As part of the NHS’s commitment to joined-up care, the Braintree Community Diagnostic Centre (CDC) is expected to open to patients in Spring 2025. The facility will offer specialist diagnostic services and clinics in its local area within the NHS’ integrated care systems (ICSs), which focus on prevention, better patient outcomes, and reducing health inequalities.
The facility, which will house CT and MRI scanning clinics alongside other imaging and diagnostic facilities, is being constructed on the site of the existing Braintree Community Hospital which currently offers mainly elective orthopaedic surgery and outpatient clinics as part of Mid and South Essex NHS Foundation Trust.
The project is a refurbishment and extension of the existing St Michael’s health centre, which is currently home to the Trust’s midwifery-led birthing centre. The centre will remain operational throughout the duration of the scheme.
Working on a live NHS hospital site brings its unique challenges, something McLaughlin & Harvey is well prepared for having nearly 150 years’ experience working on healthcare projects. On projects where clinical settings are near to the works, it’s essential that early collaboration with clinical and estates staff is established to ensure patient safety and comfort come first at every stage of the build.
Creating a modern diagnostic facility from a dated structure
The project includes full refurbishment of much of the existing building in addition to a new build extension which, together, will enable the Trust to deliver wider diagnostic services locally, providing faster diagnosis for patients and ultimately improving treatment times.
What makes this build particularly challenging is partly down to its location; on the same site as the existing Braintree Community Hospital and Blandford Medical Centre, and with the existing maternity wing attached adjacent to where the works will be taking place.
A major concern for the trust in appointing a contractor was how to make the logistics and sequencing of a scheme work on a site with limited space – due to surrounding residential and industrial buildings – without disrupting patient services or safety in the live parts of the hospital.
A focus on early engagement
Early engagement with the client right from the start of the tender process meant that we were able to offer solutions to their concerns before we were even appointed. The team came to the interview process with multiple options which would enable us to set up the site and welfare areas to deliver the project on time whilst mitigating impact and maintaining live services and emergency routes.
McLaughlin & Harvey’s healthcare operations manager, Colin McCullough, said: “Although the site we’re working on offers planned, low-risk births, they must be ready to act in case of emergency. We had to ensure access would be consistently maintained to take patients to critical or intensive care units if needed.
“Our proposed plan for the project offered an alternative ambulance parking area, immediately adjacent to the maternity ward, with a new dedicated roadway which would enable quick access for emergency vehicles away from the active site works.”
It was this clear demonstration of McLaughlin & Harvey’s experience working on complex, live healthcare sites – and willingness to collaborate with the Trust to ensure a patient-first approach – that secured the contract for this project.
Unexpected challenges
A second, and much more complex challenge McLaughlin & Harvey’s Braintree team was faced with, was the age and construction of the original building. Working on a refurbishment and extension of the original building meant we had unexpected challenges dating back to a time when building compliance for healthcare estates was less stringent.
Colin added: “When we arrived on site it became clear that the information and plans on which we’d based our tender and the reality of the building we were faced with were very different.
“This isn’t unusual in older buildings, the regulations we’re used to now were simply not in place at the time of construction and it often means we have to rethink our approach when we start to strip back and demolish existing facilities. Our healthcare experience and our willingness to work closely with our clients gives us this agility.”
The core challenge with the ‘soft’ start on site has been centred on removing ceilings and walls and discovering that the roof cavity was not always fireproofed between clinical zones. This meant that the risk of fire spreading to other areas of the site once works began, including to the live maternity ward, was significantly heightened – something we had to address in the design once we’d arrived on site.
In addition to this, services situated in that roof space supplying ventilation directly to the maternity ward were left entirely open, meaning that patients could potentially be exposed to dust or dirt from the works entering the maternity ward.
These challenges meant the design team had to revisit the plans to ensure service elements were redesigned and layouts were reconfigured to 2024 compliance standards. Temporary works were put in place in ceiling voids to compartmentalise the maternity ward from the site area and prevent impact on mothers and babies during construction.
The result is a clean and tidy site which places patient safety and compliance at the forefront without impacting delivery times for the CDC which will ultimately have a real impact on patient experience and speed of diagnosis.
Working together to find the best solutions
Where McLaughlin & Harvey’s experience has been able to add value here, even before the full construction stage has begun, is through collaborating with both clinical and estates teams to ensure problems that hadn’t been identified during the planning and tender process are quickly resolved without impacting on patients or service provision.
Colin summarises: “To be clear, this isn’t a case of suggesting the Trust’s plans or existing buildings were wrong, but in 2024 compliance and safety are of paramount importance. We know that when we arrive on site for a soft strip of an older building, the existing plans often don’t reflect what we find.
“On a live NHS site, when changes need to be made to a design or project sequencing, we need to be careful that we’re working with a whole range of stakeholders to find the best way forward without impacting patients, site safety, end use compliance, and of course value for money.
“We’re not coming in to try to upset the applecart and tell our client they can’t do things in their way, or downing tools until an architect has revised plans which will delay the entire project. It’s about being able to draw on our experience and work closely with hospital staff, architects, and our supply chains to find a way forward that will resolve a potential issue in a way that works best for all stakeholders.
We have the experience and flexibility to facilitate that collaborative approach, from scheduling more disruptive tasks on weekends when there are fewer outpatient clinics on site, to liaising daily with ward managers to understand their changing pressures or working closely with designers to ensure the revised plans are safe, compliant, and also buildable.”