Concerns over cleanliness and hygiene in hospitals have led to NHS Estates issuing design and briefing documents to supersede old ones. This has led to changes in the design and specification of in-patient accommodation.
NHS Estate (NHSE) documents such as the Health Technical Memoranda and Health Building Notes are an excellent set of guidance on activities and building components in healthcare buildings, write Alaric Smith, Freni Shroff and Ray Lane.
On PFI contracts, hospital trusts use NHSE documents as a benchmark for performance when assessing PFI consortia proposals, but the currency of these documents is not uniform. Although the NHSE is updating its documents, designers and architects should consider advances in medical treatment, the development of technology and best practice.
Updates in Building Regulations, particularly parts L and M, have also affected the design and specification of materials, sometimes resulting in more expensive solutions. Although more practices are committed to protecting the environment, there can be conflict between clinical needs and green aspirations when specifying hospital materials.
At HOK, we specify natural products where possible.
Since maintenance of PFI hospitals is the responsibility of the PFI service provider, it can be in the consortium's interests to invest in products with a longer life, with reduced costs in use. In practice, such joined-up thinking can elude the PFI procurement process, where the construction budget may be set independently from the maintenance budget, with different parts of the consortium controlling separate budgets.
From an early stage in the design process we work with manufacturers and installers to set appropriate specifications.
INTERNAL PARTITIONS Internal partitions must satisfy functional performance criteria, including structural stability, loading capability, fire rating, acoustic performance and specialist X-ray or electromagnetic shielding.
Product systems we have specified include British Gypsum and Knauf UK, and we have set the parameters with the suppliers.
Partitions in heavily trafficked areas also require protection against damage.
In this respect we have specified C/S Group protection systems.
Wa l l fi nishes vary according to the space's function, but we tend to use high-durability emulsion paints by Dulux Trade. In spaces that need a high level of infection control to inhibit microbes metabolising and multiplying, we specify high-performance coatings such as Wallglaze, supplied by C/S Group.
DOORS The nature of hospital activities means that there is a constant movement of awkward items, such as beds and trolleys, along corridors and through doorways. Doors generally take the brunt of the impact, and we are working with Leaderflush Shapland on extending the use of UPVC-encapsulated doorsets, which provide a high level of protection and cleanability, to most hospital areas. We are also pursuing the use of pocket doors on hightraffic routes to reduce the obstruction posed by held-open doors, avoiding the need for retrofitted protection bollards.
FLOORS AND CEILINGS We specify linoleum flooring in the main, with slip-resistant vinyl only for wet areas. We prefer to specify Forbo-Nairn and Armstrong Floor Products for both materials.
The current NHSE recommendation is to avoid fibrous materials for ceilings because the constant access required for maintenance can cause damage to tiles and create minute dust particles.
So we specify gypsum-based products with a washable finish, such as British Gypsum Gyprex Bio, Armstrong Ceilings Bioguard and CEP healthsector gypsum range.
SANITARYWARE The selection of sanitaryware appliances plays an important part in infection control.
HOK-designed hospitals have wheelchair access in all en-suite facilities. We specify wall-hung WCs with an integral spacer, and mixer taps or non-touch taps in criticalcare facilities, in accordance with NHSE recommendations and requirements. We work closely with Armitage Shanks on the design and selection of appliances and fittings.
Alaric Smith is deputy head of healthcare at HOK. Freni Shroff is healthcare technical coordinator, and Ray Lane is senior project architect for Barts and the London PFI Hospital project