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How can you build a hospital in just a few weeks?

02 June 2021

Major Angela Laycock shares how the Military Assessment Team from 170 (Infrastructure Support) Engineer Group supported the NHS in rapid response to the Covid-19 pandemic.

How can you build a hospital in just a few weeks?
The Nightingale Hospital Birmingham, which was set up in just 18 days. Image credit: Major Angela Laycock

While watching the Covid-19 outbreak unfold in China, I was interested in the new hospitals that they were building in Wuhan. Little did I know that in a few weeks’ time I would be helping design and build one myself here in the UK.

As England moved into lockdown in March 2020,a few of my colleagues were drafted in to support the building of a temporary hospital in the ExCel Centre in London.

As military infrastructure engineers, we support the UK in resilience tasks such as flood events and other major incidents. The support can be either in the form of providing technical advice or identifying where military engineers could fill capability gaps. In the case of the ExCel centre, it was both technical support for the installation of medical gases, security engineering and supplied pinch point tradespersons.

Site reconnaissance

After the first week of lockdown, my colleagues and I were called back from working from home to deploy as Military Assessment Teams (MATs) tasked with identifying the next locations for these temporary hospitals which were later referred to as ‘Nightingale Hospitals’. I deployed with one of my Clerk of Works (Mechanical) to the National Exhibition Centre (NEC) in Birmingham to support the NHS regional director in assessing the site for suitability to be converted into a hospital.

Using the knowledge gained from the military involvement in the ExCel centre, I was able to come up with a checklist of requirements that my team could assess in a detailed site visit with the NEC staff and NHS work strand leads. This allowed us to conduct a gap analysis to see whether there were any major constraints and what long lead items needed to be ordered quickly.

I also conducted a bedspace analysis to quickly identify how many beds could be provided, which helped the NHS select the site due to the economy of scale benefits it offered. As a military engineer, we are used to breaking down complex problems into smaller tasks and using the team effectively to gather information and analyse the data.

Using our skills to save time

We were also able to use our trades gained within the Royal Engineers. I am a chartered civil engineer, so I was able to offer technical advice in terms of construction, and a draughtsman in my team used his AutoCAD skills to draw up the concept designs with the NHS over the first weekend.

This saved a considerable amount of time, as the NHS would have otherwise needed to have waited for the designer and contractors to have been appointed to get this done. By the end of the weekend, we had drawings of each of the halls containing the suggested bed configuration, ablutions blocks and medical equipment layout. On the Monday morning, the designers and medical gas installers were already using these designs to start detailed design and plan the build.

The construction phase

Within a day of the contractors being appointed, the build began starting with the installation of the utilities and most importantly: the medical gas pipes.

I became more of the client’s representative supporting the NHS and contractors with advice, planning assistance and identification of issues both on site and across other Nightingale hospital builds.

Other military personnel were also supporting the NHS in planning, logistics, general support moving equipment and medical resource planning. The Royal Engineers were only required to support with a section of heating and plumbing tradespersons to ensure that the opening day was met. This was achieved on the 10 April 2020, just 18 days after we first set foot in the NEC.

The 'sheer scale' of the project

The main challenge was the sheer scale of the project, which at first seemed overwhelming. We didn't really know where to start, as hospital planning normally takes years, with many experts involved.

Breaking it down into bite-size sections really helped, as we focused on power, water, ventilation, logistics, transportation and bedspace layout. Breaking the team down to check the current capacity and identify what additional assets were needed made the task manageable for the NHS project team.

The lessons learned from construction work in a crisis

My main takeaways from the project were that people can really work well together in a crisis - they are focussed on the mission to get the job done.

Things like contractual agreements were organised concurrently with design, which really helped speed up the process.

In the future. I would try to break down jobs into modules again, too. This made expansion and subsequent design much quicker when you could just ‘cut and paste’ the modules into the other areas and multiply the resources.

The project has certainly been the highlight of my job as a military infrastructure engineer, despite only being a few weeks long. I met some amazing people from both the NHS and contractors who we worked with, and I felt that the Covid patients in the Midlands would have been in safe hands.

  • Major Angela Laycock, Infrastructure Specialist, Royal Engineers at Royal Engineers