Supporter: Autodesk
In March 2020 Covid-19 was making its way around the world, threatening to overwhelm the UK like a tsunami. The National Health Service was looking increasingly vulnerable as forecasts on those needing intensive care soared beyond normal capacity. The government had a solution. NHS England would build a series of seven temporary care hospitals across the country. But this announcement was also the moment that the construction industry was presented with the biggest challenge in a generation. They had to be built in less than two weeks.
This is the story of how the NHS Nightingale Hospital in Birmingham met that challenge and how the construction industry, sometimes criticised for poor productivity, gave everything it had to meet a seemingly impossible deadline when the country needed it most. And how technology enabled the immense human effort to win through.
Chosen to do the impossible
Dan Harmer, a project manager at Interserve Construction was working on building a school in Hereford when he received a call telling him to clear his schedule and prepare for a meeting. He knew it would be important, but had no idea quite what would be asked of him. “I wasn’t told what the what the project was just that you and three others need to be here Tuesday morning.”
Interserve had been selected to convert the NEC exhibition centre in Birmingham into the NHS Nightingale Birmingham. A job that would usually take years to deliver. “This sort of job would probably take a year or so in the planning phase. We’d spend six months, potentially doing all of the sort of the upfront work, and then you would bring it to site,” says Dan. “And then it would take potentially three years to do a job of this magnitude under normal circumstances.”
As soon as the NHS, the NEC and the military who were also supporting the efforts, made the decision, Interserve sent word to its team to prepare for creating the first phase,. This included 800 fully equipped beds in just nine days, followed by work to equip the site up to a total of 4,000 beds.
An effort that would see 400 contractors supported by 60 Gurkhas work over 40,000 hours to complete it.
To really get the scale of this achievement, it is important to understand the challenges facing the construction industry. It is often criticised for low productivity compared to other sectors, but unlike, for example, the automotive industry, construction does not get to perfect its processes in a controlled environment creating the same component thousands of times. Every job site is different.
“Sometimes it’s unfair to say that construction is the lag or the process. I think it’s just the fact that the way that project teams have operated and getting technology to site can sometimes actually be a challenge,” says Matt Keen, Construction Industry Strategist at software company Autodesk. “As well as access to technology, access to the internet. You know, these are they sound like very simple things, but it can really stifle adoption of technology at that phase.”
In general digital processes have only penetrated as far as the design phase of a project. Once construction begins and the plan meets reality, we see the return of printers, paper and signatures.
“You’ve seen more of it in the design phase, because these guys have access to the infrastructure that maybe the projects don’t. So I think that that was traditionally part of the challenge. I think as we got more mobile, and especially more mobile first, and everybody has access to a smartphone or, you know, a tablet these days, it means that we’re starting to see more technology adopted at the coalface at the construction site at the point where projects are actually executed,” says Matt.
Digital construction was critical
Keeping up with quickfire design changes on sophisticated modern projects, especially when they come at the incredible speed and urgency that was faced by the Nightingale project, means that printing 2D drawings off is too slow to be realistic. Then there is also the social distancing factor that could become the new normal. COVID 19 means changing some of our working processes.
“A lot of the architectural engineering and construction industry has had to pivot very quickly to using digital in order to help with work from home, to help with how is it that we can work on sites and not spend as much time on site that we might have used to say: how can we conduct inspections wants to make sure that we capture as much information as possible, and make sure there’s one version of the truth?”
Embracingnew practices was certainly critical in creating the NHS Nightingale Birmingham, where missing the deadline that could have meant life-or-death for thousands. “When I turned up there it was it was big, it was empty, it was all open,” says Dan as he arrived on site in Birmingham in late March. “Originally, I think it was sort of talked about as being a field hospital. However, the University Hospital Birmingham’s, that’s the trust that we were working for, wanted it to be more of a clinical facility.”
The Excel in London is the site of the first Nightingale Hospital. But whereas that is more of a field hospital, Birmingham was intended to be more sophisticated – a full clinical facility. This means that rather than just cannisters of gas at each bed, there was a sophisticated network of medical-grade piping that needed to be installed in recesses under the floor. “What set the NEC apart from the ExCel was the medical gas, rather than having bottles and rather than having to be mobile, having that pipes, medical grade gas to be sent, sent round, the different wards or the halls is what really made the difference, having that medical gas pumped to the bed heads, because at that time ventilators were the were the big worry, I think and I’m making sure that they could get as much of that oxygen to the to the bed. That’s what’s going to make such a difference,” says Dan.
This became the first step on the construction critical path, with the team working on installing kilometres of copper pipe. “As soon as the medical gas started, as soon as the floor lighting started, as soon as the cabling went down, we just went for it,” says Dan. “Originally, we very quickly established our team. There were four of us to start with. On day two, I had 15 people, and they were all sort of tasked to do different things. And we did this split shift and when a couple of guys that sort of manage what became the afternoon. An evening shift and then sort of going into the early hours of the morning.”
The team grew and grew, and so did the enthusiasm. There was always more work but there were always volunteers willing to offer more hours. “It was a big effort and all of our team and not just the Interserve guys and the IAS guys, but every subcontractor everybody that set foot on that site, they just wanted to do the right thing and help.”
This saw people working 12 hour shifts before stopping to sleep and then getting right back to it.
“These guys are not sort of just pushing pens. They are working hard graft, and they were laying out rolls and rolls of vinyl and they were doing it for 12 hour shifts, and didn’t bat an eyelid. It was amazing. It was really, really brilliant that everybody was just pulling together.”
That meant over 400 contractors supported by 60 Gurkhas working 40,000 hours to complete phase one. They laid over 100km of electric cable, nearly 20km of copper piping and enough vinyl flooring to cover 12 football pitches.
Gurkha Support
The Gurkhas are a traditional unit in the British Army recruited from Nepal. They have a reputation for strength, bravery, and are famous for wielding a fearsome forward-curving knife called a Kukri.
“They can be on site for 10-12 hours if you want them and they will do whatever you need them to do so if that can help them great and they did and they’re brilliant lift and shift is if you ever want lift and shift is Gurkhas are the people you need because they just that never have I seen such a military operation moving copper piping around a site like the NEC,” says Dan.
On top of all of this, everyone had to know the job of the people around them, the people further up the chain, and the people they relied on down the chain. Covid-19 was spreading, and the team had to be prepared for it to make it to the site, and cut its way through the workforce. People needed to be ready to perform multiple roles if necessary. “We needed to stagger the different teams because we had different shifts, we needed to put them into different zones,” says Dan. “Everybody needed to know the job or the position of the person above them and the person below them. So if anything happened, that they could step into that into that role.”
The enormous workload was only one part. Although he says Interserve is quite advanced when it comes to digital tools, admitted technophobe Dan knew that the project was being put together so quickly, and needed such rapid changes to the design, tried and tested analogue methods of design updates would not be able to keep up. “Generally speaking we [Interserve] are quite 21st century Myself I’m not ! I’m a bit of a dinosaur when it comes to technology. I always have been stuck in the dark ages. But there are advantages to technology in it and it can really assist and aid.”
The breakneck pace and urgency of the work at the NEC took this need to another level. And although they started out working more traditionally, working from printed drawings, this just wasn’t going to work. “So you could be drawing it head office, just up the road, and then we would need those drawings. So in the first few days we were getting in cars and driving them around and it was almost as soon as you printed our set off, driven it around got it. Through the gate and all the security passes, got it to the team that needed it driven back there was another revision because they’d move something, right. Okay, print it all off again and send it back round.”
It wasn’t working. Danneeded help so he turned to Michelle Jeffs, the Autodesk account manager working with Interserve. “Obviously, it was the just the early days of the pandemic. So we were looking at how we could assist companies during this period.”
Michelle proposed their PlanGrid software – which is a kind of group collaboration platform that allows updates and information to be shared around the entire site team and most importantly it was easy to use for technophobe Dan who made this a key requirement, “He said I need something. Michelle, that’s gonna be really easy. And my guys are just going to pick up and run with it because we need something quick,” she says.
Project Construction Cloud
PlanGrid is part of the Autodesk Construction Cloud, used by Interserve for the project and including a number of software packages to help across the construction cycle keep up with changes that happened on an hourly basis. “Ordinarily, you know, you might get a revision once a week or something like that,” says Dan. “However we were revising the drawings on an hourly basis. We were putting rooms in then we were moving rooms, then we were changing how the nurses bay and the nurses station might look so that they could have full and good view of all of the patients. And so one of the things we had to manage was making sure that we kept up to speed with the changes that were being made in the office to make sure that we weren’t building anything twice.”
Although Dan likes to say he’s a dinosaur, he’s had some experience with construction process management software before, so he knew what to expect and was optimistic, but not everyone on the site was. “There was a couple of guys who hadn’t used it in the past. And they were like, yeah, that’s never gonna work.”
But the team were quickly won over. “My colleague, Dave, I remember he said that there’s no way that that’s going to work. He says, you know, drawings are the way forward and yet he, he absolutely embraced it. He was marking up drawings left, right and centre, sort of really showing me quite excitedly, how this system was working,”
Technology enabled social distancing
Technology can also help sites stick to social distancing regulations. Dan and his team also experimented with proximity sensors to help with social distancing. “There is a system that exists to keep ground workers safe from machine buckets. It is a proximity sensor, basically. So it just makes sure that you know that you are a certain distance away from the edge of the bucket. There’s a device on the bucket itself, and there’s a device on the individual.”
This is a radio-frequency identification system (RFID). In some existing uses in some of the more difficult environments, such as tunnelling, it can be quite sophisticated – with the ability to set different distance tolerances set for workers of differing competencies. For example, a machine driver could get closer than a labourer. “We asked the question of this supplier, could there be a system that we could do that keeps people two metres away. And they very quickly developed something and they came up with this backpack device.”
This early solution required quite a lot of battery power. “And one of the things that we noticed is working 12, 18 in many cases, 20 hours, individuals doing 20-hour shifts, that would have been a heavyweight to have to carry on the back.”
But, in truth, this wasn’t really a problem Dan had while working at the NEC. And not just because of its cavernous halls where people naturally worked at a distance. “We managed to sort of disperse quite a lot of the people. And, yeah, as you alluded to before, I’ve got a big voice. And if you shout at people, I mean, you do it in a calm and polite manner. And you explain to them why we’re all here and the importance of this facility and just remind them of, you know the potentials of the virus. And the fact that we don’t want them or any of their loved ones to be using this facility. So stay apart. All of a sudden, people are taking a step that step away from each other.”
At the same time there was a team of 10 health and safety people whose sole job was to go around and just remind people of social distancing using some useful, less technologically advanced tools. .
“I said to one of my colleagues, if you just cut a stick a little thin baton two metres long, and just have it in your hand, then if anyone’s looked at me, I am two metres apart, just hold the stick up in front of you. And then it’s that visual understanding.”
Progressing Phase Two
Nine days after Dan arrived on site, on 10th April phase one was done. And it really was done – It was essential to get everything right and maximise the number of beds and optimise the setup all the way to the end, as once left the hall, they had left the hall for good.
Work on phase two would be carried out in such a way that allowed ambulances begin to deliver patients to phase one. But then, due to a countrywide lockdown and the heroic efforts of the NHS, the avalanche of cases was smaller than original forecasts. This meant that Dan and the team had more time to prepare for phase two.
“We had a bit more time because it wasn’t like that they’d had loads and loads of people coming and having to use the facility. The University of Birmingham, the QE and all of our surrounding hospitals to the best of my knowledge and what I was told in various briefings is they were coping brilliantly. They were managing the situation. And at the time, the thought was that they would keep as many people on site at the hospital as they could. And that gave us that little bit of extra time,” says Dan.
So far, mercifully, NHS Nightingale Birmingham has not been needed, and phase 3 has been put on hold.
The Nightingale is an extreme case study. It is an immense achievement that can be looked back on with pride by the whole industry as a demonstration of what it can deliver in a time of need. But without embracing new technology to manage the site, and the supply chain it could not have happened and of course not every project has this level of sheer human will driving it forward.
They need to use all the tools at their disposal. “So if you think about typical capabilities for a construction company, they’re around things like document management, estimating quality management. And so for each of those, we try to define what we think that journey looks like,’ says Matt, from Autodesk. “And we’ve come up with a five-step model that we can walk customers through from that initial move to digital, you know, to how is it that you scale that approach across the organisation?”
The Nightingale Hospital shows us what can be achieved when human effort is combined with new technology. Before COVID 19 changed all of our lives, Dan and the other heroes that deliver our critical infrastructure, would have taken three years to build a hospital. This crisis focussed construction in a way that has never been seen before. The challenge now is not to waste the knowhow and new technology that this situation gave birth to.
