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The real cost of construction disruption in the NHS

Despite a decline between the years of 2011 and 2014, the outlook for the health construction sector remains strong. In fact, just last year, the Government announced plans for around £5.7bn worth of capital projects within the healthcare sector until 2020.

With the creation of NHS Foundation Trusts, hospitals can generate their own income which has seen a rise in private providers taking on refurbishment projects within existing hospitals, creating extensions and adding new facilities.

However, there are many disruptions associated with construction within hospital environments that need to be taken into consideration.

Infection

Dust can be a cause for concern within any construction site, but it poses greater health risks within the confines of a hospital environment.

This is because dust acts as a fungi vehicle, transmitting particles far and wide. Aspergillus spores survive well in the environment and have been cultured from unfiltered air, ventilation systems, and dust produced during the course of hospital renovation and construction.

Aspergillus rarely poses a threat to normal healthy people but it is easily disturbed during construction, becoming airborne, and even carried on clothes and shoes. The fungi causes severe illness and even death in highly immunocompromised patients.

The older population also have a higher risk of being infected with aspergillus spores during hospital construction. With a growing and ageing population; and with the 65-84 age group seeing the greatest increase in admitted patient care activity, more and more are at risk than ever of infection during construction.

It already costs three times more to look after a seventy five year old and five times more to look after an eighty year old than it does a thirty year old – without the added pressure of treating construction related infections.

In order to eliminate Aspergillus, the dust generated by building work should be minimised and dust infiltration into adjacent patient areas should be prevented. The measures implemented to reduce dust emission from the construction area may vary depending on the activity being undertaken but should include providing physical barriers around the construction area to contain the spread of spores.

Damage to hospital equipment

Hospitals are unique environments that contain millions of pounds worth of high-tech equipment. If this is damaged either due to dust or vibrations from construction equipment, it is very costly to replace and when vital machines are out of use, it compromises patient safety, health and wellbeing, delaying necessary tests and treatment.

Patient and staff welfare

Whilst physical side effects due to disruptions caused by construction have been discussed, the emotional and mental side effects should not be overlooked. Due to the nature of construction, a lot of noise is often generated. If work is being carried out near to patients, noise can have a detrimental effect on their recovery, as well as affecting staff. Lack of sleep, an inability to concentrate and elevated blood pressure can all be attributed to noise generated by construction, as well as elevated stress levels. It means patients don’t get the recovery they need and staff can’t provide the level of care that is needed.

With recent statistics revealing the current occupancy rate for beds is at the highest recorded since quarterly bed occupancy data was published, there are more people than ever requiring overnight stays in hospital:

• The average occupancy rate for all beds open overnight was 90.0% in Quarter 4 2017/18 compared with 88.4% in Quarter 3 2017/18 and 89.0% in Quarter 4 2016/17.
• The average occupancy rate for general and acute beds open overnight was 92.6% in Quarter 4 2017/18 compared with 90.7% in Quarter 3 2017/18 and 91.4% in Quarter 4 2016/17.

This means more patients at risk of a disruptive stay whilst hospital construction is carried out.

If work is being carried out where older patients are who may be suffering from dementia or confusion, construction can be extremely disruptive. Changes to the environment, i.e. areas cordoned off or makeshift walkways created, can cause patients to become increasingly disoriented and stressed. They may even become lost or get into accidents. This is not only distressing
to the patients, but it becomes an extra burden to staff as well.

The cost of preventing disruption

Coping with the disruption associated with construction may, on the face of it, seem like a costly endeavour. However, when you actually compare the cost of prevention and protection to the cost of dealing with the aftermath of infections, broken equipment and elongated stays for patients within the hospital – it’s actually a much more cost-effective approach.

Through taking preventative measures, such as dust-tight and noise reduction hoarding segregation, frequent air samples, and relocating sensitive equipment and patients, it’s possible to reduce costs further down the line.

By preventing rather than curing, you avoid the need for costly antibiotics to treat aspergillus, replacing damaged or broken machinery and equipment, and taking on the cost of longer patient stays.

Westgate’s Hoardfast range can help;

• Dust-tight seal hoarding that doesn’t create any dust itself helps to keep patients, staff and equipment safe
• Panels are prepared before delivery, and easy to clean on site
• Fast delivery and installation time means quiet and minimal disruption
• Reusable and relocatable hoarding is cost effective and ideal for phased works. It can also be reused after construction to create patient rooms, wards, cubicles, isolation bays, waiting areas etc.
• Acoustic options can help with noise reduction, providing a much better environment for patients and staff
• Clear segregation and graphic signs and information can be displayed which reduces the chances of accidents for both staff and patients. It also reduces confusion for patients that may be fragile and/or disoriented.

Download a PDF version of this article.

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