Full Practice Refurbishment

The history: what was altered, by whom, and what nobody wrote down.

A single room can be rebuilt without knowing much about the rest of the building. A full refurbishment cannot, because it opens everything. Practices that have grown over twenty years have usually been altered five or six times, by different contractors, against drawings that were not updated, and the results are all still in service. A drainage run that goes the wrong way because a sink moved. A distribution board feeding two rooms and half a corridor for reasons nobody remembers. Ductwork terminating above a ceiling that was later sealed.

None of that is unusual and none of it is anyone's fault. It is simply what an old building contains, and it is the reason the survey on a full refurbishment is longer and more intrusive than on any other scope we deliver. What the survey produces is a set of known problems, which can be priced and sequenced. What it prevents is the same problems arriving as discoveries at week six, when the practice is half built and the price is fixed.

The asbestos assessment belongs in the same paragraph. On a building of any age it is a legal duty before intrusive work, and an unexpected find in an occupied clinical building stops far more than the room it was found in.

Because on this scope, how the building is divided costs more than what it is finished in.

That is counter-intuitive and it is consistently true. A full refurbishment priced against a specification and a floor plan, with the sequencing left to be worked out afterwards, is a price that will move. The sections a building can be divided into, the order they can be taken in, how many can be open at once, what temporary services are needed to keep the critical rooms running, and how many isolations have to happen out of hours are together a larger cost variable than the choice between one vinyl and another.

They are also a clinical decision. The practice knows which rooms carry the caseload, which can be doubled up for a fortnight and which cannot stop at all. We know which rooms cannot be built independently of each other because of what runs between them. The phasing plan is what comes out of putting those two together, and it is agreed before the contract. The mechanics of delivering it are the same as any phased works in a live practice; what makes a full refurbishment different is that eventually every section is in scope.

Three sectors, one contract shape, three sets of requirements to build towards.

A veterinary practice refurbishment has to keep the theatre, imaging and dispensary working while they are replaced, and the dispensary has to come back registrable. A dental refurbishment turns on the decontamination room and the radiography room, and on an appointment book filled weeks ahead. A medical refurbishment is dominated by ventilation and water, because they are the services most likely to be inadequate in an older building and the hardest to renew around occupation.

Underneath, the work is the same: strip out, structure, services, clinical finishes, commissioning and a record set. Where only part of the building is in scope, a practice fit-out is the narrower contract. Where the services alone are the job, that is mechanical and electrical work. Where the practice has outgrown the building entirely, new build construction is the honest answer, and where the layout is not settled, design and build puts the design and the phasing in the same place. Individual rooms have their own specialist room pages, and completed practices appear on our work pages as each releases its material.