Britain's oldest hospital


The redevelopment of Britain’s oldest hospital, founded in 1123, is being undertaken by Skanska which sees Barts hospital transformed into a Cancer and Cardiac Centre of Excellence.

Skanska discuss how the Scheme’s values have been implemented into this redevelopment and how they have kept waste to a minimum.

How have you incorporated the Scheme into your site?

The Considerate Constructors Scheme is embedded in all that Skanska does at Barts. Our aim is to be a responsible and respectful neighbour throughout the construction work. Due to the length of the project, it is crucial that we become part of the community and do all that we can to minimise the impact on the surrounding area. Our induction process highlights the importance of the Scheme to all of our contractors and this is reinforced through behaviour expectations that all workers must adhere to.

Since the beginning of the project, what challenges have you faced?

The site is situated in an extremely busy area, right in the heart of the City of London with constant pedestrian and vehicle movement, so logistics has been difficult.


Segregation of construction vehicles, traffic and pedestrians.

The scale of the site is huge; it’s a complicated project split into three phases with an extremely tight site, meaning no on-site storage facility or room for vehicles which makes deliveries a big challenge.

The project is adjacent to a live hospital building, so our main challenge is to ensure there is no impact on clinical activity throughout the construction work of which we are very proud to have maintained. As well as being adjacent to the hospital, the site is also bounded by a large trading bank, a medical school and residential buildings.

All manner of work has been required, such as demolition and piling which can all create noise, dust and vibration implications. These need to be actively monitored for the local environment, but most importantly, for the safety of the hospital patients. The phasing of the project has made it necessary to carry out both construction work and service diversions not only to the external hospital areas, but also to an extensive amount of live wards and clinical areas.

How have you been able to overcome these?

We employ a full time client relations manager who is the main contact for any questions or queries relating to the construction work. It is essential that we keep all of our neighbours informed. We do this through a variety of channels, including: face-to-face meetings; newsletters; information boards on our hoarding; email correspondence; comments box; website forums and a community helpline.

We also employ an experienced team of marshals who make sure that vehicle access and egress is quick and safe, thereby not impacting on the main thoroughfare of traffic and pedestrians to and from St Paul’s Cathedral. The external road outside the entrance to our site is cleaned daily to ensure construction dirt is not transmitted to the surrounding areas.

We monitor noise, dust and vibrations so we get real time information on the impact of our work. We have a full time environmental advisor who manages the monitoring programme. Prior to the start of the demolition work, all windows in clinical areas were secondary glazed and fresh air ventilation installed which protects the patients from noise and dust. An acoustic screen was erected to mitigate the noise from our work to the surrounding hospital buildings in Barts Square. We have also worked with Barts Hospital to have designated quiet periods when our noisy work stops to protect patients during their meal time. Dust can also be a nuisance when it turns into mud. To proactively prevent mud leaving site, Skanska has installed an integrated wheel and boot wash. These recycle water by filtering out the silt and then re-pump it back round to be reused. A closed system like this doesn’t draw on mains water and therefore reduces our energy usage and carbon footprint.


Traffic management.

Could you detail a few examples of good practice you have put in place on site?

A key priority for Skanska at Barts is waste. Avoiding the production of waste is the greenest option and one that we are keen to drive through all areas of the project. Two strategies that have allowed the project team to meet this goal are off-site pre-fabrication and reusable packaging.

Off-site prefabrication has been adopted in all forms; from the macro-scale of the external cladding panels and pipe modules, to the micro-scale of made-to-length modular electrical wiring and pre-lagged ductwork. The process avoids waste on site and keeps work areas clean as well as delivering a higher quality product, allowing us to get it right first time.

Barts pioneered an approach to packaging within construction that is utilised in the retail and automotive industries. Packaging is traditionally one of the largest waste streams during the fit out stage of a construction project, and the Returnable Transit Packaging (RTP) solution was adopted to tackle this. Essentially, this describes robust plastic crates or stands that can be returned to suppliers, re-filled and used time and time again. Over 10,000 light fittings were delivered to the project in this way. Not only has packaging waste been eliminated - saving approximately eight tonnes of cardboard - installation efficiency has been boosted and not a single light was damaged. Other items delivered in a similar fashion include: pipework; glazing; bedhead trunking; nurse call and electrical panels.

The very compact nature of the Barts site led the team to adopt the use of a Construction Consolidation Centre (CCC). Trade contractors deliver materials to the centre where they are consolidated before being delivered to the site on a just-in-time (JIT) basis. The concept again borrows directly from the automotive and retail sectors. JIT deliveries restrict the volume of material on site, minimising waste from damage and encouraging trade contractors to be more resource efficient. The reduction in waste on the project is estimated at 15%. This in turn improves housekeeping, undoubtedly contributing to the project’s excellent safety record – over two years without a reportable accident.

The nature of the CCC also allows us to improve efficiency by utilising reverse logistics from JIT deliveries. By transporting empty RTP crates through an already necessary journey back to the CCC from site, it reduces carbon emissions and improves the housekeeping on site. Such a system is also used to transport segregated waste offcuts for storage at the CCC, meaning that a full load can then be returned to the manufacturer in a ‘closed loop’ system.

Agreements were reached with both the vinyl flooring and ceiling tile manufacturers to return offcuts into the manufacturing process, reducing the use of virgin raw materials and leaving zero waste on site. Buy-in from the Environment Agency allows these offcuts to be treated as a ‘product’, thereby avoiding some of the restrictions associated with transporting and managing waste. In turn, the use of vinyl flooring and ceiling tiles with a high recycled content on the project effectively closes the loop on these two waste streams. During Phase 1, just less than eight tonnes of vinyl were returned to the manufacturer, and another of our suppliers used material offcuts to feed their biomass boiler thus generating heat and power for their factory.

By introducing initiatives like these at Barts, Skanska has recognised that the benefits produced are not only environmental. Innovative waste management has played a key part in the excellent health and safety record.