Abstract

The popularity of approaches to the use of modular prefabrication (and many hybrid variations thereof) in healthcare is rising, particularly where speed is a priority. Many leading NHS trusts are undertaking major redevelopment of their hospital sites where modular solutions are under consideration. 

While the design and construction of many healthcare buildings date back to when flexibility was less of a priority, modular solutions are not new. One of the early healthcare planners, Florence Nightingale, adopted the approach for her eponymous pavilion wards in Scutari. From this auspicious beginning modular prefabrication suffered a reputational decline. The Emergency Medical Service (EMS) wards, for example, provided as a short-term solution in wartime, survived well into peacetime and are still in use today. 

Now, in a rapidly changing health and social care environment, providers continuously need additional and improved space to deliver optimal clinical environments for both staff and patients, and modular prefabrication is increasingly used as a rapid response to evolving demands. However, in contrast to the EMS huts, which became permanent by accident, today’s modular prefabricated buildings are designed to survive as long as conventional buildings. The choice of prefabricated modular solutions, like any other investment decision, will be made with the holy trinity of cost, timescale and quality in mind. However, our experience suggests that while the first two criteria are influential, it’s less clear how much consideration is given to the third, with the worrying possibility that Meatloaf’s two out of three (ain’t bad) axiom may be at work. 

Methodology: This presentation will describe the results of a survey carried out on the use of modular prefabrication in healthcare. The survey aims to establish what considerations inform the decision to adopt a modular approach and the in-use experience of such buildings. The survey seeks to answer a number of questions, including how far modular buildings can compromise or complement models of care, enable workforce efficiency, support the adoption of new technology and other innovations, improve patient experience, and respond to change. 

Results and implications: The results from the survey, complemented by further research, which will be reported in this presentation, will provide an evidence-based framework that can be used to inform decision-making about when modular buildings are a favourable solution, and under what circumstances they’re suitable for delivering the intended model(s) of care.