Renovations and risks: Considerations when maintaining care facilities

Published: 10-Jul-2024

Adrian Buttress, Managing Director of PermaGroup, discusses why the healthcare estate poses different renovation challenges than any other

In any healthcare environment, patient and staff well-being is a top priority with a vast number of individuals being reliant on a buildings’ cleanliness, maintenance, and safety.

Healthcare estates support this aim in every element and principle of their design, balancing high-quality materials with the health of those inside.

When buildings do start to degrade, for whatever reason, the exterior is often the first to lose its protective properties such as weather resistance

The NHS is one of the institutions that makes people proud to call the UK their home. For more than 75 years it has provided ‘care based on need and free at the point of delivery’.

The planning, effort, and coordination it requires to run smoothly is hard to imagine, with around 1.5 million employees across thousands of sites.

It is a vast machine with many moving parts and many cogs always turning. The very nature of the service it provides means that the lights must always be on so that front line workers can operate 24/7, and patients can recuperate at their own pace.

Wear and tear

Constant use will eventually wear anything down, and repairs or replacements will be needed. Even in perfect weather conditions a building will degrade over time.

We saw this with the Reinforced Autoclaved Aerated Concrete (RAAC) crises last year in which hospitals started crumbling around its workers, with 54 recorded instances as of February 2024. Situations like this mean that hospital maintenance and regeneration has now taken centre stage.

However, when determining the best route forward, decision-makers should consider the risks of working in a live hospital environment, with many products being potentially harmful.

When buildings do start to degrade, for whatever reason, the exterior is often the first to lose its protective properties such as weather resistance - with nowhere being more prone to do so than on the roof – and require professional intervention to ensure it’s still fit for purpose.

The managing of materials is key to the successful delivery of renovations and refurbishments.

Whether it be after five years or five decades, repairs will at some point become inevitable, and with public sector buildings like hospitals, decisions need to be made swiftly and the following works carried out in the same fashion.

This is simply because disruption to service is much more severely felt by a hospital’s users over somewhere like a factory, or anywhere else that can easily pause works for a time.

This means shutting down wings or facilities is actively avoided where possible. To circumvent this, we simply conduct the repairs with the building running normally below us – a task which is best left to the experts.

Managing materials

The managing of materials is key to the successful delivery of renovations and refurbishments. The RAAC crisis again highlighted what can happen when unsuitable materials are used and this is only heightened by the healthcare sector, where materials are required to be ultra-safe so that no toxic or dangerous odours, chemicals, other hazards transmit through and harm those below.

This is especially important in areas where there are patients with weakened immune systems or areas which are close to maternity wards and where immune systems haven’t fully developed yet.

To put this into perspective, a University of Michigan study in 2021 found up to 55 harmful materials used on building sites with some being up to 1,000 times higher than recommended.

The RAAC crisis again highlighted what can happen when unsuitable materials are used

This was a study done on residential developments building homes wherein people will spend hours of the day. The study recommended anyone waiting for several weeks before moving in following construction, but hospitals don’t have this luxury.

In the UK, the BREEAM standards show specific guidance for contractors and site managers to follow, with material transparency being advocated for heavily, but corners being cut is not unheard of and, ultimately, it’s the hospital’s responsibility to ensure the safety of its patients which includes the quality of works completed on its facilities.

Advice from PermaRoof 

We recommend using skilled installers who carry out multiple risk assessments before any product is opened on-site, as well as seeking independent professionals who can recommend best practices and specifications to be on hand throughout the project as well.

Products like liquid roofing systems are often our preferred method. On a project where quick installation and safe materials are at the fore of considerations, certain high-quality liquid polyethylene membranes provide no odours or noxious chemicals from their installation. Additionally, the roll-on application means installation is quick and resistant within minutes meaning minimal disruption time and minimal exposure.

Whether it be after five years or five decades, repairs will at some point become inevitable

Especially on buildings with complicated roofs which is often the case with healthcare buildings, these systems also negate issues from having more seams and edges on the system, as well as the risk of less skilled contractors installing incorrectly.

However, the roof is just one element of a building that requires comprehensive care and consideration into its maintenance, and we recommend professional expertise to even the most minor works to ensure full protection for those inside. Caution and care should go hand in hand.

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