CASE STUDY | NHS NIGHTINGALE HOSPITAL LONDON RAPID RESPONSE When ExCeL was chosen as the site for an NHS Nightingale Hospital, the project team had nine days to build a 4,000bed critical care facility ahead of the expected surge in Covid-19 cases. Andy Pearson talks to the key engineers I t was 6.15pm on Friday 20 March when the phone rang, recalls Stephen Cowlin, a director of building services consultancy The Richard Stephens Partnership (The RSP). It was Ahmed Hassan, head of estates at Royal Free Hospital. He told The RSP to be at the ExCeL exhibition centre in Londons Docklands at 8am the following morning for a briefing with the NHS and the military. On Saturday, Andrew Panniker, managing director of RFL Property Services explained that the NHS wanted to turn ExCeL into a 4,000-bed Covid-19 surge hospital. The army told Cowlin to treat it as a field hospital that has to be built quickly in response to an immediate need. We normally start our design with the Health Technical Memoranda [HTM] and design down from this, with each derogation signed off, says Cowlin. The armys advice was to start with what it had and to work up from that to maximise what can be achieved in the timeframe available. The next day, The RSP heard that work was starting on site the following day and that the first 500 beds needed to be ready in seven days time. Cowlin says The RSP was asked to get involved because it had previously worked with the Royal Free London, which was initially in charge of getting NHS Nightingale London up and running. When Cowlin, a mechanical engineer, and fellow director Gerry Connor, an electrical engineer, turned up on site on Monday, they met James Hepburn, BDP principal, and his architect director colleague Paul Johnson, along with a small team of experienced healthcare architects and engineers. BDPs involvement followed a paper it had put together the week before, outlining the potential for convention centres to offer temporary facilities in which to treat coronavirus patients. Layout It was essential an NHS fire officer was involved from early stage, aligning the existing venue fire strategy with the new function, considering different risks in the form of increased oxygen and evacuation of the building NHS Nightingale London 1 Central boulevard 2 Ward 3 Don/Doff areas 4 Pharmacy (extends to top floor) 5 Triage 6 CT/diagnostics 7 Mortuary 8 Staff canteen BDPs architects had carried out space planning exercises, and concluded that the only facility big enough in London was the ExCeL centre. On that first Monday, the brief was: we need 4,000 intensive care unit (ICU) beds all with oxygen, medical air and power, says Hepburn. NHS England also produced a guidance document for intubated patients [where a tube is fed through the mouth into the trachea], which set out what services each bed bay needed and the size of the bays. ExCeL comprises almost 90,000m2 of column-free space, divided into two 500m-long, 86m-wide halls located north and south of a 600m-long central boulevard. The deadline meant the Nightingale project had to use as much existing infrastructure as possible, which included the ventilation system. When ExCeL is operating as an exhibition venue, giant 25m3s-1 air handling units (AHUs) suspended from the roof provide heating, cooling and fresh air to the halls through high-level ducts fitted with high-velocity jet nozzles. Under normal operation, most of the air is recirculated in the AHUs to conserve energy, with air exhausted through passive vents in the 11m-high roof. Cowlin says everything to do with the ventilation solution was developed in 14 May 2020 www.cibsejournal.com CIBSE May 2020 pp14-17 NHS Nightingale.indd 14 24/04/2020 19:32