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A new form of the Private Finance Initiative (PFI) has been used to provide outpatients in Farnham, Surrey with centralised health care. The construction of the 12 000 m2 Farnham Local Care Centre was completed using the Standard Form of Contract, but under the 25-year PFI, the consortium will be responsible only for the design, build and provision of hard facilities management ie the maintenance of the building fabric. Soft services are the responsibility of the NHS Trust and will be provided by Caxton Facilities Management.

The care centre was built for two main reasons: a change in priorities for the area's needs; and to centralise general practice and basic outpatient facilities. It has brought together primary, secondary and health care plus social services, and four GP practices from around the area will now be based here.

The care centre was built on part of the same Trust-owned 13·8 acre site as an existing 120-year-old hospital and will directly replace some of the services provided there. The construction project was split into two phases: phase one, the building of the new centre; and phase two, the demolition of the remainder of the old hospital and laying of a car park in this area.

The PFI consortium was Norwich Union Public Private Partnership, the Guildford and Waverley NHS Primary Care Trust and Gleeson Group, which acted as the main contractor.

Powerminster won the contract for the m&e installation by competitive tender. The contract was to install systems that were predesigned by m&e consultant Donald Smith, Seymour & Rooley (DSSR). Derek Cliff of Powerminster explains: "We do PFIs in which we design, construct and the fm team take it over, but on this one we've purely come in to install a predesigned installation."

Construction started on site in January 2002, with the m&e services installation commencing in September 2002.

Service centre
The two-storey centre comprises three distinct, but adjoining building sections. These each house different facilities, the separate building sections helping to distinguish the division of services.

Two sections are formed as square blocks, each with a central courtyard. The first of these houses an outpatients' facility with consulting rooms, social service and mental health facilities, plus an x-ray room and chiropody services. A plantroom is sited on the second floor.

The second square block is an 84-bed ward area with dispersed nurse call stations; half of the inpatient beds are intended for rehabilitation, the remainder are for nursing home provision. Adjoined to, and running the length of this block, is an open-plan atrium, which contains a cafe, pharmacy and waiting area. It also serves to separate the aforementioned blocks from the GP areas, which are formed of four 'fingers' stretching out of the opposite side; three of these hold GP surgeries, the fourth has a renal unit on the ground floor.

"Its almost an upside-down building," explains Powerminster's Derek Cliff, "all the plant is on the roof and there are no basements." The centre is serviced as if it were a single building and services are diluted compared to those in a hospital as there are no operating theatres.

The second floor plantroom in the first square block contains six Hoval, pressure jet, modular boilers, eight air handling units (ahus) and two direct-fired hot water heaters. This supplies the heat generation for the whole centre, which has a standard wet system with variable temperature radiators and radiant panels and a constant temperature circuit feeding heater trimmer batteries and ductwork.

Two further ahus are located above the GP surgeries and feed the adjacent areas. The basic air solution is a supply and extract system and natural ventilation has been maximised. Cooling is provided by split systems, generally cassette units.

The main spine of the air distribution supply runs along a system of walkways in the roof that mark the service routes. From here, various risers drop down into the buildings and feed into a distribution network in the ceiling voids that follows the main corridors, dispersing into individual rooms from this route.

Electrically, a 1600 A mains incomer feeds supply panels, with subdistribution by mccbs to four main, roof-level distribution boards. From here the cabling follows the same risers as the mechanical pipework. The main lv panel is in the standby generator room behind the centre and services from here are primarily run around the outside of the building in underground mains.

Installation issues
The services were installed in phases, starting at one end of the centre and working through. "We were following the construction team around," explains Cliff.

Common bracketing was used throughout, enabling one set of operatives to complete this job. The bracketing team began their installation first, followed by the ductworkers, pipework installers then electrical contractors. One set of installation teams would complete the corridor sections and branch the services to the adjoining rooms; a second team then carried out the second fixings.

Prefabrication was discounted due to a lack of space: "The corridors were so tight – that led to us going against prefabrication," confirms Cliff. The extensive use of the Mapress pressfit system achieved time savings on site.

A number of additions were made to the installation as construction progressed, the largest of which being a renal room. This is in an area originally intended as a GP surgery and was included after a need developed in Farnham. The services installation was put on hold for this single block until the final decision on the unit was made to avoid any unnecessary duplication or changing of work as the services differ from that in a GP surgery. "A number of services were re-routed, a number were added, then from natural ventilation extract, a vav system was put in and additional extract for the isolation ward," explains Cliff.

The centre's location brought its own constraints to the construction process. It is sited in a residential area, making it convenient for future patients, but this meant that working hours were restricted to 7.30 am until 5.30pm on weekdays, and from 8 am until 4.30 pm on weekends for noisy operations.

Storage space was also an issue, with Powerminster limited to three 30 ft containers for all of the m&e works. This meant that careful logistics were needed to ensure materials arrived on a just-in-time basis. Section supervisors worked with the engineers to calculate the amount of materials required for each section and placed orders for these in conjunction with the construction programme. All materials for each section arrived as a bulk order as work there was about to begin.

Construction of the centre completed in October 2003, with the first patients being moved directly across from the existing hospital. Phase two is scheduled to complete in January 2004.