Clinical Practice Fit-Out

The junctions: where the floor meets the wall, where the worktop meets the sink, where the ceiling meets the partition.

Everything else in a fit-out is visible and gets looked at. The junctions are what decide whether a room cleans, and they are where a general fit-out and a clinical one part company. A coved skirting that is welded to the sheet vinyl and carried up the wall is a different detail from a skirting that is glued on afterwards, and it costs more. A worktop sealed to the wall cladding with the right sealant in the right sequence is a different detail from one that is siliconed at the end. Neither difference shows in a photograph. Both show at an infection control audit two years later.

That is most of what we are being paid for. The partitions and the paint are the same trades in any building. The specification and sequencing of the wet junctions, the services terminations and the finishes are what makes the result a clinical room, and they are decided at first fix, not at snagging.

Not the room sizes. The services capacity and whatever the building is hiding.

Three things decide whether a layout is buildable, and none of them is visible on a plan. First, the void: how much depth there is above the ceiling and below the floor to route ventilation, drainage and containment, and whether the falls work. Second, the incoming supplies: whether the electrical capacity covers the equipment schedule, whether the water can serve the sanitaryware without dead legs, and where a plant location can go that is not the middle of a clinical room. Third, what the existing fabric contains, which on a building of any age means asbestos, and the duty to assess it before intrusive work is a legal one rather than a precaution.

A layout that survives all three is a layout worth pricing. One that does not is a variation waiting to happen, and it is much cheaper to find that in a survey than in week four of a programme. Where the layout is not settled at all, design and build is the better contract, because the survey then feeds the drawings rather than contradicting them.

Three sectors, and the same building problem underneath.

A veterinary prep and theatre suite, a dental surgery and decontamination room, and a medical consulting and minor procedures suite are regulated by three different bodies against three different documents. The finishes, the joinery detailing, the services terminations and the commissioning records are close enough to identical that a contractor who has done one properly can do the others properly. What has to change is which requirements are being built towards, and knowing that before the design is fixed rather than at commissioning.

Where a practice cannot close while this happens, the same scope is delivered as phased works in a live practice. Where the whole building is in scope at once, that is a full practice refurbishment. The mechanical and electrical element can also be taken on its own as mechanical and electrical work, individual rooms have their own specialist room pages, and completed projects appear on our work pages as each client releases its material.