Guy's Hospital, Great Maze Pond, London, UK

The NEC-procured Cancer Centre on a confined triangular site at Guy’s Hospital in central London is designed to be a ‘hospital that does not feel like a hospital’. Architects Rogers Stirk Harbour + Partners and Stantec’s competition-winning design provides four themed ‘villages’ on 14 triangular floors, with each village offering a unique range of clinical and care spaces. There is also a cancer research centre on the ninth floor.
 
Client Guy’s and St Thomas’ NHS Foundation – operating through its project, estates and facilities directorate Essentia – let the detailed design and construction of the unique building to contractor Laing O’Rourke under a £100 million NEC3 Engineering and Construction Contract Option A (priced contract with activity schedule). Aecom was appointed as project manager with Arup as engineer. Work started on site in February 2013 and the centre opened on time and to budget in September 2016.
 
Design and construction made extensive use of building information modelling (BIM) and offsite manufacture, with level 2 BIM used throughout and over 50% of the structure being factory-made for rapid assembly on site. Offsite components included reinforced concrete floor slabs and columns, fully glazed façade panels, complete balconies, serviced partition-wall units and steel-framed plant modules.
 
Sustainability was a key driver for the project, which includes a combined heat and power plant, extensive use of natural ventilation and shaded façade glazing to ensure maximum natural light with minimum heat gain. Together these helped the completed building achieve a BREEAM ‘excellent’ sustainability rating. Future flexibility is also assured by each floor having its own plant room in a 12-storey plant tower, and the 2.5 m thick block shielding for the six radiotherapy linear accelerators on the second floor being readily removable when less-invasive treatment becomes available. 

Best Practice Procurement

Essentia programme manager Sally Laban says, ‘In line with public-sector best practice, we now use NEC contracts for all procurement related to Guy’s and St Thomas’ hospital buildings and infrastructure. Compared to JCT contracts that we used previously, we find NEC less adversarial and more collaborative. NEC also ensures that we know about and resolve issues when they happen rather than leaving them to be sorted out at the end of the contract.’
 
She says the ECC Option A priced contract worked very well on the Cancer Centre project. ‘Completion was achieved on time and to budget despite the complexity of the building, its logistically challenging location in central London and scope changes.' Supported by Asite project management software, the project team adopted a genuinely collaborative approach and made full use of NEC early warnings and risk-reduction meetings. 'This ensured all risks to the project were identified at the earliest stages and provided the opportunity for us to work through the problems and find solutions.’
 
The contractor had to accommodate a number of scope changes during construction. These included general design developments by the Trust, revisions to local authority requirements for local roadworks under section 278 of the Highways Act, archeological investigations and additional works to protect and allow future access to a Roman boat buried 5 m under the foundations. ‘The additional scope could have increased the construction programme from 166 weeks to 184 weeks but, through close collaboration within the project team, we were able to meet the original September opening date.
 
On completion of the Cancer Centre at Guy’s, project director Alastair Gourlay said, ‘Using NEC we have successfully delivered this project on time without causing disruption to either the local community or patient care – no mean feat when constructing a 14-storey tower in a triangular corner of the Guy’s Hospital site which is literally inches away from neighbouring buildings. Most cancer treatment at Guy’s and St Thomas’ will now be provided under one roof rather than in 13 locations at eight buildings on two hospital sites.’ 

Benefits of Using NEC

• NEC is now industry standard best practice for public-sector procurement, with good familiarity throughout the construction supply chain.
• NEC contracts foster a more collaborative and less adversarial relationship between clients and contractors, especially when compared with JCT contracts.
• NEC early warnings and other risk-management processes ensure that clients know about and resolve issues when they happen rather than leaving them to the end of the contract.