other team
members, particularly on 3D models and specifications.
And, given the industry’s push towards the Golden Thread and
focus on digital information management, it shows the sector is
making the essential investment to increase efficiency and reduce
risk in the built environment.
A point of interest
within the report was
that despite overall
growth in the use of
technology, opinions
on whether the industry
is still lagging behind
others remain divided.
Nearly half (47%)
are still concerned the
industry is behind the
times when it comes to
the adoption of digital
technologies. But over
a quarter believe it’s no
longer the case.
Speaking on this year’s
report, David Bain, research manager at NBS, said: “It is clear from
the results that construction has ramped up digital adoption in
recent years and is a far stride from where it was three years ago.
“Looking ahead, it will be fascinating to see next year’s report as
2024 is shaping up to be big on AI and machine learning.”
Russell Haworth, NBS chief executive, added: “Looking at the
evidence, we can see that construction is shaking off old and tired
misconceptions and now relies on all manner of digital skills to
produce building excellence.
“That said, there are still some areas for improvement and no
doubt next year will bring further leaps in tech know-how and
application.” n
723 construction professionals took part in this year’s Digital Construction Survey, which
included views from architects/engineers and other consultants, contractors, clients, and
suppliers in the UK and beyond. Previously known as the NBS BIM Report, the study is a
benchmark for changing attitudes towards tech adoption and new technologies
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 23

Building Design
A ‘village campus’ approach
to mental health design
In this article we look at how the
concept of a ‘village campus’ is setting
a benchmark for the future design of
mental health units
PHOTOS: RICHARD CHIVERS
Sycamore at Northgate Park Hospital will play a
vital role in the future delivery of modern and
effective forensic mental health services in the
North East of England.
Built by Sir Robert McAlpine and developed around
the concept of a ‘village campus’, the new mediumsecure
hospital at the heart of the £60m redevelopment
of Northgate Park Hospital, provides a wide variety
of indoor and outdoor settings for relaxation and
activity, relieving boredom and addressing the risk of
challenging behaviours and poor physical health.
THE CONSOLIDATION OF SERVICES
Designed by Medical Architecture for NTW
Solutions — Cumbria, Northumberland, Tyne and
Wear NHS Foundation Trust — Sycamore is the
catalyst to enable all secure services across the trust to
be brought together from previously-dispersed sites,
and consolidated in a single, integrated secure centre of
excellence.
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Building Design
The entire redevelopment provides a
total of 116 male inpatient beds, located
in a combination of new and reconfigured
existing buildings.
The new-build element, known
as Sycamore, provides inpatient
accommodation for 72 male patients with
a range of forensic mental health needs,
including patients with complex personality
disorders and/or learning disabilities.
The project, which was delivered through
Cohort 1 of the NHS New Hospital
Programme, fulfils one of the trust’s key
strategic priorities, forming part of its
£72.6m Care Environment Development
and Re-provision Programme (CEDAR).
A UNIQUE SETTING
The existing hospital site is a large open
campus, containing a mix of buildings and
facilities.
And much of the eastern portion,
which was earmarked for development,
is neighboured by a broad area of mature
woodland.
Proposals set out to develop a portion
of the land for the new building, with
the remaining allocated for housing
development. Early feasibility work
demonstrated benefits to siting the new
hospital where it would be flanked by an
aspect of trees on three sides: the natural
setting enhancing the therapeutic nature of
the accommodation.
It is well recognised that in secure mental
health inpatient units, boredom leads to
challenging behaviours and poor physical
health.
Therefore, a key driver for the design was
to ensure a meaningful day for all patients,
promoting recovery through activity.
As a result, the facility is devised as a
‘village campus’ focusing on the individual
patient and staff experience, with as many
spaces as possible, both inside and out,
offering opportunities for mitigating
boredom.
This is achieved in a range of settings
that can be accessed autonomously,
from bedrooms to living spaces, and
sheltered gardens to open courtyards, with
opportunities for both structured and
unstructured sports and activities.
AN INCLUSIVE SPACE
The six patient wards are paired together
and arranged around a large recreation
courtyard.
Each building is adjoined, creating
a secure boundary without the need
for fences, minimising the feeling of
confinement.
With rich landscaping and integrated
security measures, this shared space does
not feel like a typical forensic mental health
facility.
And the courtyard is separated into
two distinct character zones—‘Passive’
and ‘Active’ — to ensure patients and staff
are able to benefit from its therapeutic
qualities.
The ‘Passive’ zone provides opportunities
for refuge, with restful places to sit among
plants and grasses.
These smaller-scale spaces offer a sense
of enclosure, combined with views out to
the wider recreation area to provide gentle
enticement into the activities offered.
The ‘Active’ zone includes a 200m
jogging/walking loop, activity spaces, and
a fitness ‘trim trail’, to promote physical
activity and the associated wellbeing
benefits.
Within the main reception building
— which provides the public frontage
to the facility — a covered sports barn
allows activities to continue in all weather
conditions.
MAKING A CHOICE
In addition to these communal spaces,
at the centre of each ward, a private
landscaped courtyard for relaxation is
provided, and between each ward pair is a
designated activity courtyard, with sports
court markings.
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 25

Building Design
The technical requirements for forensic
mental health buildings, particularly with
regards to security, can present challenges
to the creation of supportive and recoveryfocused
environments
This arrangement offers safe access to a
variety of different outdoor areas.
In each ward, the bedrooms are arranged
to face outwards, with views to the
surrounding woodland.
And the majority of the day activity and
living space is at the centre of the ward, with
direct access into the courtyards.
Abundant daylighting, attractive views,
and a sense of spaciousness contribute to
the therapeutic qualities of the environment
and play an important role in patient
rehabilitation.
PERSONAL SPACES
While use of the common spaces is actively
encouraged, it was acknowledged that this
patient group may choose to spend time in
their own room, particularly in the morning
and evening.
To maximise the opportunity for activity,
the design of the bedrooms stemmed from
a detailed re-imagining of how these spaces
could work.
In an evolution of previous designs for
the trust, the bespoke fitted furniture is
devised to assist with a personal workout
outside of scheduled recreation time.
Adequate floor space for exercise and a
television which can be easily viewed from
the bed or floor enables a patient to either
be active or to rest.
The transition from private bedroom to
shared circulation and day spaces has been
considered to provide a reassuring path into
more-stimulating environments.
The bedroom corridors are single-sided,
with immediate views to the landscaped
ward courtyards from each bedroom door,
providing orientation, good observation,
and balancing circadian rhythms.
CHALLENGING THE STIGMA
The exterior appearance of the new facility
is extremely important and has a major role
to play in reducing the stigma surrounding
mental illness, as well as engendering pride
in the building as a workplace.
The front reception building provides a
secure boundary to a large section of the
internal plan, reducing the need for high
fencing.
And a visible and publicly-accessible
café with integrated artwork provides
a welcoming space for visitors and staff
working across the site.
A consistent and controlled palette of
materials and architectural styles has been
developed to integrate the building with the
most-recent additions to the hospital site
and to present a positive image for visitors
and new arrivals.
Paul Yeomans, director at Medical
Architecture, said: “It is fantastic to see this
important project realised.
“The technical requirements for forensic
mental health buildings, particularly with
regards to security, can present challenges
to the creation of supportive and recoveryfocused
environments.
“However, standing in the thriving
central courtyard, it is hard to tell you are in
the middle of a forensic hospital.
“That normalising of the accommodation
will have such a positive impact on patient
wellbeing.”
John Carson, head of capital
development at NTW Solutions, added:
“This has been a fantastic scheme to deliver
and there was a true team spirit with all
involved, especially with the clinical teams
on site.
“That teamwork has paid off and it
is inspiring to see the unit in use and
heartening to hear the early feedback
from clinicians about the quality of the
accommodation.
“This is a flagship development, and it has
set a new standard, not just for our future
projects, but for the whole mental health
sector.” n
26 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Building Design
Angela Rayner and Martin Brown
The formula to MMC success
Retirement community developer, McCarthy Stone, has started work on its tenth MMC site in
the last three years, with more in the pipeline, reflecting the increased use of offsite construction
techniques within the health and care sectors
McCarthy Stone, the UK’s
leading developer and manager
of retirement communities, is
driving forward its use of Modern Methods
of Construction (MMC) and is set to start
work on its tenth development to be built
in full using this approach since 2021.
Once complete, it will deliver 473
specialist retirement properties, with more
MMC schemes planned.
The announcement follows a recent
letter from the chairman of the Built
Environment Committee to the
Government stating that the UK has so far
failed to build MMC homes in meaningful
numbers, and shows how the issues the
committee raises can be overcome.
FASTER AND GREENER
As a national first for a UK developer,
McCarthy Stone has a partnership with
Remagin — formerly Sigmat — Europe’s
leading manufacturer of panelised
MMC is helping us to further increase our
build quality, control our costs, and, most
importantly, build more energy-efficient and
greener communities
structural steel frames, to use its ecofriendly
Light Gauge Steel Frame (LGSF)
MMC solution, where the panels are built
in a factory and then assembled onsite,
helping it to build faster, greener, and more
affordably.
Three schemes are already complete and
open and four more will complete by the
end of this year, with a further three due to
start on site shortly.
The first scheme, in Hexham, opened
in 2021 and was delivered significantly
faster than traditionally-constructed sites,
saving around 15% in time, despite adverse
weather conditions.
And it was completed with half the
number of defects expected to be found on
a traditional scheme.
More-recent schemes have saved around
20% in build time.
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Building Design
Our focused
approach to MMC,
and our secure
pipeline of consented
land, means we have
found the right
formula to enable us
to use it to accelerate
housing delivery
McCarthy Stone and Remagin have also
evolved their approach over recent years,
with windows, external doors, and external
insulation now also fitted in the factory,
further reducing risks and delays.
Future developments will also
progressively incorporate a streamlined
closed panel solution to maximise the
benefits of MMC.
Peter Forsyth, director of strategic
initiatives at McCarthy Stone, said: “We’ve
had plenty of success with MMC thanks to
our partnership with Remagin.
“MMC is helping us to further increase
our build quality, control our costs, and,
most importantly, build more energyefficient
and greener communities.
A FOCUSED APPROACH
“Our focused approach to MMC, and our
secure pipeline of consented land, means we
have found the right formula to enable us to
use it to accelerate housing delivery.
“MMC is now becoming a key
component of our development pipeline.”
David Bridges, chief investment officer
at Homes England, added: “Having an
established pipeline of projects is absolutely
crucial for the MMC sector to grow, so it’s
great to see McCarthy Stone’s continued
commitment to delivering multiple MMC
schemes.
“We’re involved in the scheme at
Failsworth, which is set to complete this
year, as well as Erdington, Bradford, and
Huyton, all of which are expected to
commence construction shortly.”
And Scott Bibby, country manager
for Ireland & UK at Remagin, said:
“Despite recent adverse media publicity
about MMC, Remagin’s partnership with
Failsworth Retirement Properties
McCarthy Stone proves that, with the right
collaborative approach, MMC is still very
much a solution to the challenges of today’s
housing market.
AGGREGATING DEMAND
“Through partnering together, we have
been able to develop and fine-tune a highlyenergy-efficient
product which delivers
speed, quality, and consistency of build,
while also addressing cost and affordability
concerns.
“The future of our partnership looks
exciting.”
McCarthy Stone has also written to the
Housing Minister to note how the use
of MMC could be deployed successfully
across the later living sector, including
setting specific targets, aggregating demand,
aligning supplier solutions by using a
standard ‘chassis’ approach, and investing
in qualification and regulation frameworks
to create simple standards and approval
processes. n
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 29

Estates and Facilities Management
Out of gas!
How making improvements to medical
gas supplies can help hospitals to
reduce their carbon footprint
Image: Sasin Tipchai from Pixabay
Charing Cross Hospital is one of only a handful
of major hospitals in England to decommission
its entire nitrous oxide manifold in one go —
reducing carbon emissions by more than 460 tonnes
a year.
Nitrous oxide has been used for over 175 years as
part of anaesthesia within healthcare, but it is a potent
greenhouse gas, estimated to be nearly 300 times worse
than carbon dioxide for the environment.
And recent research revealed a significant proportion
of emissions at older NHS hospitals like Charing Cross
is due to waste from manifolds and the associated old
pipe structure.
Speaking to Healthcare Property, Dr Tom Dolphin, a
consultant anaesthetist at Imperial College Healthcare
NHS Trust, which runs Charing Cross, explains:
“Nitrous oxide is a key contributor to trusts’ carbon
footprints.
Dr Tom Dolphin, Charing Cross Hospital
30 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Estates and Facilities Management
Staff switch off the nitrous oxide manifold
“But, when we compared the number of
empty cylinders with clinical use from our
digitised anaesthetics records, we realised that
the number of cases every month where it was
being used clinically, and how many litres that
represented, was far lower than the amount of
gas we were piping through the system.
OLD PIPEWORK
“We did various checks and confirmed our
suspicions that almost all of our usage was
in fact leaks at various points along the
ageing pipework system.
“While the leaks did not pose a health
risk, they were bad for the environment.”
Working with medical gas specialist, SHJ,
the trust had three options: Stop providing
nitrous oxide altogether and turn off the
supply; attempt to repair the whole nitrous
oxide pipework system; or decommission
the manifold and replace it with a new
supply system located much nearer to the
few areas where it is still used.
Dolphin said: “There is still a need to
provide nitrous oxide for the very-few
clinical situations where it is used, and
repairing and replacing pipework right
across the building — across 14 storeys of a
50 to 60-year-building — would be a major
undertaking.
We are one of the biggest NHS trusts in
the country, with an ageing estate, and are
absolutely committed to reducing our impact
on the environment and reaching carbon net
zero before 2045
“Instead, we chose the third option.
“This meant manually turning a lever to
cut the flow from the cylinders, sending
them back to the British Oxygen Company,
and then capping off the outlets at the point
of use with end blanking plates to make it
clear they are no longer in use.”
GETTING BUY-IN
However, getting buy-in from the various
departments was a much-longer process.
“What I underestimated was the sheer
number of people involved in a decision like
this,” said Dolphin.
“The majority of the work was governance.
We had to involve the medical gases
committee, pharmacy, portering, estates and
facilities, anaesthetists — a lot of people were
involved, and we needed to get buy in from
them all and understand their concerns.
“While the physical work is relatively
minimal, what really took time was making
sure we spoke to all the right people.”
But, having now completed the work, the
results are already being realised.
It is estimated the move will reduce
greenhouse gas emissions by at least 460
tonnes of C02e (carbon dioxide equivalent)
a year — around 1% of the trust’s overall
carbon footprint.
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 31

Estates and Facilities Management
Dr Tom Dolphin
This saving is estimated to be the
equivalent of driving a petrol car around the
earth 57 times.
INNOVATION
Dr Bob Klaber, director of strategy,
research, and innovation at Imperial
College Healthcare NHS Trust, said: “This
is a really-innovative and impactful project
and I am grateful to the many teams who
worked so hard over the past six months to
make it possible.
“We are one of the biggest NHS trusts
in the country, with an ageing estate, and
are absolutely committed to reducing our
impact on the environment and reaching
carbon net zero before 2045.”
The trust is now looking more widely
at its use of anaesthetic gases to identify
additional areas for improvement.
The includes the trialling of volatile
capture technology (VCT) canisters
designed to capture anaesthetic gases at
Charing Cross, Hammersmith, and St Mary’s
hospitals, as part of a large-scale feasibility
trial funded by Imperial Health Charity to
reduce carbon emissions in surgery.
The canisters are designed to capture
significant volumes of the exhaled
anaesthetic gases, which can then be
There are currently
around 90
anaesthetic machines
across our hospitals,
with thousands of
anaesthetics given
each year to patients,
so making this
change would be a
significant step in
reducing our carbon
footprint
purified and reused.
And the team will use the findings from
the trial to make a case to roll this out
permanently across the trust.
Dolphin said: “There are currently
around 90 anaesthetic machines across our
hospitals, with thousands of anaesthetics
given each year to patients, so making
this change would be a significant step in
reducing our carbon footprint.” n
WELSH TRUST MAKES ITS MARK
Decommissioning of the nitrous oxide
piping system and manifold has also
taken place at hospitals in Gwent as
part of carbon-cutting efforts by Aneurin
Bevan University Health Board.
A project carried out by the clinical
workstream of the health board’s
Decarbonisation Programme Board found
there was significant wastage secondary
to small leaks in the ageing pipelines and
out-of-date gas cylinders.
Dr Jenna Stevens, a consultant
anaesthetist, sustainability lead, and
clinical lead for the decarbonisation board,
said: “The clinical use of nitrous oxide
over the last 10-15 years has dramatically
reduced.
“What we were finding was that even
though our use had declined, we were still
purchasing a significant quantity of nitrous
oxide.”
Dr Jenna Stevens
As part of the project, the team has been
able to decommission systems at Ysbyty
Ystrad Fawr, Nevill Hall Hospital, St Woolos
Hospital and Royal Gwent Hospital.
Smaller, more mobile cylinders are now in
place at all of these sites, providing the gas
where necessary and reducing emissions
and waste.
Financially, this represents a saving of
£14,500 per year. But its environmental
impact is much greater, estimated at 900
tonnes of carbon dioxide equivalent and
equating to over 2.2 million miles driven by
a car.
The team now plans to look at ways to
reduce the impact of Entonox wastage.
32 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Environmental
Greening
the NHS
How Green Plans are underpinning every
NHS trust’s carbon reduction efforts
In October 2020, the Greener NHS
National Programme published its new
strategy, Delivering a net zero National
Health Service.
The report highlighted that, left
unabated, climate change will disrupt
care, with poor environmental health
contributing to major diseases, including
cardiac problems, asthma, and cancer.
And it set out trajectories and actions for
the entire NHS to reach net zero carbon
emissions by 2040 for the emissions it
controls directly, and 2045 for those it can
influence, such as those embedded within
the supply chain.
To support the co-ordination of carbon
reduction efforts across the NHS and the
translation of this national strategy to the
local level, the 2021/22 NHS Standard
Contract set out the requirement for trusts
to develop a Green Plan to detail their
approaches to reducing their emissions in
line with the national trajectories.
And, given the pivotal role that
integrated care systems (ICSs) play, this
has since been expanded to include the
expectation that each system develops its
own Green Plan based on the strategies of
Our Green Plan is our commitment to reduce
our impact on the environment and put us on
a path to deliver a cleaner, greener, healthier,
and more-equitable future
its member organisations.
Here, we look at how one trust has
approached this and the support available.
FIT FOR THE FUTURE
“Our Green Plan is our commitment to
reduce our impact on the environment and
put us on a path to deliver a cleaner, greener,
healthier, and more-equitable future,” said
Stacey Hunter, chief executive of Salisbury
NHS Foundation Trust.
The trust, which runs Salisbury District
Hospital, delivers a broad range of clinical
services to approximately 270,000 people
in Wiltshire, Dorset, and Hampshire,
including specialist services such as burns,
plastic surgery, cleft lip and palate, and
rehabilitation, while the Wessex Regional
Genetics Laboratory extends to a muchwider
population of more than three
million.
Salisbury District Hospital also includes
the Duke of Cornwall Spinal Treatment
Centre, a purpose-built, 45-bed unit which
specialises in caring for people who have
spinal cord injury and serves a population
of 11 million covering an area across most
of southern England.
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Environmental
Services are delivered by 4,800 staff and
the estate covers some 21 hectares, with a
large proportion of services housed in older
accommodation.
To address the carbon emissions
associated with these services, and the
buildings from which they are delivered,
the trust’s Green Plan focuses on nine key
areas:
• Adaptation
• Travel and transport
• Workforce and leadership
• Medicine and gases
• Sustainable models of care
• Supply chain
• Estates and facilities
• Digital transformation
• Food and nutrition
The 17-page document sets out 14 key
priorities, and many of these are estates
and facilities driven, including developing
mitigation and adaptation plans in response
to climate change, promoting and investing
in energy and water-saving measures,
ensuring modern building methods are
applied to new building projects, and
reducing the volumes of residual waste
through supplier engagement, avoidance,
reuse, and recycling.
The estates section of the plan lays out
some of the interventions which have
already been deployed, including the
appointment of an energy conservation
manager; investment in solar panels, which
now generate 4% of the trust’s electricity;
installation of combined heat and power
(CHP) technology, providing 40% of the
onsite electricity demand; LED lighting
upgrades; and the development of a
recycling centre.
And, with an ambition to ‘make every
kWh count’, the trust outlines another 13
steps it will take by the end of this year.
These include reducing water loss (leaks)
and investigating the opportunity to recycle
water in it swimming pools; developing
plans for the transition to more-efficient
lighting and preparing buildings for
electricity-led heating; further embracing
modern methods of construction; replacing
inefficient infrastructure and buildings;
and preparing the estate for severe weather
events.
The report states: “Achieving NHS
carbon reduction targets will require new
hospitals and buildings to be, at the very
least, net zero carbon compatible.
“We are committed to the delivery of
NHS carbon net zero objectives and our
‘campus development’ programme will
make a significant contribution to achieving
this commitment.
“It will enable us to move out of old,
inefficient buildings and facilitate the
Achieving NHS carbon reduction targets will
require new hospitals and buildings to be, at
the very least, net zero carbon compatible
construction of new buildings that
meet modern building standards and
use technologies that are highly energy
efficient.”
DEVELOPING A PLAN
To support trusts in developing plans, NHS
England has published guidance, due to
be updated later this year, which proposes
three-year plans are created.
It states that, in developing plans, each
organisation should:
• Review progress since the organisation’s
last Green Plan (or equivalent), to
determine what facets have worked well
and which need renewed focus or a
different approach
• Take into account the national targets
(and interim 80% carbon reduction
goals) for the NHS carbon footprint and
carbon footprint plus, as well as learning
from trusts which are already aiming to
exceed these ambitions
• Engage widely with internal stakeholders
and key partner organisations to inform
sustainability priorities and identify areas
for productive collaboration
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 35

Environmental
• Develop and refine SMART (specific,
measurable, achievable, relevant and timebound)
actions focused on early efforts to
directly reduce carbon emissions
• Develop systems and processes to
measure and report on progress against
plans and commitments annually
And it says that development of the plans
should be led by a designated board-level
net-zero lead, which ‘should generally be
one of the existing executive directors’.
The guidance states: “The plan will
require senior, expert input from a
broad range of disciplines and functions,
including clinicians, estates and facilities,
procurement, finance, and human resources.
“These senior individuals should also be
informed by vibrant, representative, and
well-supported sustainability groups and
networks drawn from a wide range of staff
across each NHS organisation or ICS.
“Progress against an approved Green Plan
should be formally reported annually to
the trust board or ICS governing body and
progress reported formally to the relevant
regional greener NHS team, in a format and
frequency agreed with them.”
But key to any plan is being able to
effectively and accurately track and report
progress.
The guidance states that new data
collection methods are being developed
The plan will require senior, expert input from
a broad range of disciplines and functions,
including clinicians, estates and facilities,
procurement, finance, and human resources
to enable the more-granular calculation
of carbon footprints at regional, ICS,
and trust level, with The Greener NHS
Data Collection launched in April 2021 to
understand actions that are taking place and
provide a baseline from which progress can
be understood.
A number of other resources have also
been made available, including the Greener
NHS Dashboard and Health Outcomes of
Travel Tool.
And, while it states that most
interventions will be cost neutral or provide
an immediate cost benefit, it recognises
that additional capital investment may be
needed.
It adds: “In developing a Green Plan,
organisations should consider how net
zero principles can be routinely integrated
into all business-as-usual upgrades and
maintenance.
“This may facilitate the use of funding
set aside for backlog maintenance to be
deployed more effectively to reduce future
costs and carbon emissions, while improving
resilience to the local effects of climate
change.
“Beyond this, sources of additional
funding to support the UK-wide move to
net zero enshrined in the Climate Change
Act are increasingly forthcoming.”
Recent examples of additional funding
made available to NHS trusts include the
£50m NHS Energy Efficiency Fund for
LED lighting and a number of awards
under the Government’s public sector
decarbonisation scheme, which is now in its
third phase. n
36 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Environmental
Andy Richardson (left) and Craig
Wood at Elliott Chappell Health Centre
Hull health centres install
100%-sustainable LED lighting
Thirteen health centres in Hull are
becoming some of the most sustainable
medical facilities in the country, thanks
in part to an ambitious programme of
lighting replacement.
Healthcare estates management company,
Hull Citycare, has been working with
Sewell Facilities Management across its 13
health centres in the city to replace almost
7,000 light fittings with low-energy LEDs,
dramatically reducing energy usage and
costs and lessening their carbon footprint.
The project is being funded and operated
through the NHS Local Improvement
Finance Trust (LIFT) programme, and, as
well as using less energy, the LEDs are
brighter than standard compact fluorescent
lighting, providing cost savings and lasting
up to 10 years — 10 times longer than a
normal light bulb.
The final light of the programme was
recently fitted by Sewell FM technician,
Andy Richardson, at Elliott Chappell Health
Centre, making Hull the only city to have all
its health centres fully fitted with LEDs.
Community Health Partnerships (CHP) is
the head tenant at 308 healthcare buildings,
built under the LIFT programme in England.
And so far 24 of its buildings are fully LED
lit, with 13 of those in Hull, making the city a
leader in energy-efficient lighting.
The scheme, which has taken two years
to complete, was started when Sewell
FM wanted to find a new way to help Hull
Citycare save time, money, and energy.
Sean Henderson, managing director
of Sewell FM, who manages building
maintenance for the health centres, said:
“Decarbonisation is at the top of everyone’s
priority list at the moment, so when Sewell
Facilities Management came to us saying
they could reduce energy consumption and
also save money, it seemed like a win-win
situation.
“It is already saving the health centres
thousands of pounds every year, which is
money that can be spent on clinical services
and making the health centres even better
for patients.”
Tim Wigglesworth, chief executive of
Hull Citycare, added: “Our primary and
community buildings are crucial healthcare
estate, aligning to the NHS net zero
ambitions.
“The stainability agenda is a key driver for
CHP and we understand the importance of
this to our tenants.
“Being able to deliver sustainable
facilities and value for money has never
been so important and we are delighted
that 100% of Hull Citycare buildings now
have LED lights — resulting in significant
environmental and financial savings across
the health system.”
Changing a traditional lightbulb in a health
centre is not easy as you need to close off
the space, put up barriers, and sometimes
even bring in mobile elevating working
platforms to reach fittings in higher and
difficult-to-reach areas.
This causes disruption for building users
and staff, takes facilities teams away from
urgent jobs, and then, a year or so after you
have put the new lightbulb in, they need
replacing again.
After trialling LEDs at Bilton Health Centre,
the team knew the benefits that moving to
LEDs would bring for the buildings, patients,
and staff, so agreed to pay for and fit the
new lights to all the health centres.
The buildings now have much-longerlasting
lights that do not need changing
every year, freeing up estates teams to carry
out more-important works.
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 37

Environmental
Phase 2 saw the creation of a 4MW solar farm
Revolutionary
solar scheme gets
£3.6m extension
Health board announces expansion of the country’s first
hospital solar farm
In 2021 Morriston Hospital became
the first hospital in Wales to develop a
solar farm, which has been successful
in cutting Swansea Bay University Health
Board’s carbon emissions by 1,933 tonnes
a year.
And now work has begun on a new
£3.6m solar extension and battery energy
storage system (BESS) project which will
deliver another 1MW of clean energy.
The new BESS will allow for the energy
created during the daytime to be used after
sunset, enabling more of the electricity
generated to be used by the hospital.
In addition to the carbon savings, the
solar farm and extension are expected to
save over £1.2m in energy costs per year.
Des Keighan, the health board’s assistant
director of estates, said: “The solar farm
has been a huge success in the two years it
has been operational, and the savings in
finances and energy prove that.
“As a healthcare provider it is important
we respond to our obligation to protect
health, the environment, and public
finances.
“Those two factors are really important
and our savings coincide with the rising
costs of electricity, and in terms of carbon
emissions it is at a time when it is more
important than ever to look after our
environment.
“As a health board, we are determined
to continue reducing our carbon
footprint, and the solar farm has helped us
enormously in that respect.”
The additional 1MW will increase the
overall generation of power to 5MW — an
extra 1,000,000 kWh per year — taking
the total expected annual generation to five
million kWh.
The total demand for the hospital is close
to 15m kWh per year.
The solar extension and BESS are
expected to generate a third of Morriston
Hospital’s power and make an additional
annual saving of around £325,000 to the
£900,000 already being saved each year on
electricity costs.
Until now, the solar farm has provided
around a quarter of the hospital’s electricity
needs.
As a health board,
we are determined
to continue reducing
our carbon footprint,
and the solar farm
has helped us
enormously in that
respect
Beverley Radford, estates programme
manager, said: “The combined effect of
both of these systems will be to further
reduce reliance on grid electricity at
Morriston, with a corresponding additional
saving of around £325,000 a year, plus
helping to insulate the health board from
volatile and generally-increasing future
energy costs.
38 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Environmental
Work underway on the new battery energy storage solution
The Battery Energy Storage Solution
“We saw unprecedented swings in
electricity prices and energy prices generally
caused by global geopolitical factors outside
of our control in 2022 and last year. And it
was this backdrop of spiralling energy prices
which led to the increase in generation
capacity and the addition of the battery
to our solar farm, together with the health
board’s commitment to reduce carbon
emissions to net zero by 2030.
“During this time, there were occasions
when the solar generated more power than
the hospital needed, so the electricity was
sold back to the grid.
“The price of that has doubled within
two years, which has impacted on the
viability of the farm and is one of the
reasons it is now possible to expand.”
This latest phase is expected to be fully
operational by April.
It is the first solar farm in the UK to
directly power a hospital and has already
delivered a cost-avoidance of £1.8m in
electricity bills since being switched on
two years ago by generating its own power
instead of the health board purchasing it
from the grid.
The farm initially cost £5.7m, with this
extension costing £3.6m — repayable over
11 years and funded by an invest-to-save
grant from the Welsh Government’s Wales
Funding Programme.
Scott Lutton, operations director
for industry partner, Vital Energi, said:
“Swansea Bay UHB has a fantastic
approach towards decarbonisation.
“It has a long-term plan, with a clear
strategy of how it will reach net zero and we
are delighted to be able to work alongside
the board to deliver this.
“By focusing on energy reduction
first, then creating a solar farm and
decarbonising its heating infrastructure,
the board has demonstrated how a phased
approach can yield strong decarbonisation
and we believe it is a role model for public
sector organisations which need to meet
their net zero targets.”
Work is already in progress on the
upgrade, with over 1,800 new panels being
constructed, taking the total to 11,836. n
Technology helps to
reduce emissions
Vital Energi is working with NHS Forth
Valley on a multi-technology project to
improve energy efficiency, reduce carbon
emissions, and support delivery of the
board’s net-zero targets.
Work will include the installation of
more-thermally-efficient glazing, roofmounted
solar, insulation, LED lighting, BMS
infrastructure, and electric boilers.
Financial savings from the improvements
are expecting to be around £59,000 a year,
utilising a blend of energy conservation
measures tailored to the board’s shortlisted
buildings.
Lifetime carbon savings are anticipated to
reach 1,595 tonnes of carbon dioxide and
the scope developed in this phase creates
a pathway for further carbon reduction
solutions to be implemented in the future.
Kieran Walsh, Vital Energi’s operations
manager for the North and Scotland, said:
Solar panels have been installed by
Vital Energi at Nottingham City Hospital
“We have seen from previous projects with
the NHS that there is scope to provide
innovation to the way health boards
generate and consume energy, reducing
both their carbon footprint and energy bills.
“NHS Forth Valley is taking a significant
step towards its net-zero goals by
harnessing a mixture of technologies that
capitalise on energy and carbon reduction
opportunities across the estate and we
are delighted to be assisting them on their
journey.”
Almost £2m of funding from the Green
Public Sector Estate De-Carbonisation
Scheme will be used to improve the energy
efficiency across 13 sites, representing over
12,000sq m of floorspace.
Derek Jarvie, NHS Forth Valley’s head
of climate change and sustainability, said:
“Increasing the energy efficiency of local
healthcare facilities across Forth Valley is a
key priority as this will not only cut energy
bills and generate income, but will also help
reduce carbon emissions.
“This work is just one of a wide range of
initiatives underway to reduce waste, use
more-environmentally-friendly products, and
deliver greener, more-sustainable services
in our efforts to achieve net-zero emissions
by 2040.”
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 39

Products
The importance
of antibacterial
George Emms, specification sales leader at Polyrey, part of
Wilsonart UK, explains the key considerations when specifying
surface materials for the modern healthcare estate
The primary function of the
healthcare estate is to improve
patient outcomes.
And all design, wherever possible, should
be geared towards this aim — providing
care and comfort in an environment that is
effective, safe, and operationally efficient.
Each aspect of a modern built
environment contributes towards this,
whether directly or indirectly.
Indeed, beyond the clinical aspect, it is
important for patients and providers alike
to be in a comfortable and convenient
setting if the best outcomes are to be
achieved.
FORM AND FUNCTION
Engineered surfaces such as melaminefaced
chipboard (MFC), high-pressure
laminate (HPL), and compact laminate, are
key to this.
Beyond intangibles such as developing
trust and comfort through high-quality
Antibacterial laminate panels are designed to destroy 99.9% of bacteria within 24
hours due to the enhanced silver ion protection being integrated into the material
during the resin impregnation stage of the manufacturing process. Image: Susanne Krauss
aesthetics in public spaces, a hospital’s décor
must match form with function.
This includes acting as a safeguard against
the risk of infectious agents and healthcareassociated
infections (HCAIs).
This conclusion is neither new nor novel
for specifiers working on healthcare projects.
Yet there are important nuances and
details to be discerned when discussing
surface hygiene and specification in the
hospital environment.
BEYOND THE EXPECTED
From the waiting room to the operating
theatre, all surface coverings used in
healthcare must meet rigorous standards
around cleanability and durability.
Hospitals are demanding places with
unique stresses and strains that every aspect
of the modern built environment must
consider beyond the clinical aspects of
patient visits.
It is with this in mind that the area of
microbial protection must be explored.
Despite infection prevention being increasingly important post COVID, there remains no identifiable
standard across Europe governing the time in which bacteria is killed off. Image: Susanne Krauss
40 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Products
From the waiting room to the operating theatre, all surface coverings used in healthcare
must meet rigorous standards around cleanability and durability. Image: Timothée Lance
Currently, all surfaces must be selected
with hygiene management and the
prevention of bacterial proliferation in
mind. This includes ensuring any specified
products are hard-wearing without
requiring additional protective coatings
such as varnish or paint and that they are
easy to maintain.
Given the requisite emphasis on
cleanliness in hospitals, prioritising surfaces
resistant to a large variety of sanitation
procedures is vital.
For example, they must be able to
withstand intensive cleaning procedures
such as bio cleaning or disinfection with
hydrogen peroxide, while also being
resistant to a large variety of cleaning
products.
However, this should be considered as
standard.
Considering the renewed focus on
cleanliness following the COVID-19
pandemic, it can be argued that healthcare
estate specifiers should look to exceed
current expectations, especially where
hygiene is concerned.
HYGIENIC VS ANTIBACTERIAL
From here, an important distinction
must be made between coverings that are
classed as ‘hygienic’ and those designated
‘antibacterial’.
Specifically, while the former passively
limits bacterial proliferation; the latter
actively assists toward this aim.
Importantly for specifiers, while
all laminate surfaces will generally be
considered hygienic, not every type of
surface can be classed as antibacterial.
Whether used in a decorative or technical
context, antibacterial laminate panels are
designed to destroy 99.9% of bacteria
within 24 hours.
This is made possible due to enhanced
silver ion protection being integrated into
the material during the resin impregnation
stage of the manufacturing process.
Consequently, this benefit is enmeshed
within the product, meaning its effect
will not deteriorate over time due to
expected wear and tear within the hospital
environment.
When complemented with the rigorous
cleaning practices expected in healthcare
estates, antibacterial panels can provide an
important marginal gain toward infection
control and patient safety that more-basic
laminate panels cannot.
RIGOROUS TESTING
These solutions are currently only offered by
Polyrey due to its work with SANITIZED
AG, a leading producer of antimicrobial
hygiene function and material protection
for textiles and polymers.
To ensure the continued effectiveness of
its antimicrobial protection technology,
SANITIZED AG’s performance certificate
is renewed every year following rigorous
laboratory testing, further ensuring peaceof-mind
for hospital stakeholders.
This innovation has been integrated
into Polyrey’s in-house processes to ensure
antibacterial grade products including
MFC, HPL, and compact laminate are
included as standard without additional
costs or manufacturing delays.
And it is certified as food safe, skin safe,
and when combined with the properties of
water-repellent laminate materials, prevents
moulds and bacteria from proliferating.
Additionally, the silver ions used within
the material are not soluble, non-migratory,
non-allergen, and do not lead to respiratory
effects, so are not dangerous for patients or
the healthcare environment.
As a result, surface cleanliness can be
enhanced and HCAI risks mitigated.
An important distinction must be made
between coverings that are classed as
‘hygienic’ and those designated ‘antibacterial’.
Image: Jonathan Alexandre
STANDARDISATION
It is important to note that though
antibacterial materials are currently widely
used across the healthcare sector, there
remains no identifiable standard across
Europe governing the time in which
bacteria is killed off.
And this lack of a centralised knowledge
resource may lead to information gaps when
specifying in the hospital setting.
As a result, the sector must continue to
adapt its working practices to avoid such
pitfalls.
The supply chain has a key role to
play in this, and it is advised that project
stakeholders leverage their expertise
— and that of their suppliers — in all
aspects of the build, from the clinical to the
environmental.
With patient protection paramount to
hospital design, antibacterial surfaces are
absolutely a part of this.
The guidance of manufacturers may
therefore be instrumental in ensuring
bacterial proliferation does not occur in all
areas of the healthcare estate.
For healthcare architects or specifiers
keen to explore the selection process more
formally, the company offers a suite of
RIBA-accredited CPDs.
This includes Everything You Wanted
to Know about Decorative Panels and
Engineered Surfaces, Waterproof Laminate
Panelling Systems: A Viable Alternative to
Tile, and The Changing Face of Performance
Wall Surfaces as an Alternative to Tiles. n
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 41

Products
Jacksons Fencing recently installed its Barbican Imperial
railings at Camberwell Lodge care home in Southwark
Pushing the
boundary
of design
We look at how fencing designs for health and
care settings have evolved to strike a balance
between the need for safety and security and
the desire to create more-therapeutic, lessinstitutional
environments
Building design is critical in healthcare settings, providing the
optimal environment for staff to deliver care and for patients
to recover.
And, while landscaping and access to, and views of, nature have
more recently become intrinsic to overall design approaches, one
element often overlooked is fencing.
However, this is a crucial consideration as it not only protects
sensitive medical equipment and maintains privacy and dignity, but
it also helps to control access and prevent unauthorised entry.
Recent years have witnessed a strategic evolution influenced
by government directives and consulting expertise, leading to a
diversification in fencing strategies.
And one prominent trend reported by manufacturers is the
An example hospital layout with various
fencing requirements: Jackson’s Fencing
1. Vertical bar fencing creates a boundary fence
2. Bi-Folding Speed Gate for rapid access
3. Mesh fencing with tamper-proof fixings prevents vandalism
4. Acoustic Barriers reduce noise around fans and air
conditioning units while keeping them secure
5. EuroGuard Combi safely secures waste and keeps it out
of sight
6. Bollards segregate vehicles and pedestrians
7. Traffic barriers enable paid access control for visitors and
access only for staff
8. Timber fence panels create a secure and tranquil
recovery garden
42 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Products
Gates and entrances
should be designed
to accommodate
wheelchairs,
stretchers, and other
medical equipment,
and at the same time,
the whole security
strategy should
present a welcoming
aesthetic conducive
to healing rather than
hostility
adoption of fencing solutions that not only
enhance security, but also offer additional
benefits.
For instance, there is a growing emphasis
on fences that provide both security and
visual concealment, ensuring privacy while
safeguarding property.
SECURING THE BOUNDARY
Peter Jackson, managing director of
Jacksons Fencing, explains: “When
specifying fencing for health and care
environments, several key considerations
must be taken into account to ensure the
safety, security, and wellbeing of patients,
staff, and visitors.
“The primary consideration is ensuring
the fencing provides a secure boundary to
prevent unauthorised access; fencing should
be robust and resistant to tampering or
climbing. But it should not hinder access
for emergency services, staff, or individuals
with mobility challenges.
“Gates and entrances should be designed
to accommodate wheelchairs, stretchers,
and other medical equipment, and at the
same time, the whole security strategy
should present a welcoming aesthetic
conducive to healing rather than hostility.”
He advises opting for fencing designs that
allow for clear visibility, both inside and
outside the facility, for effective surveillance
and monitoring.
SENSITIVE LOCATIONS
“Privacy is also crucial in some areas to
protect confidentiality and maintain
dignity, particularly around recovery
gardens, critical care units, and sensitive
locations where there is a view through
windows or doors,” he adds.
“A design that can hide clinical waste
should also be specified around waste areas
and the layout of the facility should be
carefully mapped to implement correct
placement of suitable fencing to balance
visibility and privacy across the site.
“Specifiers should select materials that
are durable, weather-resistant, and low
maintenance to minimise the need for
repairs and upkeep over time.
“And, if the facility caters to children or
Attractive artwork can be applied to Britplas’ Fortress fencing
families, consider additional safety features
such as childproof locks on gates and
barriers to prevent accidental injuries or
unauthorised access.”
NOISE NUISANCE
Acoustic fencing ranges, in particular, have
grown in popularity within health and care
settings.
Jackson said: “Rather than settling
for conventional security measures,
stakeholders are recognising the value of
fences designed to mitigate noise pollution
from sources such as air conditioning units.
“By opting for fences that serve multiple
purposes, stakeholders can achieve a
comprehensive approach to security while
simultaneously addressing other concerns.
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 43

Products
Britplas’ Fortress fencing at Foxhall House secure mental health facility in Suffolk
Walking out into an
external space where
you aren’t just faced
with an expanse of
institutional grey
fencing is far more
preferable and much
more therapeutic
“For example, installing a timber acoustic
fence that not only deters unauthorised
access, but also reduces noise levels from
machinery like air conditioning units,
is not just a practical choice, but also an
aesthetically-pleasing one.
“The evolution of fencing reflects a
strategic shift towards solutions that optimise
security, functionality, and aesthetics.”
REDUCING STIGMA
One area of the healthcare sector where
fencing is key is within psychiatric facilities,
where standards require fencing heights
of between 2.2m-5.2m, depending on the
security level.
A spokesman for manufacturer, Zaun,
said: “There is still a lot of stigma attached
to mental health and mental health
facilities.
“Many people still picture scary fortresses
with barbed wire, rather than state-of-theart
medical facilities, but modern solutions
are a far cry from the days of barbed wire.
“Fence height, post details, and gating
are all important to prevent escape and any
personal damage, but the overall look also
needs to be in keeping with a harmonious
aesthetic that is congruent to promoting
good mental health.”
Britplas is a leader in the field of mental
health fencing — having launched its
Fortress Fencing range in direct response
to requests from a mental health trust in
Manchester.
The product features an innovative
cloaking system which makes the fencing
anti-climb as well as preventing the passing
of unauthorised items through the mesh.
And artworks can be applied to the
cloaking to enhance the environment,
creating attractive vistas which are
aesthetically appealing and calming, while
also minimising the fencing’s physical
presence, adhering to salutogenic principles.
Kevin Gorman, Britplas chairman,
said: “Walking out into an external space
where you aren’t just faced with an expanse
of institutional grey fencing is far more
preferable and much more therapeutic.”
THE RIGHT SOLUTI€ON
Over 60m of 4.2m-high Fortress Fencing
was specified by Norfolk and Suffolk NHS
Foundation Trust (NSFT) to alleviate
absconsion issues, plus to cover a small
seclusion area separated for difficult users.
Each area was separated by a gate with
printed mesh on both sides.
And Jacksons fencing recently installed
154m of Barbican Imperial vertical bar
railings at Camberwell Lodge care home
in Southwark, London, operated by
Country Court.
The railings, standing at 1.8m high, are
hot-dip galvanised and polyester powdercoated
in black, ensuring long-lasting
durability, another key consideration for
specifiers.
Jackson told Healthcare Property:
“When researching fencing options, use
comparison tools to help you decide and,
if ever in doubt, pick up the phone to the
fencing manufacturer and speak to them.
No question is stupid, and with years of
combined experience within sales teams,
they will be more than happy to help and
may give you insights and advice you hadn’t
thought of.
“Case studies showcasing hospitals
and care homes, or the product you are
interested in, are a great way to see how the
product works in a real setting. Also, don’t
be afraid to work with other consultants
and specifiers.”
SUSTAINABILITY
In the future, he predicts that fencing
designs will continue to reflect the desire of
health and care operators to better balance
safety and security with the creation of
more-therapeutic spaces.
And sustainability will also play a key
role.
He said: “As strategies for enhancing
security and patient welfare continue to
evolve, there is a growing aspiration for
sustainability to play a pivotal role in
fencing designs.
“This shift is driven by the recognition
of the long-term benefits that sustainable
practices can provide, not only in terms
of cost reduction, but also environmental
stewardship.
“By prioritising sustainability in fencing
designs, healthcare property stakeholders
can mitigate the need for frequent
replacements, thereby reducing longterm
costs and upheaval associated with
maintenance and replacement of fencing.
“Moreover, sustainable fencing solutions
have the potential to minimise the
environmental footprint by curbing the
accumulation of discarded fencing materials
in landfills.
“In essence, integrating sustainability
into fencing designs represents a forwardlooking
approach that aligns with broader
societal imperatives.” n
44 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Products
REHAU is the cure
for Epsom Hospital
This case study looks at how partnership working was critical
to the upgrading of windows at Epsom Hospital
When Epsom Hospital was
in need of energy efficiency
upgrades, Epsom and St Helier
University Hospitals NHS Trust looked
to specify REHAU’s curtain walling and
TOTAL70C windows.
However, with the install set to take
place in an active emergency department
environment during the peak of a
global COVID-19 pandemic, seamless
collaboration across the NHS, REHAU,
Hanevo, JM Aluminium, and LH&E Cost
Consultancy would be necessary to ensure
there was no disruption to the emergency
department and operating theatres.
Epsom Hospital is a healthcare facility
like any other, providing services spanning
accident and emergency, diagnostics, and
more to the people of its namesake borough
in Surrey.
And, as a critical piece of infrastructure,
its continued operation is vital to the health
and wellbeing of the local community, with
this being proven more than ever during the
COVID-19 pandemic.
However, like any long-serving site,
upgrades to the building’s fabric would
eventually be necessary in order for it to
remain operational.
MEETING THE CHALLENGE
“Getting projects across the line in a live
hospital environment is a challenge at the
best of times, let alone during a global
pandemic”, said Dan Kocev, project
manager at the trust.
“However, vital energy efficiency
upgrades were necessary to bring the site
into the 21st Century and ensure that it is
able to continue providing the best-possible
environment for care.”
Natanael Florut, the trust’s project
commissioning manager, added: “We had
some old timber screens and windows that
simply weren’t up to scratch in terms of
energy efficiency.
“I had previously worked with REHAU
products from my time in Romania and
while choosing something like REHAU’s
curtain walling was quite straightforward,
Working in critical
infrastructure means
we’re no stranger to
complex projects, but
we knew that this
installation would be
difficult, even by our
own standards
I knew that the matter of the installation
would be something else entirely, especially
as our database did not have too many
technical records from when the hospital
was initially built.
“Here, the expertise of Kevin O’Neill,
commercial manager at REHAU, during the
design process proved to be absolutely crucial.”
46 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

Products
Collaboration can often be a buzzword
across the industry, but I don’t think
I’ve worked on a project that epitomises
it more than this
From left: Kevin O’Neill, commercial manager at REHAU;
Natanael Florut, project commissioning manager at Epsom
and St. Helier University Hospitals NHS Trust; Jozef Mountain,
contracts manager at Hanevo; and Dan Kocev, project manager
at Epsom and St. Helier University Hospitals NHS Trust
REHAU was approached by the trust
and designated as the appointed supplier
for the job.
A COMPLEX PROJECT
Owing to the complex nature of the project,
critical infrastructure specialist, Hanevo,
was also brought on board to facilitate the
design and build.
JM Aluminium was then awarded
the contract for the installation, while
LH&E Cost Consultancy provided cost
consultancy and contract administration
services.
Noel Hanley, executive chairman
at Hanevo, said: “Working in critical
infrastructure means we’re no stranger to
complex projects, but we knew that this
installation would be difficult, even by our
own standards.
“However, through close collaboration
with REHAU and the other project
partners we were able to come up with a
design that we were confident would work.
“Jennifer Marshall at LH&E was amazing
in helping the entire project team, by
financially reviewing the different design
options to ensure the solution selected met
the client’s budgetary expectations.
“Annie Thomas then successfully
managed the project post contract as
contract administrator and kept on top
of all commercial aspects in her role as
quantity surveyor.
“And Kevin helped with the drawings
and window specification and ensured
that the whole project was compliant with
building regulations.”
BEATING THE ELEMENTS
He added: “The section we were replacing
backed onto critical operating theatres
and quiet rooms that would remain in use
during the installation, so the plan was to
complete the removal screen by screen.
“This would also help keep the site
protected from the elements as we worked
through the winter.”
With the stage set for the installation, it
fell upon JM Aluminium to put the plan
into action.
“This was one of the most-ambitious
projects we’ve ever taken on, but the
comprehensive planning and collaboration
across the team gave us the confidence
that we could get the job done”, said David
Morant, director at JM Aluminium.
“The new curtain walling was to be
installed over a live ambulance bay and
main pedestrian thoroughfare, meaning
some pretty-comprehensive health and
safety assessments were necessary.
“From there, it was clear that we’d need a
specialist system to get the profiles up safely.
“We were able to work closely with
London Network Scaffolding to design a
bespoke hydraulic and mechanical system,
adapting the top of the scaffolding and
fitting an electric hoist to raise the panels up
through the middle.
“This proved to be an ingenious solution,
allowing everything to go to plan and
exactly according to timescale.”
WORKING TOGETHER
Alongside the complex curtain walling
installation, the project also saw the
installation of 20 TOTAL70 windows in a
foil wood grain finish.
All in all, the project would take 16
weeks, beginning in spring 2022 and
concluding in the winter.
O’Neill said: “Collaboration can often
be a buzzword across the industry, but I
don’t think I’ve worked on a project that
epitomises it more than this.
“The outcome simply wouldn’t have
been possible without the hard work and
adaptability of all of our stakeholders, from
design through to installation.
“Minimising disruption was our main
priority over the course of the project and
the NHS has told us that it was enamoured
with the lack of complaints they received,
so we hope to lend our expertise to similar
projects in future.” n
HEALTHCARE-PROPERTY.COM MARCH-APRIL 2024 | 47

People
Carbon Trust appoints new CEO
Chris Stark, the UK’s
chief climate change
adviser, has been
appointed as the new
chief executive of global
climate consultancy, the
Carbon Trust.
He will take over the role in spring 2024 to
lead the organisation as it drives accelerated
climate action towards net zero.
His appointment comes after the Carbon
Trust’s chief executive of over two decades,
Tom Delay, announced he would step down
in June of last year.
Chairman of the Carbon Trust’s board,
Julia King, Baroness Brown of Cambridge,
said: “Chris has been a leader in the
climate action space, both within the UK
and globally, and his approach has always
HEFMA CHAIR
TAKES ON NHS
ENGLAND ROLE
Kay Mulcahy,
chairman of
the Health
Estates &
Facilities
Management
Association
(HEFMA),
has been appointed
associate director for
national estate operations
for hard and soft facilities
management within NHS
England.
Mulcahy has been an
active member of HEFMA
for 16 years as a former Trent
branch chairman, HEFMA’s
national secretary for seven
years, and a board director
for six years.
She joined the NHS in
1996 with her present trust,
Nottinghamshire Healthcare
NHS Foundation Trust, where
she is currently director of
estates and facilities.
In her new position, she
will be responsible for the
operational effectiveness
of hard and soft FM,
including productivity,
digital transformation, and
workforce.
been underpinned by a combination of
pragmatism, integrity, and openness.
“This is fully aligned with both the
mission and values of the Carbon Trust,
making Chris the right person to lead
the organisation into its next stage of
development.”
Stark, a world-renowned climate policy
expert, has advised UK governments
for over a decade, including in his mostrecent
role as chief executive of the UK’s
Climate Change Committee where he led
independent advice on the UK’s net zero
target and developed multiple pathways to
ensure the whole economy could meet this
target.
And he has a wide breadth of experience,
having previously led teams at the UK
Treasury, the Department for Business, and
the Scottish Government.
As part of this, he specialised in the
intersection between policy and business
and, particularly, the role of the private
sector in achieving the net zero transition.
In response to his appointment, he said:
“I’m delighted to join the Carbon Trust.
“Tackling climate change is my life’s work
and I believe the Carbon Trust will continue
to play a key role in that mission.
“The organisation has been a climate
pioneer over the last 20 years, driving
innovation in climate solutions and
providing practical support to businesses,
governments, and financial institutions to
accelerate decarbonisation.
“I’m excited to lead the organisation in the
next phase and grow the Carbon Trust’s
positive impact even further.”
Knott to lead on NHS FM expertise
NHS Property
Services
(NHSPS) has
appointed
Simon Knott as
the head of hard
FM expertise.
Knott joined
NHSPS in 2018 as the principles
operations compliance manager
in the technical compliance
team, which is responsible
for ensuring NHSPS’ portfolio
remains compliant and fulfils all
statutory and mandatory legal
obligations.
His new role will involve
leading the hard facilities
management expertise team,
providing advice and expertise
on technical standards,
governance, infrastructure
asset management, fire safety,
reporting, and statutory
inspections, in addition to
supporting the organisation’s
regional delivery function.
The compliance expert held
similar roles at Carillion and
BT Facilities Services prior to
joining NHSPS.
In his new position he will
play an active role in supporting
the health and property
organisation’s hard FM strategy.
“Hard facilities management
services are one of NHSPS’
staple offerings, so I want
to ensure we support our
customers through correct
standards of property
maintenance and in-house
expertise,” he said.
“I’m excited to lead this
customer focused team as
we drive our philosophy
of supporting the NHS in
delivering excellent patient care.”
CURRIE & BROWN’S NEW HEALTHCARE LEAD
Currie & Brown has recruited
Ian Mitchell to head up cost
management for the healthcare
sector in London and South
East England.
His appointment will add to
Currie & Brown’s expertise in healthcare cost
management and experience, ensuring that
complex healthcare projects are delivered within
budget.
The firm has provided cost management
services on a number of New Hospital
Programme (NHP) schemes and for NHS clients
including Great Ormond Street Hospital for
Children, University College London Hospitals,
Barts Health, James Paget, and Lewisham &
Greenwich.
Mitchell rejoins Currie & Brown following
a seven-year gap and brings extensive
experience in whole-life costing, business case
development, and benchmarking, along with a
deep knowledge of technical standards.
Alongside adding value to Currie & Brown’
clients, he will also play an important role in
implementing the firm’s growth strategy, drawing
on his experience in senior leadership teams at
top-tier construction consultancies.
David Keith, senior director for London at
Currie & Brown, said: “The Government is
investing heavily in our healthcare infrastructure
to futureproof facilities and Ian’s specialist
experience means he is ideally placed to support
clients and ensure their investments deliver on
expectations.”
48 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM

People
SAFETY GURU FOR
PRIVATE HOSPITAL
King Edward VII’s Hospital has hired
Jabeen Ahmad as its first patient
safety partner (PSP).
The PSP is a new role for both private
and NHS healthcare settings, working
under the new Patient Safety Incident
Response Framework (PSIRF) which
aims to establish a systems-based
approach to responding and learning
from patient safety incidents.
Ahmad will support PSIRF within the
hospital, providing a perspective through
a patient lens — she has a chronic
health condition herself — to support
developments and innovations and to
drive continuous improvement of quality
and safety of services.
The role will involve the designing
of safer healthcare at all levels in the
hospital to promote safety and maximise
opportunities for effective and embedded
learning.
Ahmad has more than 20 years
experience and previously worked as
director of pharmacovigilance roles
at several global pharmaceutical
companies. In addition to medicines
safety, she led projects raising awareness
of the lack of images of clinical symptoms
on black and brown skin in medical
textbooks, as well as highlighting the
need to test medical technologies such
as pulse oximeters on a full range of skin
tones to ensure accuracy in all patients.
David Barron, head of governance at
King Edward VII Hospital, said: “Through
Jabeen coming on board, we are making
a commitment to every patient’s clinical
pathway throughout the hospital.
“Her role will provide unique insight
and constructive challenge to ensure the
continued enhancement of a systemsbased
approach to responding and
learning from patient safety incidents,
responsive and high-quality patient
experience and ensure that a patient’s
views are taken into consideration in
every decision-making process.”
Private equity firm takes
on healthcare advisor
Eddisons makes senior
planning appointment
Lydia Pravin, MSc, MRTPI,
has joined property specialist,
Eddisons, as an associate
planning director.
Previously working for Brown
& Co as a senior associate
planner in its St Neots office,
Private equity
firm, Permira, has
appointed Jon
Serbousek as a
senior advisor to its
global healthcare
team.
Serbousek has more than 35 years
experience in the healthcare sector,
including international leadership roles in
medical technology companies.
Most recently he led Orthofix Medical as
its president and chief executive, and until
recently as executive chairman of the newlymerged
Orthofix-SeaSpine.
His previous roles include worldwide group
president of Biomet Orthopedics, worldwide
president of Biomet Biologics, division
president for Medtronic Spine and Biologics,
and vice-president of marketing and product
development for DePuy Orthopedics, a
Johnson & Johnson medical device and
biologics company.
Permira has investments in approximately
20 healthcare companies globally, deploying
more than €4bn, and employs over 500
people in 15 offices across Europe, the US,
and Asia.
Pravin is a qualified chartered town planner and has a
masters degree in urban and regional town planning.
Based at Eddisons’ Peterborough office, she will
primarily work across the firm’s regional office network
in the East Midlands and East of England.
Announcing the appointment, planning director, Kate
Wood, said: “Lydia joins us at a time when many local
authorities in the region are at key points in their local
plan lifecycles and reform of the planning system is,
once again, in the spotlight at national policy level.
“With over a decade in the planning profession, Lydia’s
senior experience in both private practice and the
public sector brings insight and skills to the Eddisons
professional services planning offer that will prove
invaluable to the firm’s clients.”
Eddisons is an independent firm of chartered
surveyors specialising in a number of key sectors,
including education and healthcare.
VINCI BUILDING APPOINTS
LONDON AND NORTH DIRECTOR
Paul Tumelty has been
appointed as regional
director to look after
VINCI Building’s
London and North
region.
John Roberts,
managing director, said:
“The appointment of Paul will strengthen
our senior team and business to drive
VINCI Building’s pursuit of excellence in
London and surrounding areas.”
Tumelty, who has previously worked
at Laing O’Rourke and Balfour Beatty,
has a wealth of experience within the
construction industry.
VINCI Building’s London and North
office, which combines a value of around
£80m, is delivering Hellesdon Hospital
Rivers Health Campus, three new stateof-the-art
wards and refurbishment of two
exiting wards under the Integrated Health
Projects (IHP) joint venture with Sir Robert
McAlpine.
50 | MARCH-APRIL 2024 HEALTHCARE-PROPERTY.COM