Two new operating theatres at Alexandra Hospital built using modular construction

Worcestershire Acute Hospitals NHS Trust is undertaking a multimillion-pound investment in the operating theatres at the Alexandra Hospital. This is to combat the issues faced with aging theatres and to address the expanded list of operations because of the Covid-19 pandemic.

The project involved the construction of two new operating theatres with supporting clinical and staff areas. They provide improved clinical space, more flexibility and are better suited to current clinical practices. 

The two new theatres were built incorporating modular construction. The remainder of the new-build; the linkages to the original hospital building and supporting clinical and staff areas, were constructed traditionally. 

Funding was secured through the NHS/E&I Targeted Investment Fund 2 (TIF2) scheme, which aims to reduce the backlog of elective surgery caused by the Covid-19 pandemic. 

Our role in supporting the Trust deliver its objectives 

Currie & Brown supported the Trust by providing cost management, employer’s agent and business case writing services. 

Pre-procurement, we costed the various options proposed by the Trust’s design team to assess their feasibility. This ranged from options costing up to £49 million for a new-build multi-storey complex, down to a £11 million scope of works option.

Once the scope and scale of the project was agreed, we developed the project’s business case to apply for TIF2 funding. The business case was accepted with £18.86 million of funding secured. Certain spend-timeline criteria conditions were included in the funding agreement.

We then drafted the project contracts, including a pre-construction services agreement, two enabling works contracts and two main works contracts.

During construction, we performed cost advisor and employer’s agent roles, working closely with the Trust’s internal project manager and wider team.

Providing solutions to overcome cashflow challenges

A major project challenge was cashflow, and the requirement for the Trust to spend an agreed amount of the secured funding before the end of the 2022/2023 financial year. Considering the funding was only secured in October, this led to substantial time pressures. 

We suggested using modern methods of construction to provide the Trust with the best chance of achieving the funding requirements. This led to the selection of a hybrid modular/traditional solution. The modular elements of the work would be on site by the end of March, so the Trust would achieve the spending targets.

Rapid procurement was a priority due to the cashflow requirements imposed. We conducted a mini-competition procurement exercise using the NHS SBS Modular Buildings Framework for the project’s modular elements. This led to the selection of the modular supplier. The principal contractor was selected via a direct-award procurement exercise through the Constructing West Midlands Capital Works Framework. The modular contractor was appointed as a sub-contractor to the principal contractor.

Mitigating programme delay for operations to commence as planned 

A further challenge became apparent when the ground conditions were significantly worse than expected and existing survey information was inaccurate. This, along with programme delays from the principal contractor, was in danger of affecting the ‘first patient date’ specified by the Trust and linked to the funding approval requirements. 

To mitigate the programme delay, a partial handover was agreed. This required the construction of some temporary access to allow the modular theatre units to be used before all the traditional elements were completed. This solution mitigated the impact of the delay and allowed operations to commence as planned on the original completion date. The remainder of the construction work was then completed.

Endorsement of the Currie & Brown team

“The Currie & Brown team worked extremely hard to ensure the project was delivered on budget. They provided solutions to the project’s complex funding and cashflow requirements, ensuring operations went ahead on the planned date. 

These two new theatres are an important step in the Trust’s vision for the Alexandra Hospital being a surgical centre of excellence for patients across Worcestershire and beyond. Currie & Brown has played a significant role in supporting us achieve this vision.” 

Jo Anyon, Deputy Director Estates and Facilities (Strategic Estates), Worcestershire Acute Hospitals NHS Trust