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Steeling ahead on a massive hospital build

Famous for its cricket ground, Edgbaston is now home to one of the country’s largest ever PFI projects, a £570m super hospital

Client University Hospital Birmingham NHS Foundation Trust and the Birmingham and Solihull Mental Health NHS Trust
Contractor BNH JV: A 60/40 joint venture between Balfour Beatty Group companies Balfour Beatty Construction and Haden Young
Steelwork Severfield-Reeve
Total project build cost £570 million

“Ay ya gorra berrer oydea o’were ya wanna gew mayte?” says the taxi driver as he speeds from Birmingham’s New Street Station toward what will be the city’s super hospital, “Only it’s a mossive soyte yu see.”

Unlike locals from other UK regions it is not in any Midlander’s psyche to make a fuss about nothing. Modesty and diffidence is very much the order of the day. So when a Brummie taxi driver tells you a site is massive, you know its going to be on the large side.

And he’s not wrong. What will become the latest addition to Birmingham’s clutch of state-of-the-art medical facilities is indeed massive. Sitting deep in the city’s suburb of Edgbaston, the three towers that will eventually become part of the Birmingham
Acute and Adult Psychiatric hospital are thrusting skyward.

A joint venture team between Balfour Beatty Construction and the group’s mechanical and electrical business wing, Haden Young, will spend the next five years erecting the towers of the acute services building, fitting them out, constructing the mental health facilities, providing car parking and refurbishing some of the retained buildings – at a total cost of £570 million.

It’s a complicated and difficult build for Balfour Beatty’s PFI director Mike Harris and his colleague, project co-ordinator Tim Francis. They will spend the next five years juggling the complexities of providing state of-the-art hospital facilities.

Despite having worked on PFI hospital projects before, Mr Harris concedes just the very scale of this particular project can seem daunting.

“It is a huge project, certainly one of the largest in the UK at the moment. There’s only Heathrow Terminal 5 that’s bigger and that’s near completion.”

But the two exude quiet confidence that, when the project reaches it end date in autumn 2012, they will not be worrying about time overruns.

For Mr Harris this is the third major hospital project he has worked on for Balfour Beatty – with experienced gained at new medical facilities in Edinburgh and Blackburn before being charged with looking after Birmingham – and it is this experience that helped the joint venture team make its first big decision. Despite having had the initial design costed as a reinforced concrete frame, the joint venture chose steel as its preferred option of framing material despite it being
slightly more expensive.

“There were quite a few reasons why we chose steel in the end. The speed of construction was the most obvious, it’s far quicker than concrete to erect, and by fabricating off-site it meant that work on the frame could begin while we were still carrying out site preparation works,” says Mr Harris.

“If we had chosen concrete we would not have been able to do that. In-situ concrete is also far more weather dependant, and with the poor summer we have just had who knows where we would be. There is a premium to be paid when using steel, but this is completely outweighed by other benefits the material brings.”

Indeed current programme estimates from Mr Harris and Mr Francis have the scheme running approximately two months ahead of schedule.

While much of this gain is due to the efficient running of the site, it’s hard not to apportion some of the credit to the framing method chosen and the fabrication excellence of Balfour Beatty’s steel supply
partner, Yorkshire-based Severfield-Rowen.

The two companies have forged a strong relationship over the years after working with each other on similar projects, and one of Severfield’s specialists companies, Severfield-Reeve, has fabricated the
steel for the Birmingham job.

Steel vs concrete

“There is a total of 12,500 tonnes of steel on this project,” says Mr Francis, “about 10,000 tonnes has already been erected so there’s a little way to go yet.”

But what of the old argument that steel is inappropriate for use in hospitals because the sensitive machines used in hospitals could be affected by vibration because of the metal’s relative light weight when compared to concrete?

“Well you just beef up the frame around those particular areas that may be affected. With advances in medical science shifting toward lighter machinery and equipment it is unlikely that this will become an issue,” adds Mr Francis.

“We just increase the size of the frame locally if thereare areas which have been highlighted as potentially problematic by the hospital authorities,” he explains. “But the big machines are all located on the ground floor anyway and so are not a problem, and the rest of the hospital design has been ‘future proofed’ so that it will be able to accommodate any advances in equipment. Vibration is not really an issue.”

Putting a ceiling on costs

“On this project we are using our already established relationship with a highly experienced steelwork specialist – in Severfield-Reeve – who has a track record of delivery on this type of project,” says Mr
Harris, “we are confident this is the right design and the right material to be using.”

But fluctuating steel prices did alarm the team – not enough to make them consider using other materials but enough to ensure they bolted down a price.

“We negotiated a top end price that we would pay for steel,” says Mr Harris, “we agreed that we would pay up to that price but nothing more. It means that we can cost on that maximum price. Anything under that rate is a bonus for us.”

Material prices aside, one of the problems on the project is the existing mental health unit which sits slap bang in the middle of the footprint for one of the towers. This means the project team has to complete the new mental health facilities before patients and staff can be transferred over from existing.

If they were anywhere else on the site the two new psychiatric wings – the south Locality, which will be a general in and out patients facility and the speciality services, which will provide care for the severely impaired and blind and deaf patients – would themselves be impressive buildings, but sitting next to the three towers there is a tendency to dismiss them as afterthoughts.

These wings – alongside two further centres being built away from the main Edgbaston site – are large-scale, steelframed buildings in their own right and the project team has worked hard to bring these buildings in ahead of schedule.

“We are in the position where we can offer the Trust possession of the psychiatric care buildings before our contracted handover date. The Trust may chose not to take us up on that offer so that they can have longer for its staff to complete their move. Either way we are ready,” says Mr Harris.

The towers will make up all the wards, with the podiums which project from them at ground level housing the laboratories, day-care treatment areas and initial diagnostic rooms. All will be clad using a prefabricated cladding and glazing system made in Italy by manufacturer Permasteelisa, who have worked alongside Severfield-Reeve on a number of major projects.

“It’s a relationship that Severfield brought to the table,” says Mr Francis, “they have worked together on a few projects in the UK and have a good working relationship.”

The cladding system features a self-launching system which avoids the need to scaffold around the whole project – once again helping to save precious time, according to Mr Harris.

“On hospital projects it is important to realise that you need as much time as possible to be spent on the fit out. That is one of the key benefits of using a steel frame. It allows you to press on with fitting out the building at an earlier stage than other methods,” he says.

Making the most of prefabrication

The concept of pre-building as much as possible away from site is not lost on Mr Harris. He is a keen fan of anything that will help keep installation time down and help bring his projects in on time.

On the hospital project it seems that pretty much everything has some element of prefabrication about it. From bathroom pods manufactured entirely from glass fibre to plant rooms delivered in kits, the project has the lot.

“By using prefabrication techniques as far as possible we have managed to save on time and staffing costs,” says Mr Harris.

“Overall we probably have about a third of the labour volumes you would normally expect on a project of this scale.”

The modular plant rooms are manufactured by heavy engineering company Babcock and feature a steel frame around which the air handling and ductwork systems are hung.

Delivered in six sections all the site engineers need to do is to make sure they are all connected up once they have been craned into position.

Similarly, the riser modules have been produced to ensure ease of installation. Once again they are supported on a steel frame which incorporates pipes, ductwork and decking. The frames are then craned into position and bolted together – enabling as much as 50 m to be installed in a day.

“What has worked well,” explains Mr Francis, “is having structural, mechanical and electrical engineers working alongside one-another. It has allowed us to pick each others brains.”

Pre-packed walls

Such is the gusto for time-slashing concepts that Mike Harris helped develop a wall system that incorporates all the power cables, oxygen pipes, clinical services and drug delivery systems in a plasterboard sandwich.

“They are manufactured by Komfort Workspace in Birmingham. Basically it is a steel frame covered in plasterboard with a tough vinyl coating. All the services and cabling are already installed and they are connected up once they get to site.

“Hygienically they are much better because there are no edges for dust to collect and they just look cleaner. They will be used in the acute wards and theatres.”