I feel compelled to write to express my continued concerns with the inadequacies in the design and specifications of new build hospitals within the United Kingdom having read the recent audit report press release of KPMG regarding hospitals in Scotland where conflicting design information exists.
I have been in the construction industry for 41 years and have seen a continued decline in the quality of the drawings, specifications and design generally since I started work in the industry in 1978. Whilst IT systems have become more and more prevalent in the industry and more and more advanced in their capabilities, claiming to improve the quality of design and specifications, yet we are seeing more and more problems. This is not so much an issue with the IT itself but more of the users’ reliance upon the IT to do what was once carried out by highly trained and skilled people in building design detailed work.
Too often in modern times I have heard the saying "it's the software" when something goes wrong but this is not necessarily so. Even something that comes from a computer software system needs to be reviewed and checked for quality control and compliance – after all, the software may well have been written many years before construction started.
The conceptual design of hospitals has improved considerably and hospitals appear to look so much more pleasing to the eye, but the detail that is required to build to the very demanding quality, functionality, programme and budget requirements of the NHS seems to just get worse, yet the cost of producing this necessary detailed design ever increases as the quality similarly seems to fall.
I hear frequently that Austerity and Lean are very important factors in construction. Is this part of the problem and not the solution?
The government had set a design requirement through BIM (building information modelling) of a minimum level 2, whereas the Middle East had been operating at level 3 for over seven years now. We are simply not progressing the more detailed design to BIM 3 or better whilst the Middle East is striving to achieve BIM level 5 and beyond.
The level of detail that is now required to run a hospital for 50 years requires much more detail in respect of the operational life of the products through cost in use analysis, because of the complexity and advancing technology in place. These small detailed issues, like a simple move to LED light bulbs, has a very significant impact to a hospital build contract already put in place.
Now with the new Conservative government, who are pushing the NHS into the next programme of works to take us into possibly the next century, planning to build many new hospitals, what with tragedies of fires in tower blocks at Grenfell and Bolton, now is the time the industry should push back at the NHS procurers and insist that more fully detailed design with cost in use and product choice is completed before embarking upon the construction phase of any new hospital.
The building regulations that appeared woefully inadequate in Bolton and Grenfell should be fully modernised and updated to new standards to reflect lessons learned over the last 10 years so as to deliver a new generation of hospitals for the next 50-100 years.
Disgruntled NHS supporter