Construction Excellence reports on the sustainability champions introduced throughout the refurbishment of UK's oldest hospitals

Two of the country’s oldest and best known hospitals are undergoing major refurbishment.

Contractor Skanska included sustainable initiatives in the £1bn schemes at St Barts in Smithfield and the Royal London in Whitechapel.

Once complete, Barts will become a cancer and cardiac centre of excellence with the majority of care provided in a new state-of-the-art facility. Most of the services currently provided at the London Chest Hospital in Bethnal Green will also move here.

Clinical services at the Royal London, including London’s leading trauma centre, the capital’s second biggest children’s hospital and one of Europe’s largest renal units, will be brought together in a new landmark multi-storey building.

Hospital refurbishment presents a number of unique challenges. Both Barts and the London Hospitals have has to stay 100% operational throughout the lifetime of the project. And, noise, dust and vibration must be kept to an absolute minimum due to potential adverse effects on patient recovery time.

Demolition contractor engagement

The project’s lead-in time enabled Skanska to focus on planning and preparation and engage key partners at the outset.

Engagement of the demolition contractor Keltbray at an early stage meant that waste separation could be planned from the beginning of the project and targets could be agreed between all partners.

These targets were then incorporated into the contract and waste management plan.

Client buy-in

Early planning, strict monitoring and regular communication has led to a mutual understanding of requirements and agreement on how these can be achieved allowing any changes to be made before problems occur.

To ensure complete buy-in throughout the team, sustainability champions have been appointed. Due to the sensitive nature of the users of the building, noise and dust prevention were considered a priority.

In addition to Section 61 Agreements, a noise, dust and vibration protocol has been agreed. The protocol establishes a continual monitoring regime and sets strict compliance thresholds.

Techniques for segregation

To ensure that maximum value is obtained for all waste products, a waste hierarchy has been established.

Salvage was viewed as the most desirable option followed by reuse on-site or off-site, then recycling either on-site or off-site followed by recovery and the last, least desirable option, was landfill.

This hierarchy was written into the contract and the project’s site waste management plan. The waste is then monitored via monthly returns, waste transfer notes, audits and inspections.

The management of waste on the project has many logistical issues. At the Royal London site, it is possible to segregate the waste on-site. However the small size of the Barts site has meant that innovative techniques for waste segregation will have to be employed with some having to be done off-site at a separate facility.

Pollution Prevention

Construction must take place without disrupting patients’ recovery and new and innovative solutions have had to be sought. Dust, noise and vibration levels were identified as key issues so the client and contractors agreed acceptable levels at an early stage.

It was decided that an acoustic screen was needed to shield the children’s intensive care unit at the Royal London which is directly adjacent to the building site.

The screen would also avoid the need to move the patients to alternative hospitals for the duration of the works which saved project time. Existing acoustic screens were found to be inadequate and generally designed for short-term use, ending up in landfill.

A high quality, durable and deconstructive acoustic screen was erected 1m from the hospital. It is six floors high and covered one entire portion of the remaining hospital building.

Measurable Benefits:

• 50,000 tonnes of waste diverted from landfill
• 99.6% of demolition waste recycled
• Over 250,000 bricks have been sent for reuse
• No fuel spillages
• To date, work has not been stopped due to noise, dust or vibration
• Good relationship with relevant Local Authorities enables swift
Section 61 Agreements whenever these are required.
• The initial figures will be used as a benchmark against which
future phases of the project will be measured.