East Cheshire NHS Trust – Theatre Refurbishments

East Cheshire NHS Trust wanted to increase the range and complexity of surgeries it was able to offer by upgrading three existing theatres and adding ultraclean ventilation (UCV) canopies, making them suitable for orthopaedic procedures.

The Eco-floor 2800 UCV canopy, surgical panel and steelwork came from Medical Air Technology (MAT). The canopy lighting was from Denmark and sourced by Bender. The overall solution was designed to provide the latest UCV technology coupled with outstanding energy efficiency.

We built the shell for the canopy and surrounding shelving, installed the suspended Whiterock ceiling, vinyl flooring and completed the decorations.

What challenges were faced?

The Trust wanted to minimise disruption to its day-to-day running by phasing the works to allow adjacent theatres to remain in use throughout. Successful execution was reliant on close communication and liaison between Novus and the estate’s team, theatre staff, as well as MAT, Bender and other subcontractors engaged on the project.

A key critical path for the project was to complete each theatre on time. This is as we had to have theatre 1 and 2 airflow and BMS commissioned before starting theatre 3. The hospital had programmed surgeries into the live theatres precisely on either side of our works. This was critical to the operation of the hospital and their appointment system.

The project was still completed on time/within budget and to the client’s satisfaction despite some unforeseen circumstances beyond our control that we managed and mitigated along the way.

We completed the handover & commissioning of the BMS and canopy, including the rollout of aftercare and training to the surgeons and end-users.

Risks and issues and action taken

There was a joined up extract between live theatres and the theatres we were working in. We had live theatres operational on either side of our works at one point. This meant that we had to re-balance the air between theatres. Theatre 2 linked up to theatre 1 on the air ventilation, meaning we had to re-balance the airflow to theatre one whilst we shut down theatre 2. When undertaking the work on theatre 3 we had to re-balance 1 & 2 and then commission before works could be done. This was done out of hours to ensure no disruption to the live environment.

We cleaned the ducting through use of a high-powered vacuum and rotary brushes to ensure they were sterile and fit for purpose.

We kept dust & noise levels down by segregating our construction areas with secure entrance points and appropriate warning signage displayed. Infection control measures were in place, including the erection of airtight plastic and drywall barriers around our work areas.

We had to ensure we separated the clean corridor access from the remaining theatres. Theatre 2 doors faced Theatre 3’s entrance door, so we had to make them airtight. To do this we used a Hoardfast system.

There was a significant requirement for work within the roof space. Therefore, we pre-empted that noise would be a problem when working within the live environment. We took the weekly appointments for each theatre and worked around their operations. This largely involved programming the works out of hours.

How did Novus resolve problems during the works?

As part of the Trust’s design, there was no safe access to the isolation valves for water and medical gases. It was fit for purpose but not for future maintenance because the valves would be inaccessible once the canopy had been installed due to the additional steelwork erected to hang the canopy.

We identified the problem and worked with Days Architects to facilitate a new design encompassing safe access. We recognised this mid-way through theatre 2. This final solution involved the installation of a permanent galvanised steel access platform from an extension of the existing walkway by 6 metres in the ceiling to get to the isolation valves. We managed to turn around the amended design and installation with zero disruption to the programme.

First-class theatre facilities

The final solution provided first-class theatre facilities for Macclesfield. The new ultraclean theatres allowed the hospital to increase its surgical output, range and complexity.

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