Makeover magic

As the final commissioning programme at Synergy’s first multi-million pound healthcare supercentre in Manchester draws to a close, Welconstruct is preparing to hand over the fully converted £3m fit-out and process project to the clients, Synergy Healthcare.

Synergy, the UK’s largest provider of decontamination and sterilisation services for hospitals and Primary Care Trusts (PCTs), was determined to get the right partners on board for the Wythenshawe-based facility. The company went out in search of one provider of concept-to-compliance design and build services.

Following an initial lockout period of six months for design and building discussions, Welconstruct, which has worked with the health specialist on a range of other health service-related projects for more than a decade, secured the nine-month fit-out project. The result of its appointment has been the transformation of a former industrial shed into a state-of-the-art 18,000ft2 supercentre that will process millions of instruments each year.

Sterile services

Operated by Synergy, and located at the Roundthorn Industrial Estate, the service will provide for the collection of surgical instruments from five hospitals to its Wythenshawe site. The Centre is responsible for cleaning and sterilising all the re-usable instruments and equipment used in the operating department, and the many wards, clinics & departments.

In total, Synergy’s supercentre will deal with approximately 268,000 DIN baskets each year. Every item has to be washed, checked, lubricated, packed and sterilised. Every item has a label declaring the date of sterilisation, autoclave number and the cycle number. All the items are then distributed to the correct locations ready for use.

The volume and complexity of the work involved and the constraints of the duration of the machine cycles means it can take any thing up to four hours to complete the decontamination of a tray of instruments.

The £3m centre will provide combined decontamination and sterilisation services for three NHS Trusts and one NHS Foundation Trust in the locality – University Hospital of South Manchester NHS Foundation Trust, North Cheshire Hospitals NHS Trust, Christie Hospital NHS Trust and Trafford Healthcare NHS Trust.

Barry Redford, general manager of Welconstruct and a process engineering specialist won the contract due to its experience in process and installation technology. As a specialist contractor in on-site and supercentre facilities, the company has supplied a full turnkey service, including the design of the facility, provision of all M&E and utilities, including purified water, steam, gas and medical air specification to other Trusts and hospitals in the UK.

The company has recently completed a number of similar project, which include a £330k Wolverhampton Trust scheme and a £350k project at Homerton NHS Trust in London. The most recent project to be completed was a £1.1m sterile services unit at Oxford NHS Nuffield Orthopaedic Centre in Oxford.

There Welconstruct provided a new sterile service facility to the hospital’s operating theatres that includes the installation of washing disinfectors, sterilisers, boilers and RO plant with all the necessary M&E to support it. This completed the internal fit-out of the Nuffield Theatre Sterile Service Unit, which sits inside the new hospital built by Morrison Construction.

Speaking on behalf of the Oxford NHS Trust, project manager John Marshall said: “We are really pleased the new decontamination unit was available for use on time and is now open. It is one of only a small number of units that met the national 31 March 2007 deadline for having fully compliant facilities. The fact the Welconstruct team took such a proactive approach to the project was a core factor in its success.”

Demanding and enjoyable

Synergy has been the most demanding and the most enjoyable bespoke project the team has worked on. Kevin Hill, Welconstruct’s design engineer, explains: “We were presented with an empty building, the numbers of process equipment it was to house, the throughput criteria, a timeframe of nine months and a blank piece of paper. Our brief was to optimise the facility’s operational outputs while remaining within the allocated budget and timescales.

“The first challenge that we faced was having to design an operational facility that best satisfies all of the three operational factors of production, people and raw materials. This is as well as keeping in line with strict legislation and practice frameworks.”

Steve Inns, another member of the sterile services team who is project managing the site on a day-to-day basis, added: “The transit of these areas has to be finely scoped. Considerations include the route of staff to the decontamination area, the path of the instruments once they enter the facility and the location of power supplies for all the major machinery.”

“The production area needs to have a separation of in and out flows to avoid cross contamination, waste materials need to be disposed of on entry and we needed also to plan out holding areas for incoming instruments and storage as well as cooling areas for completed work.”

Other considerations included the requirement for staff to be able to get to their specialist area of work quickly after changing, via gowning rooms. This meant that Welconstruct needed to implement the shortest distance possible into the operational design to reduce travel times to their workstations.

Raw materials are also a key issue. They need to be brought into the building and stored adjacent to the cleanroom, while the plant room needs to be as close to the operating equipment as possible to keep costs down and maintain efficiency.

Eight weeks after the official green light to go ahead on the scheme, the Welconstruct engineering and process team presented the operational plan. The development includes 4000ft2 of offices, training rooms, the decontamination area and the Inspection and Packaging (IAP) rooms. The plan had been developed working with input from Synergy managers as well as key utility suppliers, such as the water board with whom the team discussed reducing opportunities for water-borne infections.

The second major challenge was to ensure that the centre operated efficiently at a sliding scale of usage and met an average four-hour turnaround timeline for products. On one day there could be seven sterilising machines and 10 washing machines being used, subject to demand from all of the hospitals. The following day it could be a completely different ratio, maybe three sterilising machines and two washing machines. But no matter how many machines are in use, over what period of time, the efficiency of the machinery needs to remain at the same high levels throughout.

“The best analogy to use as regards the importance of efficient machinery can be related to the building and running of cars,” explains Barry Redford, general manager of Welconstruct and a process engineering specialist. “Take a car that can reach speeds of 150 mph. One day you drive it at 30mph and the next at 90mph; automotive manufacturers have to ensure that whatever the speed, the car remains consistent and efficient in its operation throughout its lifetime.”

Synergy’s other special requirements were simple and not unique but still required serious attention to detail. The supercentre plans to operate 24 hours a day. It needs to be able to cope at full capacity at very short notice and deliver a fast turnaround for all the hospitals that would be using the service. This is relevant for not only for an efficient health service and fast patient turnaround but also for Synergy which plays a key role as a ‘behind the scenes’ supplier in case of major incidents such as road and air crashes.

Risk management also played a major role in the development of the project. Ensuring an efficient service could be maintained under stress required a critical back up service. As with all hospitals and health facilities, this is especially significant for utilities such as gas, electricity and water.

Taking into account that operation is 24 hours 365 days a year, the plant needed to be robust enough to withstand this usage with total utility emergency back-up and duty standby on all major plant and equipment. Welconstruct selected and installed a stand by generator should the electricity supply fail, incorporated gas supply back-up for the same reason and arranged for sizable water storage tanks to be readily located on site.

There is also obvious back-up on all the invaluable major plant and process equipment. This includes standby machines for all the principal services of steam, RO water and hot water.

Kevin Hill, Welconstruct’s design engineer says: “Very few companies would be able to undertake the scope of the engineering work that we have undertaken. Of course there are a host of specialist consultants who create a bespoke project team comprising representatives from different companies, but Welconstruct’s strength is that all this expertise falls under one roof.”

“The development is a real success story,” affirmed Geoff Andrews from Synergy. “Not only has Welconstruct been able to build an attractive and high quality building but it's also within budget and on schedule.”

Welconstruct had no major set backs on the scheme and the company has worked hard to ensure its expertise in the sterile services sector remains second to none.

“We have always remained on the ball in terms of what was happening following the EU directives on decontamination issues and the action taken by the NHS Trusts in response,” said Redford.

“Although the deadline of March 2007 has officially passed, we know that there is still a high number of on- and off-site buildings and equipment supporting decontam-ination operations, such as sterile service departments, that need refurbishment or replacement and we are currently in negoti-ations with a number of clients on such projects.”

The Synergy super-centre is due to officially open its doors this month.