At Healthcare Estates 2025, Tony Sinden, enterprise account manager – Northern Europe at Honeywell, interviewed Simon Boundy, head of healthcare, and architectural assistant Jakub Raspl, both of Stride Treglown Architects, winners of the 2025 Healthcare Estates Refurbishment Project Of The Year Award. They discussed the methodology behind – and challenges presented by – an extensive refurbishment project at Bigbury Orthopaedic Surgical Suite for University Hospitals Plymouth NHS Trust that involved the relocation of non-clinical services while minimising disruption to core services.
Tony Sinden: What was the vision behind the project and how did it evolve?
Simon Boundy: We’ve been working with University Hospitals Plymouth for about 20 years, so we understand their estate. We developed their strategic development plan, site development plan, effective development control plan. One of the projects which came out of that strategic plan was the relocation of non-clinical services, wherever possible, off the acute site and maximising the use of the acute site for core clinical services — theatres, intensive care, inpatients, etc. So this project — just to give an overview — it’s right at the core of the existing hospital, which was built in the late 70s. It’s relocating what were the main hospital kitchens to an off-site location — so that’s lower cost for the trust — and transforming that space into an operating theatre suite. That’s part of an ongoing programme where we’re looking to move, long-term, pathology, kitchen, sterile services, off-site — all those functions which absolutely don’t have to be on the acute site. It reduces congestion on the site, and frees up space for those core clinical services.
Obviously, you had some key challenges. How did you overcome them?
Jakub Raspl: The biggest challenge was fitting such a large, equipment-heavy suite into a really constrained space. We were right between live operating theatres and the main loading bay for the hospital, so fitting that in while keeping the hospital operational around it was a big challenge, and that required a lot of coordination and collaboration with the design team, stakeholders, and the estate team to make sure that we could build this while keeping everything around it still working.
Another challenge were the spatial constraints of the site. It wasn’t originally built to house clinical facilities. So, we had to carefully plan the layout and work with stakeholders to identify what was critical for them, where they could make compromises, where we could make compromises, and how to put all this together in such a small space.
What positive impact has it had on the hospital and the environment?
JR: It’s had really good impact on the actual users. We had really good feedback and testimonials from the users saying they really enjoyed the space. And it actually enabled what the Trust wanted, which was to decrease waiting times and enable this clinical operation within the main building.
SB: We looked at a number of options for providing the additional theatre capacity, and one of the options would have been a modular solution or a standalone solution on one of the car parks. But the important thing was that long-term master plan — so we’re not sterilising external space, taking up car parking space, which is at an absolute premium on the site, in common with most hospitals.
It also it meant those theatre suites going exactly where they needed to be within the hospital — close to the ward which is supporting them, with direct links to intensive care. And it has been extremely successful in reducing the waiting list for elective treatments.
What it reflects for me actually is the importance of that strategic plan. Everything you do is part of that longer-term thinking, [rather than] knee-jerk reactions which then cause you problems further down the line.
Take us through the importance of partnership and collaboration.
SB: It’s a partnership at every level. That long-term working [relationship] with the Trust is incredibly important. We have an understanding of what they need and their sometimes challenging demands on the estate’s teams and Trust teams to turn these projects around quickly. But because we know the Trust, we’re able to respond to that in a meaningful way and support them. And actually, one of the estates team used to work with us, so to have that understanding is really, really important.
JR: The collaboration happens on all levels. We started working with the stakeholders really closely from the beginning. We talked to all the different people involved, from clinicians and surgeons to the FM team and the delivery team — just making sure that we understood what they wanted and — because it’s a refurbishment and retrofit — [where we needed to] derogate, making sure that they were happy.
The collaboration continued throughout the process. When the contractor joined early, they knew the site, they knew the hospital and the client, so they were able to advise us on how to build it. They were working on projects next door as well — they were doing the enabling work of relocating kitchens out of the site. So, the collaboration was really close. If we uncovered anything on site that we didn’t know about, we could respond quickly and efficiently and change the design to fit the site.
What lessons did you take out of this? Did you learn anything to help you grow as a business?
SB: One of the lessons is that actually you can refurbish some of these [sites]. The hospital is now 45 years old, but the core structure has to remain — there isn’t enough investment to build a new hospital. So you have to find ways to effectively reuse that existing estate, and you can’t keep adding things onto the edge of it because you run out of space — there are constraints on that. So it’s about what you can take off the site so you can maximise use for clinical space.
There are some real challenges with what we’re seeing with the sustainability agenda and Net Zero. The air handling units, the engineering systems that go into a new hospital, the digital control systems — [they] take up a lot more space. There’s a lot more of it than the hospital was designed to accommodate. So how you accommodate those additional engineering systems in a sensible way and in a way that can be accessed is a core part of the thinking when you’re designing these retrofit solutions. Part of the master plan is planning where the air source heat pumps are going to go, where the larger air handling unit is going to go as part of those future development strategies. So, there are some really valuable lessons for how you effectively reuse that hospital estate, because most of our existing NHS estate — they’re older hospitals.
What was your approach on long-term sustainability?
SB: It’s ‘sustainability’ in the broadest sense. How do you create a sustainable hospital? By thinking about what that hospital is going to look like in 25 years’ time and making sure that everything you do moves towards that endgame. But there are also things like moving the kitchens off-site to a commercial location. They’re high energy use facilities and you can provide new systems because you’ve got more space, you’ve got more flexibility [off-site] rather than being squeezed into the bowels of the hospital, which is the reality of what was there already. So you can have better logistic solutions, you can have an optimised solution for catering or for pathology by moving that off-site rather than constraining it in the existing building. So, I think of sustainability in those terms. We’re not building [something] new — we’re making as much use as we can of those existing facilities.
So, following this recognition, what’s next for your practice?
SB: We’ve got three younger colleagues within our studio that are currently going through the apprentice process. For me, as someone who is a specialist in healthcare — I’ve worked in healthcare for a long time — it’s not always the most glamorous sector to work in. And to see younger colleagues wanting to work in healthcare and getting the value of engaging with clinicians, engaging with clients and seeing the benefit that work does is brilliant. And the more we can do to bring that next generation into working in healthcare — I think that’s so important. We do all sectors, but for us, healthcare is a really big part of our business, and we continue to work with local clients. The value of embedding ourselves with clients and working with them long-term is really important.
That’s absolutely fantastic. And Jacob — being an apprentice and winning this award, being a part of the team, that must feel really good — what an achievement.
JR: It’s been really rewarding. This project has been my apprenticeship journey. When I started my apprenticeship, I started working on this project and have been working on it ever since. And now, completing the apprenticeship and looking back, it was a point of professional development.
Finally, what can you share with others in your sector?
JR: Looking again from the design development of projects like this, [it is important to] challenge what is seen as ‘the norm’. So, with this project, we didn’t have a lot of natural light. We had only one roof light, one high level window. So we looked at how we can use colours to enhance spaces and make the people that work there and come there feel good, rather than just using the standard white and grey palette of clinical spaces. I think challenging norms and what is seen as the default is important on projects like this.
SB: I’ll just reiterate the point I made earlier — for us, it’s about having a long-term plan and making sure you’re building to that long-term strategy. But it’s also about embracing refurbishment and retrofit as a way of delivering high quality healthcare facilities in a cost effective and a sustainable way.