Identifying Sustainability Requirements in the Refurbishment of Hospitals: The Built Estate, Models of Care, and the Challenge of Adaptation Planning

Grant Wilson; Richard Laing; Mohammed Kishk
Public spending across the United Kingdom is facing unprecedented challenges as a result of the economic downturn. Nowhere is this more keenly felt than the interface between the National Health Service (NHS) and the construction industry. Limited government investment is challenged by the ever-evolving demographics and technological changes which are driving the need for flexibility and progress throughout the NHS. In tandem with these financial and evolutionary challenges, the NHS bears a legal responsibility to reduce its Carbon Footprint significantly, in line with the requirements of the Climate Change Act. Additionally, the service is driven by the organisational and legal requirements of the wider sustainability drivers. The emphasis on construction within the NHS has focused predominantly in the area of new build within the last 10 years. This paper discusses the need to focus on the area of Refurbishment. The main aim of this paper is to present a contextual basis for an ongoing research study to develop a sustainable refurbishment model for hospitals. A comprehensive literature review has been employed as the methodology to discuss the current situation relative to organisational, financial, and sustainability factors. It is demonstrated that an understanding of the nature of refurbishment is required. Challenges specific to refurbishment, such as lack of as-built data and information on the state of the existing fabric and services, may have significant effects on the project in regard to time and cost. It is further demonstrated that the hospital facility has unique characteristics and Client expectations which do not affect a ‘standard’ commercial refurbishment.
National Health Service (NHS); Refurbishment; Sustainability; Management; Climate Change Act; Adaptation
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