Offsite construction is playing vital role in addressing the acute pressures facing today’s healthcare infrastructure. It offers a practical, systems-level view of the constraints clients are working within, particularly NHS trusts operating under rigid annual funding cycles.

James Almond, Director at P+HS Architects, shares his insight into how design teams and modular manufacturers can collaborate to meet specific client needs in compressed timeframes.

Offering a pragmatic perspective, James explains how offsite technology is not a radical departure, but one of many tools in the architect’s arsenal.

He explains how focusing on repeatable, efficient building types in healthcare and education can deliver better, faster outcomes.

How do you engage between the manufacturers and the design teams on healthcare projects?

It really depends on the procurement route the client chooses. Sometimes, the design team is appointed before the contractor is on board. In other cases, we’re brought in together as part of a main contractor’s tender team. In those situations, we’re effectively part of one and the same team.

When the client says they want to deliver a project in a particular way and to a tight deadline, we advise them on how they might use, say, an NHS-compliant modular framework like the SBS Modular Framework, or another relevant route. These frameworks help identify the right partner, right fit and right size of organisation to deliver the scheme.

Sometimes, clients issue the schemes directly to the modular market. In those cases, the modular suppliers often seek support from specialists like us to help realise the full healthcare design aspect.

They’re highly proficient in manufacturing the buildings and understand their own systems and processes extremely well. However, they may not always fully grasp the specific nuances of healthcare design and that’s where we come in. We bring that expertise and work collaboratively with them and their associated design teams to deliver the scheme within a compressed timeframe.

Why do you think healthcare and education seem to be natural fits for offsite construction.

It’s a good question. The truth is, offsite doesn’t suit every building type. Some areas of healthcare lend themselves well to MMC, while others are more difficult. If we take the New Hospital Programme (NHP) as an example, it’s aligned with the ProCure23 framework, which stipulates that 70% of the project must involve MMC.

Now, how that 70% is made up is open to interpretation. It could include innovations in M&E, in structural systems, or it could involve volumetric solutions. All of these options are explored to achieve the right delivery solution. When you consider education facilities, or outpatient and bedroom facilities in healthcare, those are areas where design is highly repeatable.

Think about it: a room, perhaps with a bathroom, sits next to a corridor. On the opposite side of that corridor, you might have another room with or without a bathroom. These units are mirrored and repeated, they can be manufactured relatively easily as modules. And if you have a run of identical modules, the process becomes very efficient.

That kind of repeatability is what manufacturers are looking for, designs that are simple to manufacture and simple to build at scale. It becomes more challenging when you deal with complex healthcare areas like operating theatres or other specialist clinical spaces. These are bespoke, they involve larger room sizes and often exceed the dimensions of a single module. As a result, the pre-manufactured value (PMV) is lower than ideal and there are often further complications, such as higher soffit heights or specific structural requirements, that make modular construction more difficult.

So, like any procurement decision, it’s about choosing the right solution for the right project, at the right time and price. In some cases, it works brilliantly. In others, less so.

Take the NHP’s Standardised Design 2.0 model, it’s all about single-bedroom ensuite rooms, arranged around a central support core of storage, offices and service rooms. That layout can be very easily modularised. For example, each floor might have 30 bedrooms. If each of those is identical, you’re building 30 of the same module. That level of repeatability allows for fast, efficient construction.

It’s the same with classrooms. A classroom is essentially a large open space, often naturally ventilated, that accommodates 25 to 30 students. You might have three modules forming a classroom, then a corridor and then the layout repeats on the other side.

These are straightforward configurations to build. The government’s drive for speed in delivering educational buildings has supported the push towards modular solutions. Faster programmes have become a priority and MMC offers a way to meet those targets.

Can you tell me why you chose to speak at the event and what you think events like this bring to the offsite construction sector?

We chose to speak at Offsite Expo because we’re deeply involved in the MMC, offsite and industrialised construction industries. We’ve been delivering a wide range of construction projects using these methods for a long time.

Events like Offsite Expo provide an invaluable opportunity to share knowledge, ideas and expertise across the sector.

We welcome the chance to contribute to that conversation, to help develop understanding and to raise standards. This isn’t a new area for us. As a practice, we’ve been engaged in industrialised construction for 15 to 20 years. It’s not a passing trend, it’s a core part of our delivery model. It would seem strange to us to disregard such a significant part of the industry by only offering traditional methods of delivery.

We want to ensure we’re at the cutting edge of construction. That means understanding what technologies are available, how they’re evolving and how they can be used to help clients meet ever-changing briefs, whether that’s achieving net zero carbon targets, faster programme delivery, or meeting new regulatory and compliance standards like post-Grenfell safety.

All of those challenges have to be tackled within the industrialised construction context and that’s one of the main reasons we’re keen to be part of this event, to help shape and progress the conversation.

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