Portman Dental Care, Lewisham

18 months ago the NHS announced its plans to re-tender all NHS orthodontic treatments with all services being bundled and offered to the market on a 10-year contract. This resulted in the majority of existing dental practices having to bid against one another.

Naturally, Portman wanted to take the opportunity to win these contracts, regardless of the rigorous and complex application process. To prepare their bid, Portman needed to demonstrate how the proposed practice would function on a number of facets. This included a demonstration and understanding of the UDA rate (Units of Dentistry), location, proximity to public transport, overall layout and most importantly, the standard of practice facilities.

To achieve this, Portman needed a practice that could assist with all stages of the bidding process from sourcing, selection and planning submissions through to the interior design, drawing packages, project management and gaining all relevant certification.

Size: 127 sqm

Location: Lewisham, South London

The overall brief

In January 2018, Harrison Ince Architects and Interior Designers were engaged by Portman Dental Care to assist in the procurement, design and planning of potential buildings for use as orthodontic practices. At this time, the NHS offered 14 contracts to the market, all of which were to be bid on by Portman.

The initial role of Harrison Ince was to visit potential properties and produce a feasibility plan as applied to the most suitable site. This feasibility plan would have to adhere to the NHS, CQC (Care Quality Commission) and general Dentistry & Orthodontic regulations.

The overall layout of practices had to include a communal waiting area suitable for all, including but not limited to, children, elderly & disabled patients. As required under the NHS and CQC, it was important that any furniture selections in this space had anti-microbial, wipeable and hygienic fabric.

Stemming off the reception and waiting area, was to be the Treatment Coordinators Office (TCO). In line with Portman’s philosophies of always putting patients first, this space would offer a private, yet relaxed environment to discuss Patient Treatment Plans.

There would also be a separate Practice Manager’s Office and, where possible, a reception overflow room. The reception overflow space serves multiple purposes of enabling any phone calls and paperwork to be dealt with confidentially and also ensuring that the reception and waiting rooms retain a relaxed and calm environment for waiting patients.

Ancillary spaces included suitable colleague rooms with changing and locker facilities as well as necessary compressor and secure server storage areas.

As part of the bid criteria, it was essential that any proposed premises were fully DDA (Disability Discrimination Act) accessible and had appropriate washroom facilities.

Should any of the bids be awarded to Portman, it was the role of Harrison Ince to produce appropriate construction drawing packages and see the projects through to completion.

The Lewisham Brief

We were required to construct an Orthodontic Practice that met the stringent NHS & CQC guidelines as well as bringing the project in on time and on budget. Due to the nature of the NHS contract, there was no flexibility with the deadline and it was essential the project was handed over on the agreed date.

A pre-commencement meeting was organised by Harrison Ince, the contract administrators, where we were able to communicate their program, timescales, logistics and other health & safety information to all parties involved. As the Main Contractor, we had the responsibility of managing all other contractors on site who were organised directly by the client.

Our first task on site was to fit out the ‘shell’. This primarily involved the large openings having brick infills and new curtain walling. We were simultaneously required to liaise with utility companies to create points for the required services such as water, electricity and BT lines for telephone and internet access.

Once the site was weathertight, POI was required to fit out the interior to create the various surgeries, waiting rooms and ancillary spaces. This required the co-ordination of other contractors such as the suppliers and installers for any medical equipment.

The initial challenges

Like any construction project, there are inevitably challenges. Working within the NHS guidelines presented the following challenges which were dealt with during the planning stage:

Minimum surgeries NHS requirement

The solution

Harrison Ince always strives to surpass in delivering the minimum requirements of a practice. Three treatment rooms are always preferred by Portman, however this could only be achieved through the addition of a mezzanine level. Given the set timescale and budget for Lewisham, the layout plan was instead revised to meet the minimum requirement of 2 surgeries.

Specific NHS & CQC-compliant furniture requirement

The solution

Anti-microbial, cleanable and hygienic fabrics were sourced. A variety of chair styles were also used to ensure some had arm rests at appropriate heights.

Curtain walling

The threshold to the site is generally finished in line with the rest of the building construction. The premises at Lewisham consist of a ‘shell unit’ on the ground floor of a high-rise residential block where this threshold had been temporarily boarded up. When fitting out the unit, this threshold required the installation of new brickwork and curtain walling as a permanent and secure finish.

The solution

We worked closely with a specialist Curtain Walling Contractor to retrofit a Curtain Wall into the existing openings. This required some specialist detailing once the temporary hoarding had been removed from site and existing details exposed. Given the lead times for the curtain wall manufacture being between 4 and 6 weeks, we had to be proactive in finalising these details with the contractor to ensure deadlines were hit.

X-ray room requirement

An x-ray room must pass safety and compliance inspections.

The solution

Lead-lined walls were created and an RPO (Radio Protection Officer) visited the site to inspect and sign off the room at the completion of the project.

Quiet Space requirement for confidential Patient discussions

The solution

Planned space for this within the small building.

Practice manager & overflow office space requirement

The solution

Planned space for the Practice Manager office within the layout. Given the small floor plate, there was not sufficient space for the reception overflow. The reception overflow space is not a necessity – but rather an ideal addition. In this case it could not be included, however the reception desk was large enough for multiple colleagues to sit at.

Colleague room requirement

The solution

Small yet highly-functional colleague room was created so employees could enjoy facilities for lunch and recreation.

Changing facilities requirement

The solution

Planned space for lockers and changing space for employees.

Decontamination room requirement

The solution

Planned space for this within the small building.

General equipment room requirement

The solution

Planned space for comms, compressor and other technicalities within the small building.

Appropriate Accessibility for all Patients

The solution

The building had level access to both the entry and fire exit, with all interior rooms accessed off a single, level floor. The DDA toilet could be easily located from the front door and waiting area. The furniture in the waiting area was varied in style to ensure selected chairs had armrests for ease of use.

Branding and design requirement

Portman required a distinctive design to effectively communicate the desired ‘look and feel’ of the dentistry practice. The orthodontic brand was different to the wider Portman dentistry brand given that the target market was initially based around 13-18 year olds. Portman worked with the company, Rally, to produce a new branding scheme. As the projects progressed, this branding was altered in order to appeal to a wider audience. This decision was based on a commercial decision to appeal to the private client base – especially for cosmetic treatments.

The solution

To overcome this challenge, Rally tweaked the branding and the interior design was altered.

External walls restrictions

Due to local planning requirements, the external wall specification had to be changed from a rendered finish to brickwork with feature glazed bricks. A sample had to be constructed on-site prior to planners signing off the project. Given the project timescales, it was important that any bricks selected were available immediately rather than having to be imported from overseas where they are generally made. Should the bricks not be installed in line with the program, there would be a knock-on effect to the rest of the building work potentially jeopardising the finish date.

The solution

Bricks selections were done in close communication with both the planners and brick suppliers to ensure any bricks selected were immediately available. Once specified, we had the bricks quickly delivered to site so bricklayers could install and other contractors could push forward with the internal work in line with the project timeline.

Utility requirement

A common challenge in ‘shell’ buildings is establishing and managing the utility supply as these need to be located and installed in line with the rest of the building supplies.

The solution

We solved this through effective contractor management, ensuring the utility companies attended site at the right time during the projects.

The journey

We collaborated with the project team to adhere to all timescales in order to deliver the project. This enabled us to fully fit out the orthodontic practice to Harrison Ince so they could handover to Portman in time for their NHS deadline.

There were inevitably challenges in both the organisation and build, however, the Team worked together to solve these through regular, clear communication.

Jo Waterhouse, Director at Ince Harrison Architects, commented, “There will always be challenges in building projects – especially projects with such tight and unwavering deadlines. Planned Office Interiors (POI) took a proactive and organised approach to work with us to overcome these challenges. Ultimately, the project team delivered a high-quality Orthodontic Practice to the Client within the specified time.”

The results

On receipt of their new property, Portman expressed their delight in opening as a new Orthodontic Practice offering both private and NHS funded services. The design and branding is welcoming to all whilst also reflecting Portman’s values and philosophies. Portman was especially pleased that this project was delivered on time and within budget and look forward to any future opportunities to open more practices.

Overall, the project was truly enjoyable. We were proud to overcome challenges to deliver a great final working space – all while meeting NHS guidelines and adhering to CQC regulations.