Front elevation view of Foleshill Health Centre

Foleshill Health Centre

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The UK’s award winning, greenest health centre built to meet Passivhaus standards – a model for the green future of the NHS.

The £3.3 million project is a partnership between Community Health Partnerships (CHP) and NHS Coventry and Warwickshire Clinical Commissioning Group (CCG). The GP team at Foleshill Surgery (part of Coventry and Rugby GP Alliance) started seeing patients in August 2021.  Foleshill Health Centre received Passivhaus Classic certification on 19 October 2021 after a detailed scrutiny process.

From concept to build

 

Approach and approval

Foleshill Health Centre (FHC), Coventry, an innovative example for future sustainable NHS estate design. It is the first and only British Passivhaus healthcare building. The primary care centre has a three-year data monitoring plan in place, and demonstrates its potential for repetition and upscaling across the future NHS health estate.

CHP chose the Passivhaus approach because of its overall sustainability ethos with low running costs and health benefits. Passivhaus is an international low energy, design standard which has been used to design, build and test over 65,000 buildings worldwide. This is the first time that NHSE/I has approved this type of building for the NHS in England.

Cost and partners

Foleshill cost £3.3 million and is a CHP-delivered, public capital funded scheme. Despite a higher initial capital cost, the annual utility running cost for the building is expected to be less than a third of the cost of a traditional building, giving significant savings over its lifetime (a predicted minimum of 6.3% over 40 years, using the NHS’s 1% annual energy inflation assumption).

The health centre was delivered through a partnership between CHP and NHS Coventry and Warwickshire Clinical Commissioning Group (CCG) without the need for debt funding or joint ventures and using the NHS SBS procurement framework. Coventry and Rugby GP Alliance are the GP provider organisation.

Delivery partners included Portakabin (main contractor), Tooley Foster Architects (Passivhaus specialists), AECOM infrastructure consultants and Arden Estate Partnerships Limited (development project management).

Collaborative design process for the build

The project team used project management principles and processes subsequently included within in the Government’s December 2020 Construction Playbook, which captures Modern Methods of Construction (MMC), commercial best practices and sector reforms.

Having a collaborative, integrated design and construction team rather than a traditional approach resulted in a smoother project management process. The architects Tooley Foster (Passivhaus experts) and cost consultants AECOM worked together as a collaborative design and build team with modular experts Portakabin as the design, development and build contractor.  The major benefit of early engagement with the main contractor Portakabin was a single point of responsibility for cost, time and quality.  Each of these aspects was critical to the project’s success as an example for future sustainable NHS estate design and enabled the design to be developed to suit the modular solution.

The project was supported by the Coventry based LIFT Company, Arden Estate Partnerships as development managers via their Management Services provider gbpartnerships.

Impact of COVID-19

The centre was built and opened during the Covid-19 pandemic in only 10 months. This presented many challenges, which included ensuring contractors and staff could work safely and socially distanced on site, the impact on completion timelines, and supporting the GP team to move in and begin seeing patients.

Building specifications

Foleshill is built to meet the Passivhaus standard: the leading international low energy, design standard.  The GP surgery has an EPC A rating and is expected to be BREEAM Excellent by design.

Size, location and capacity

Foleshill is a 619m2 building serving up to 10,000 patients in inner city Coventry. The new GP surgery has two storeys, five consulting rooms, two treatment rooms, offices, a reception area and a waiting room  The health centre was built on a brownfield site, the location of a former council swimming pool that closed in 2013.

Factory-built modules by Portakabin

CHP took an early decision to use factory-built modules.

The CHP Developments team, Portakabin and the Tooley Foster teams planned the interiors and engineering services at the offsite construction stage.

Internal fit out was completed at the Portakabin specialist manufacturing facility in York, then transported to site to be assembled and installed over three days in December 2020.

Using exacting standards of engineering to tolerances of 1mm, the Portakabin team delivered precise control across every aspect of the project from design to manufacturing; measuring every resource used and any waste generated.

Works duration was reduced by 26.5% with the majority of the fit out completed prior to delivery to Foleshill.

Insulation, triple glazed windows and sun shading

The building is highly insulated, so it is warm in winter and cool in the summer. The insulation exceeds the Building Regulations fabric insulation values by about 40%.

Its energy-efficient features include triple glazed windows, which can be opened if required. Triple glazed windows are more energy efficient than double glazing, and can be more comfortable to sit next to as less cold air is created next to the glass.

Each window has a sun shading system (called brise soleil) that breaks up the sun’s rays to reduce direct summer sunshine entering the building, with different sizes on each side of the building.  These black window shades contribute to the comfortable internal summer temperatures within the building.

Air circulation and heat recovery

The building is very airtight – the leakage rate roughly equates to a hole the size of a golf ball across the whole building – and fresh air is circulated 24/7. All rooms have filtered 100% fresh air from ducts in the ceiling, supplied from ventilation units that recover heat from stale air leaving the building via the mechanical heat recovery unit. The air is filtered to a similar standard as an operating theatre, ensuring a safe and clean environment (ISO  ePM1 – June 2021).

Sustainable lighting, water, heating and power

The building has been designed to achieve energy consumption figures of about a quarter of a typical health centre of the same size

The design maximises natural light and is welcoming for patients and staff. There is a small heating system using air source heat recovery pumps connected to small radiators.  Photovoltaic (solar) panels  on the roof provide electricity and all the lighting is provided by energy efficient LED lamps.  There are no fossil fuels used on site and it has achieved Energy Performance Certificate  (EPC) A.

Each basin and sink has its own instant water heater which operates when the hot tap is turned on.  This is best practise for the control of legionella and other water-borne pathogens.

External finishes

Foleshill is clad with white render and wood effect Rockpanel boards on the ground floor. Rockpanel boards are durable; they are made of highly compressed stone wool fibres made from basalt a volcanic rock.  Each panel is at least 50% recycled material, with a 60-year life span, and will be recycled at the end of their life. 

Green transport

The site is easily accessible by public transport which aims to reduce traffic flow.  It also has an electric car charging point and bike storage.

Carbon footprint

Foleshill leads the way for carbon emissions reduction in this type of building, with significant projected annual carbon emissions savings (e.g. 411 tonnes CO2/pa).  The building has a Energy Performance Certificate (EPC) A with a score of 12 very close to net zero.

It supports the NHS Carbon Footprint aim to be the world’s first carbon net zero national health service. The health estate makes up 4-5% of England’s carbon footprint.

  • The NHS Carbon Footprint (emissions NHS controls directly), will be net zero by 2040, with the ambition to reach an 80% reduction from 2028-2032
  • The NHS Carbon Footprint Plus (emissions NHS can influence), will be net zero by 2045, with the ambition to reach an 80% reduction from 2036-2039.

Meeting the health needs of the Foleshill community

CHP are committed to working collaboratively with our customers and a wide range of health and social care professionals for the benefit of patients and service users.

Foleshill Health Centre was specifically developed to best suit the needs of the local population. Previously, the GP surgery delivered services in poor quality, cramped accommodation a quarter of a mile away from the new  Foleshill site.  Patients are now treated in a modern, innovative 21st century primary care building.

Foleshill is a densely populated inner-city area with a mix of light industry, housing and retail areas. It is also one of the most ethnically diverse wards in the city, with:

  • over 50% Asian/Asian British ethnic group residents (50.1%). This is the highest proportion in the city
  • 8% white residents (about a third)
  • a highly transient population with the highest proportion of residents who were born in other countries (36.2%)
  • the lowest proportion of households who are ‘not deprived’ in the whole City (21.6%), compared to the City average of 38.4%.

 

Life expectancy

In Foleshill, people have lower life expectancy than the average for England because of heart disease, cancer and other conditions. There are also significant numbers of people with long-term conditions – for example, high blood pressure, diabetes, coronary heart disease and a severe breathing disorder (COPD) – who need greater support, closer to home in modern primary care buildings.

Life expectancy has improved in recent years, but needs to improve further. Since Coventry became a Marmot City in 2013, there has been progress in outcomes both across health and across society. There have been improvements in health outcomes, school readiness, life satisfaction, employment and reductions in crime in priority locations. Many innovative projects and initiatives are yielding positive results for the people of Coventry.

Awards and praise for Foleshill

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Constructing Excellence East Midlands (2 September 2021)

Won the Offsite Award, Highly Commended in the Value award 

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Constructing Excellence West Midlands (10 September 2021)

Won the Sustainability, Offsite, Value Awards and Winner of Winners

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CABE Built Environment Awards 2021 (14 October 2021)

Sustainability Award Winner

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Healthcare Estates IHEEM Awards (19 October)

Won the Best New Build Project of the Year and Shortlisted for Sustainability Achievement

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Building Better Healthcare Awards (9 November)

Won Best Carbon Reduction Initiative

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Sustainability Awards (23 November)

Won Infrastructure Award

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Constructing Excellence Yorkshire and Humber (25 November)

Won Offsite Award

Foleshill Health Centre has been shortlisted for the Hospital Building Award at the Health Business Awards 2021 (9 Dec).

“We are really excited to see patients move into this fantastic efficient modular build. The services that will be provided from this building will ensure we continue to provide high quality, safe and effective care for the local residents of Foleshill.”

Dr Sarah Raistrick

Chair NHS Coventry and Warwickshire Clinical Commissioning Group

“We are really happy to continue to offer our patients a high-quality service from within a modern and energy-efficient new building.”

Dr Peter O’Brien

Chairman of Coventry and Rugby GP Alliance

“This pilot project is pushing the boundaries of offsite construction within the public sector as well as the perceptions of that which can be achieved with MMC (Modern Methods of Construction). Foleshill is showcasing the flexibility of MMC and is a bold and brave step toward creating a legacy of buildings that will help the construction industry proactively tackle climate change.”

Lee Connolly

Head of Project Design and Engineering at Portakabin