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Healthcare providers across the UK are facing an unprecedented challenge: expanding capacity at speed while maintaining safe, high-quality environments for patients and staff. Traditional construction methods, often slow, disruptive and complex, are increasingly unable to meet the demands placed on today’s health systems.
As someone who works alongside NHS Trusts and Health Boards every day, I see the urgent need for estate solutions that are faster, more predictable and deliver long-term‑term value. Volumetric modular construction, and specifically high pre‑manufactured value (PMV) projects, answers that call.
Volumetric construction, or modular construction, is the process of manufacturing modules in an offsite factory, bringing them to site and then joining them together to construct a building.
Installation of a diagnostic centre in the heart of the community
There are a number of different types of volumetric construction. Vanguard, at our factory in Hull, uses modular building techniques to create high-quality, clinical spaces for use exclusively in healthcare. These include sector leading operating theatres, wards, clinics, emergency care facilities central sterilisation units, endoscopy suites, decontamination suites, surgical hubs and community diagnostic centres.
Hospitals must find ways to add capacity without compromising safety or service continuity and for many NHS Trusts and Health Boards, this creates a difficult balance: they must build more space, much faster than ever before, at a time when traditional construction methods are struggling to keep pace with operational and regulatory demands.
It is a reality that those responsible for managing and developing healthcare estates feel acutely.
Projects must not only move quickly but also deliver predictable outcomes, minimise disruption and comply with increasingly stringent standards around infection prevention, energy performance, fire safety, acoustic quality and sustainability. In this context, volumetric modular construction, particularly with high pre‑manufactured value, has begun to transform how the NHS considers estate expansion.
Of course, for those working within healthcare construction, the concept of modular building is not new. What is different now is the level of precision, sophistication and clinical readiness that high PMV volumetric solutions can offer. When more than 80% of a building is manufactured offsite, the benefits for the NHS estate become tangible, measurable and directly linked to operational continuity. The promise of faster construction is often the headline, with ground works on site happening concurrently with the construction of the modules in the factory, and the advantages extend far deeper than programme duration alone.
Nurse Base in the modular CDC
At Vanguard our role as a creator of specialist healthcare solutions has shown us just how transformative these modern methods can be. Volumetric construction offers a major opportunity for healthcare providers looking to increase clinical capacity with minimal disruption.
A recent project saw the Vanguard team design, build and deliver a modular Community Diagnostic Centre in Swindon, on behalf of Great Western Hospitals NHS Foundation Trust. Using modern methods of construction, we built a centre to include two endoscopy treatment rooms and six patient pods for pre- and post-treatment. Other rooms include a reception and administration team area, waiting area, admission room, two consultation rooms, nurse station, storage areas, utility rooms and scopes stores, and staff welfare rooms and kitchen. With an anticipated 6,000 patients over 12 months, the potential impact of the unit was clear.
Fundamentally, the higher the PMV, the less work is required on-site. Pre-manufactured modules were delivered to site and installed over two days, minimising inconvenience caused by noise, dust and traffic. The new facility is now treating patients in their local area, meeting the accreditation standards for endoscopy services of the Joint Advisory Group on Gastrointestinal Endoscopy (JAG), and contributing towards achieving the national objectives of the NHS.
The speed at which the project could be delivered as a high PMV project meant patients were being seen for their essential procedures as soon as possible.
It’s no secret that hospitals today cannot contend with lengthy construction programmes. Surgical hubs, community diagnostic centres and sterile services departments (CSSDs) are needed now, not years from now. Capacity for imaging, diagnostics and elective procedures must be expanded immediately if national recovery ambitions are to be met.
By manufacturing modules offsite while groundworks are completed onsite, high PMV projects can cut delivery programmes by up to 40% compared with traditional construction. Modules arrive fully fitted, tested and ready for installation, reducing time on site from months to weeks.
Modular surgical theatre
That parallel workflow delivers something that healthcare providers tell us is their most urgent need: certainty. Certainty of programme, which allows clinical commissioning and workforce planning to take place with confidence. Certainty of cost, created through a more controlled and predictable manufacturing process. And certainty of quality, made possible because within the factory, the construction environment is more easily controlled, facilitating consistency and tightly governance.
NHS estates professionals understand better than most the sensitivity of hospital environments. Major works occurring within or close to clinical areas carry risks that extend beyond construction logistics. They can affect infection control, air quality, accessibility, emergency planning and the day‑to‑day experience of patients, visitors and staff. And any large-scale hospital expansion must respect the needs of patients, visitors and staff.
With less noise, fewer vehicle movements, better control of dust and air quality and a smaller area needed by contractors for equipment and materials, modular construction supports the operational resilience that healthcare estates teams work tirelessly to preserve and for a healthcare provider working to keep services running during a redevelopment, these are not small advantages, they are essential.
Healthcare environments also demand exceptional levels of quality and compliance as well as exceptional precision. Air change rates must be verified. Acoustic separation must protect confidentiality and support healing environments. Structural interfaces with existing buildings must be reliable. Compliance frameworks within clinical spaces are unforgiving.
Meeting these requirements on a traditional construction site can be challenging because conditions vary, resources fluctuate, and the effects of weather and sequencing can introduce inconsistency.
In a factory, however, each module is built under controlled, repeatable conditions. Vanguard’s volumetric facilities operate to tolerances of plus or minus two millimetres, allowing interfaces between modules, foundations and adjoining buildings to be engineered and tested with a degree of accuracy not normally seen, even in healthcare construction. The result is a level of quality control that improves compliance outcomes, reduces the need for rework and drives down whole‑life cost.
Put simply, in a factory setting, quality can be controlled to a degree simply not achievable on a traditional building site - ensuring seamless interfaces with foundations, existing buildings and essential services.
Factory conditions also improve safety performance. With up to 90% of the work completed offsite, there is far less need for operatives to work at height or within tight clinical corridors or around live hospital infrastructure. The controlled factory environment reduces risks linked with weather, manual handling and multi‑trades working on site. For NHS estates teams having responsibility for ensuring that clinical operations can continue safely throughout a build, these improvements in health and safety performance are key.
Sustainability is no longer an optional consideration - environmental performance and Net Zero commitments now sit at the heart of every long‑term NHS estates strategy.
Volumetric construction contributes meaningfully to those ambitions. Buildings manufactured using this approach consistently demonstrate improved airtightness and thermal performance, reducing the energy required for heating and cooling. Factory‑led construction enables tighter materials management, leading to up to 90 percent less waste when design engagement begins early.
Traffic reductions associated with the scaled own onsite programme contribute to lower local emissions, reducing the environmental burden on hospital sites and their communities. For estates teams looking to expand their footprint while supporting organisational carbon reduction targets, these environmental advantages form a compelling part of the business case for modular building. They offer practical, achievable steps towards helping the NHS hit its Net Zero targets while adapting the estate.
One of the most striking recent examples of high PMV healthcare construction is the CSSD facility Vanguard developed for University Hospitals of Strasbourg.
CSSD module, fitted with equipment before delivery to site
Manufactured entirely in our Hull factory, the building arrived in France with four washers, three steam sterilisers, a hydrogen peroxide low temperature steriliser and changing rooms, staff rest area, sluice, office space and storage – all already installed.
With its existing CSSD undergoing refurbishment, the hospital needed a fully operational alternative facility that could be deployed rapidly and safely. A high PMV modular approach made this possible. The building arrived in France ready for rapid assembly, testing and commissioning. This kind of deployment illustrates the maturity volumetric construction has achieved and how well it aligns with the operational realities healthcare providers face, not only in the NHS but internationally.
Volumetric construction works best when architects, planners, clinicians and construction partners collaborate from the start. Early engagement allows for standardisation of designs, reduced waste, faster manufacturing, improved compliance and clearer cost certainty. Healthcare providers who bring modular partners into the conversation early see the greatest benefits in programme, budget and operational performance.
As the demands on healthcare continue to grow, modern methods of construction offer a scalable, predictable and high-quality solution. Volumetric construction is not simply an alternative to traditional building. In many cases, it is a better way: quicker, safer, greener and more aligned with the operational realities of modern healthcare.
At Vanguard, we believe high PMV modular facilities will play a central role in how the NHS expands sustainably and strategically in the years ahead.
Understanding how volumetric construction works in practice is essential for estates teams considering whether it is the right approach for their next project. More than traditional builds, where construction and design often progress concurrently under changing site conditions, modular buildings benefit significantly from early engagement between architects, design teams, planners, clinicians and modular manufacturing partners.
Early involvement allows designs to be standardised where appropriate, waste to be minimised and manufacturing processes to be optimised. Estate strategies that incorporate modular thinking from the outset tend to see the greatest gains in delivery speed and cost control.
The process typically begins with site identification, acquisition or assessment. As no two NHS estates are the same - some hospitals have clear areas where they can be expanded or temporary infrastructure can be placed, it’s more difficult for others.
It also depends on what the facility is set to do, and the procedures it will perform. It may need to be close to specific other wards, theatres or facilities, patient flow may be a concern while others can feasibly act as ‘standalone’ solutions, positioned away from the main hospital building.
When we are working with a healthcare provider, our approach includes collaborative early‑stage assessments that consider utilities, access, relationships with existing services and the impact on patients and staff. These initial considerations form the foundation for subsequent design work. Design and planning follow, informed by feasibility studies that estimate the number of modules that will be needed and how they will be configured.
Because volumetric construction relies on a high level of precision, early engagement is critical. Design teams must develop configurations that meet the clinical, operational and technical needs of all stakeholders, but also support efficient manufacturing.
Standardisation is central to this stage. It makes sure that modules can be produced consistently, with predictable interfaces to foundations, central cores and existing buildings. Fire compliance, structural loadings, thermal performance, air permeability, mechanical ventilation, façade design and services integration are all resolved early to reduce the likelihood of changes later. For NHS estates teams, this reduces risk and enables clearer communication with planning authorities, clinical leads and capital programme boards.
Manufacturing then begins in a factory environment where quality control processes are deeply embedded. The aim is for approximately 80–90 percent of construction to be completed at this stage, including structural assembly, internal partitions, M&E installations, clinical fit‑out, fixtures and fittings, and specialist systems such as medical gases or ventilation plant.
With standardised production lines and clearly defined operating procedures, the factory environment supports continuous improvement, efficient material usage and consistent output. This contrasts with traditional building sites where weather, subcontractor availability and sequencing constraints can introduce variability. For estates teams responsible for clinical compliance, the predictability of factory manufacturing is a significant advantage.
Modular, two-theatre surgical facility
While the building of the modules is underway in the factory, there is also focus on the construction logistics onsite. Precision matters here too: modules built to a two‑millimetre tolerance require foundations and structural interfaces which are designed and executed with comparable accuracy.
It’s a complicated and complex process and collaboration between modular manufacturers, groundwork contractors and hospital estates teams is crucial to ensure successful installation.
There’s much to think about. Transport routes must be planned, cranage capacity assessed, lifting configurations defined and storage areas prepared. Utilities and service connections need to be verified and tested. And it is essential that throughout, public safety and patient accessibility must be safeguarded at all times.
The legal framework for modular construction differs from traditional procurement models, especially regarding ownership and transfer of risk, which may occur while modules are still in the manufacturing facility.
Quality control processes also require contractual clarity to ensure inspections can take place within the factory. At Vanguard we encourage clients to visit the Hull factory during production to assess progress firsthand and verify compliance, giving estates teams greater visibility and assurance throughout the build.
Practical questions come up when estates teams evaluate volumetric construction. Fire safety is paramount, and modular buildings are designed in accordance with all relevant fire legislation, with fire resistance engineered into both individual modules and the completed building structure.
Any concerns around acoustic and thermal transfer are addressed through the design of modules that bear only on their corners, limiting contact between adjoining units and enhancing performance.
Some teams ask whether fixtures and finishes can be customised; the answer is yes. Modules are designed in consultation with clinical teams to make sure that the finished spaces meet operational needs.
Others ask whether modular buildings settle after installation. They do not, because the primary structural material is hot‑rolled steel that maintains its integrity throughout the building’s lifespan.
And another, and often decisive, question concerns speed. Just how quickly can a modular building be on site and operational? A development of 100 pre-built modules can be assembled within weeks, not months, giving estates leaders a rapid route to increasing capacity with minimal risk.
As the NHS looks to expand sustainably, improve patient flow and modernise outdated infrastructure, high PMV volumetric modular construction offers a way to deliver estate improvements at the pace clinical services now demand.
It reduces disruption, enhances quality, improves safety, accelerates delivery and lowers environmental impact, all while ensuring compliance with the rigorous standards expected of healthcare buildings. Modern methods of construction are often described as an alternative to traditional building, but for many healthcare applications they are not merely an alternative but a superior and more aligned approach. They support the NHS’s need for resilience and flexibility while delivering facilities that meet the technical and clinical requirements of modern medicine.
For estates teams working in an environment of rising demand, complex regulatory pressures and limited downtime for major redevelopment, volumetric construction represents a fundamental shift in what is possible.
As demonstrated by projects across the UK and internationally, high PMV modular buildings are already providing the certainty, quality and speed that healthcare providers urgently need. In the years ahead, as pressures on clinical capacity continue to grow, this approach will play an increasingly central role in enabling the NHS to expand safely, sustainably and strategically, ensuring that patients benefit from modern clinical facilities delivered at the pace and precision healthcare requires.
This article first appeared in the Health Estate Journal: HEJ May 2026 :: 52
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