26 September 2024

Boosting capacity and helping to keep the lights on

Reliable, modern electrical infrastructure is key to the optimal running of modern hospitals, but with technological advancements demanding more resources, and reliance on ageing utility systems and IT networks, many NHS Estates and Facilities teams face an increasing challenge to balance existing effectiveness using limited budgets, and the need to effectively plan for future upgrades. Chris Rose, Business manager with Quartzelec, the electrical engineering service-provider, explains how it is helping a number of Trusts plan and cost-effectively implement 'future-ready' infrastructure solutions.

Hospitals across the UK are Increasingly reliant on sophisticated electrical systems and diagnostic equipment n the dally treatment of patents, but such equipment itself relent on a secure and stable power network to deliver 24/7 operation Whether it be in the A&E Department, an operating theatre, wards, or service areas Including - for example - the kitchens, ensuring a stable and reliable electrical supply is key to maintaining uninterrupted healthcare and support services.

While overall energy consumption across the NHS England estate fell by 1.65% in 2023 over the previous year,¹ a calculated 11.2 billion kWh of power was still consumed. Energy costs have also significantly increased in recent years. putting additional strain on the balance sheet. The total cost of running the NHS England estate last year was calculated at E12.4 bn an increase of 12% since 2021/22, and the expectation is that this will only continue to rise, With increasing energy use, and the need for repairs to the fabric of the buildings, both significant factors.

‘Old and dilapidated'

The NHS estate contains many old and increasingly dilapidated buildings. In 2022/23 It was reported that 42% of the estate had been built before 1985, with 14% pre-dating the NHS itself. Although the age of some of these buildings is not necessarily a problem, many NHS Estates & Facilities teams are being put under pressure by other factors. Among the key ones are reductions in staffing levels, a growing maintenance backlog, and historical under-investment in Infrastructure. Implementing upgrades to High Voltage (HV) and Low Voltage (LV) switchgear systems and local sub-stations. along with the associated data, communication monitoring, and alarm systems - which in some cases have exceeded their safe operational life expectancy - requires specialist knowledge, which is why, With over 100 years of heritage, Quartzelec is increasingly being contracted to deliver cost-effective solutions.

Scheduled HV and LV work

Planned infrastructure upgrade works can deliver huge benefits, and the work carried out at the Royal Alexandra Hospital in Paisley, part of NHS Greater Glasgow and Clyde, is one such example. It was identified that both the HV and LV network systems at the hospital could no longer be safely or economically maintained. and in fact actually increased the risk of power outages affecting potential critical procedures.

The on-site facilities team recognised that the HV infrastructure was antiquated, with operational restrictions within its switching capacity. This meant systems had to be fully Isolated to then allow faulty sections to be switched - which frequently caused critical supply loss. as not all loads were covered by LV back-up. The LV infrastructure in various critical areas, including the Maternity and Industrial sub-station, also Fed multiple points of failure. A detailed feasibility study for thus extremely challenging and critical programme of works was undertaken and costed at over £l.5 m. The NHS stakeholder and Estate management teams, working collaboratively with external stakeholders and specialists, facilitated the full HV and LV equipment specifications to be inclusively considered. This included factoring in timescales, enabling, and site works, plus managed interruption of electrical supplies.

The tendering and planning phase took around 14 weeks to deliver, with the detailed enabling and delivery work completed in a further 56-week timeframe The HV equipment aspect of the programme was developed to minimise downtime and maintain primary power to all locations. Part of the strategy was to have standby generators connected to the LV switchboards at various temporary locations, providing primary power as and when needed.

 'Not without its challenges'

 The programme was not without its challenges. The Maternity ward required a brand new LV sub-station, but with no space available within the ground floor of the building, the solution was to construct it in an adjacent courtyard. Council planning consent for this first needed to be secured, however. Groundworks and construction works - including the moving of existing LV cabling, and all new enclosures being installed - also needed to be carried out, all before any of the necessary electrical works and installation of the new switchgear could start.

“As the works affected critical parts of the hospital Infrastructure (including the Energy Centre, theatres, A&E and the Maternity unit), detailed planning and negotiation with NHS stakeholders was required to agree the required outages and contingency resilience required during each changeover. The works followed a critical path with HV and LV plant replacements," explained Douglas McGregor (Electel Systems Design), who led the 'in house' NHS Project Design team. "Extensive testing and verification of the existing and new Infrastructure was performed to reduce risk and outage durations. Thanks to the professionalism and attitude of our chosen service partners, the entire project was completed on time and on budget, but more importantly it has helped increased NHS resilience, capability, maintenance. and capacity to the parts of the electrical infrastructure that were upgraded. We established a great working relationship with Quartzelec during delivery of the project."

Over recent decades advanced technologies and working practices have meant that new solutions have had to be developed and integrated into existing hospital infrastructure

Switching to LED lighting has delivered many advantages to hospitals, thanks to reduced energy consumption and longer lifespan, which helps make savings on the maintenance schedule, and in almost all cases LED lighting was an easy adaption to roll out. However, more technically advanced system changes bring With them their own HV and LV network challenges that need to be safely and practically resolved.

More sophisticated diagnostic and treatment equipment often result in increased demand for power in particular areas. Even the increased use of computer systems adds strain to what is often an already overstretched IT network and power distribution infrastructure. Many hospitals have adopted local solar power generation or Integrated Combined Heat and Power (CHP) solutions, to improve their 'green' credentials, while simultaneously reducing operational costs. These bring benefits, but also their own technical challenges - the ramifications of which need to be fully addressed. Even adding a helipad to a hospital, its structural requirements aside, is not without its associated electrical supply issues.

Obtaining expert advice from external sources is often a more cost-effective solution in the long-run, compared with trying to use what is often an already stretched in-house team, even if the team's overheads are already covered. External experts like ourselves not only bring with us critical knowledge and experience from other NHS sites, but also a fresh perspective, and we can often envisage, and therefore compensate for, what could be an ‘unseen' and potentially more costly problem further down the line.

The New Hospital Programme

However, it is not just ageing HV and LV electrical systems and infrastructure that cause NHS Trusts to struggle. Back in 2020 the Government committed to building 40 new hospitals in England² to address issues with the capacity, age, and condition, of parts of the NHS estate. While a number of these are already under construction or have recently been completed, the anticipated target completion date of 2030 has already started to slip, and new replacement and expansion schemes are still in the discussion and development process. In 2023, seven existing hospitals were also identified as being at immediate risk, and were thus added to the ‘build programme' due to the use of reinforced autoclaved aerated concrete (RAAC),³ which when introduced was deemed an innovative building material, but is now proving problematic. These healthcare facilities were prioritised due to the safety risk they posed, and a growing number of others have also been identified as needing urgent remedial action. Likewise, in Scotland, a network of 11 new national treatment centres (NTCs) was identified to fast-track the care and treatment of patients.⁴ The future of at least six of these was put in jeopardy due to a lack of funding, and most recently all NHS build projects in Scotland were put on hold. Similar delays have also occurred with plans in Wales and Northern Ireland.

Modernised to meet future demand

Our work delivered at Bassetlaw Hospital in Worksop demonstrates how elements of a hospital's electrical infrastructure can be completely modernised to meet future demand. Much of the hospital complex was constructed in the mid-1970s using RAAC. Despite the absence of an imminent threat to the structures, the Trust decided upon a pre-emptive course of action to eliminate the RAAC materials prior to the emergence of any potential issues, replacing them with a cutting-edge roofing system, but throughout the process wanted to retain full operational capability and electrical supply.

Extensive surveys of the existing M&E services were conducted, in consultation with all the key suppliers, and a plan was developed to enable the Trust to retain access to at least four operating theatres. Part of the devised solution also included the strategic use of modular units, allowing patent treatment to continue, and these were put in place. Playing a pivotal role, Quartzelec ensured the functionality of these temporary units by providing essential utilities, such as water and electrical connections. Attention was then turned to the man building; removing the existing services from the underside of the roof, where the challenge was working in severely space-restricted areas in readiness for the RAAC works. New M&E services, including small power, lighting, fire safety, lightning protection, ventilation and medical gases, were then installed. Other buildings in proximity also benefited from HVAC, and modifications to the nurse call, phone, data and TV systems, along with a significant HV/LV man cable diversion for the newly developing Bassetlaw Emergency Care Village.

 “Bringing together specialist engineering service teams meant we could gain many economies of scale and significantly improve our overall facilities moving forward," said Phil Worsnip, Buildings Project Manager at IHP, the joint venture between VINCI Building and Sir Robert McAlpine. “The entire construction team was intrinsically engaged with clinical teams affected by the renovations, as well as with the Estates, compliance, parking, and fire officers, to keep the impact on both staff and patients to an absolute minimum. Given the scope of the operations, some disruptions were inevitable, yet the concerted efforts of the teams Involved to mitigate these disturbances played a crucial role in minimising inconvenience, and in the careful planning that underpinned this project. We take pride in this collaborative approach, which consistently delivers valuable benefits to our customers, reaffirming our commitment to service excellence."

Mobilising for immediate support

Quartzelec regularly steps in to address isolated, non-scheduled, but nonetheless critical, issues. When a water leak on the roof of the Doncaster Royal Infirmary Women’s and Children's Hospital Unit flowed down six floors and into the basement, damage was caused, as water compromised electrical systems control equipment in a service riser. Already on site delivering the third phase of an HV / LV Infrastructure project, Quartzelec was able to instigate temporary supplies, as well as get critical systems functional and safe within hours.

Mathew Gleadall Acting Operational Director of Estates and Facilities, said: “The damage was extensive throughout affected areas, and we were extremely grateful to the team from Quartzelec, who worked tirelessly alongside our own staff to help get essential clinical services back open.”

Quartzelec was then further able to support this NHS Trust client, helping deliver The Mexborough Elective Orthopaedic Centre of Excellence (MEOC for short), which is part of Montagu Hospital In Mexborough, and a collaboration between Doncaster & Bassetlaw Teaching Hospitals, Barnsley Hospital NHS Foundation Trust, and The Rotherham NHS Foundation Trust. The dedicated £14.9 m specialised orthopaedic hub with 12 inpatient beds delivers additional services for the people of South Yorkshire, operating 50 weeks per year, undertaking two and a half four-hour sessions per day, currently five days a week, rising to six.

From an electrical services aspect, modular prefabricated hospital units contained the theatre and recovery rooms, and these were brought onto site pre-configured, incorporating all the necessary electrical infrastructure to deliver the consultation and theatre requirements. The complete revamp also included upgrading the adjacent wards to provide a mix of modern single and four bed units.

Andy White, Head of Capital Infrastructure said: “Our aim was to create a facility that can undertake over 2,000 orthopaedic procedures annually, equating to about 40% of the current orthopaedic waiting list locally. Going modular was the simplest and most cost-effective solution to provide all the modern facilities we wanted in the shortest timeframe. The core electrical services were cabled to the point of requirement, and then it was simply a plug-and-play process to get everything operational, as all the main cabling work had already been completed off site within the pre-fabrication to minimise disruption to existing scheduled procedures."

Necessary works needn't take months, or even years, to plan and complete. When an NHS hospital in the North West needed to carry out planned ‘intrusive’ maintenance of its man LV switchgear Quartzelec stepped in to carry out the task over just two planned evening shifts.

The building was being supplied via two ABB 1250 kVA dry resin transformers, that in turn supply two man LV panels. Over two planned evening shifts, both the A and B panels were Individually Isolated, with all affected sub-circuits re-supplied via local section boards, allowing the servicing, including the interrogation of all air circuit breakers, to be achieved.

As part of this project, detailed recordings of the protective devices, ratings, and settings, were similarly Included, and a full report summary outlining the overall condition of the switchgear was issued upon completion. Thermographlc imaging was also captured prior to isolation of the main supplies, with all connections and torque settings inspected and each cubicle thoroughly cleaned, confirming that the LV infrastructure was in a satisfactory condition and fit for continued use.

At another West Yorkshire Hospital, the implementation of a programme of intrusive switchgear maintenance to the man SS1 sub-station and the LV panel that supplies a mental health unit,      where continuity of supply is crucial, was a key requirement. Following a sub-station distribution site survey, including a load appraisal, a plan was established that necessitated the introduction of a 200 kVA AMF generator package to ensure the continuity of supply to these critical services during a I0-hour window, while the intrusive switchgear maintenance to the SS1 sub-station LV panel was carried out and completed. A 200 A supply was also installed into the essential side of the panel board supplying the mental health block, via a 200 A MCCB to BS 60947/2, feedin a 250 A swich fuse to facilitate the temporary generator connection point.

It was soon agreed that this installation would remain a permanent addition to the electrical infrastructure , enhancing the site’s ability to provide continuous clinical delivery, and underpinning the resilience of the mental health unit. The site’s essential intrusive switchgear maintenance is an essential component needed to ensure continuity of supply, without compromising patient safety.

External Factors

One of the greatest risks to electrical infrastructure integrity is from lightning strikes. While lightning poses significant risk to many critical systems, inspecting and maintaining lightning protection systems is often overlooked. Every year the UK experiences approaching 300,000 lightning counts, with a heavy thunderstorm day typically generating over 10,000 strikes. Each of these huge electrostatic discharges commonly generates around a gigajoule – more than enough to knock out complete electrical systems. Adequate earthing has to be in place and regularly maintained, as detailed in BS EN 623052011 but when was the last time you considered or inspected the earthing points on your building or equipment? A managed programme should be in place, and NHS Estates managers are increasingly turning to specialists like Quartzelec to undertake the often complex calculations needed to help develop and install both direct and non-isolated protection solutions to ensure they keep up to date with requirements.

Conclusions

In today's rapidly changing landscape Estates managers and specialist service engineers often struggle to keep up with workloads and the increasing levels of compliance that go with them. That's why our skilled teams are increasingly being called upon to help meet modified Infrastructure requirements.

If your Trust needs to improve power management and distribution infrastructure in order to keep up with changing demand for energy around the site, wants to expand to integrate new resources and capabilities within the existing power distribution network, or need support in a crisis situation, Quartzelec has the knowledge, experience, certification, and qualified engineers, to develop and deliver solutions that could see you through the next couple of decades and beyond.

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