On Wednesday 25th June, the Offsite Manufacturing & Technology group were delighted to visit Royal Surrey NHS Foundation Trust’s Cancer and Surgical Innovation Centre (CASIC) at Royal Surrey County Hospital which is being delivered by MTX. We were fortunate to be hosted by the MTX team for a presentation about the project, the MMC solutions used and benefits realised, as well as a tour of the site.
About MTX
MTX is a construction engineering company specialising in innovative Modern Methods of Construction (MMC) to deliver advanced, fast-tracked solutions for the healthcare sector. With over 40 years of partnership with the NHS, MTX is deeply committed to social responsibility, actively supporting community engagement and construction industry initiatives.
Project Brief
Royal Surrey County Hospital identified the need to modernise its surgical facilities, which were outdated and unable to support new technologies or safe patient flow. To resolve this, the Trust initiated the Cancer and Surgical Innovation Centre (CASIC) project to boost surgical capacity, improve care, optimise staff and patient flow and reduce waiting times.
MTX were awarded the Pre Construction Service Agreement (PCSA) through the NHS SBS Modular Buildings Framework to cover RIBA stages 0-4. They were engaged to deliver six operating theatres, a short-stay unit, a pre-assessment hub, and essential circulation infrastructure. Three sites were assessed, with the chosen location requiring a new link-bridge and integration with existing theatres to ensure smooth workflows.
MTX’s role included ensuring health and safety compliance in line with the Building Safety Act and covered architectural, mechanical, and structural design, healthcare planning consultancy, BREEAM certification, compliance with building regulations, and coordination with local authority planning requirements.
Due for completion in June 2026, CASIC will transform surgical services for the local community.
Superstructure
The CASIC project is a three-story volumetric system comprising 170 offsite-manufactured modules, all installed in just 21 days. Each module weighed between 3 and 10 tonnes and incorporated a total of 620m³ of fibre-reinforced concrete. Installation was carried out using a 450-tonne capacity mobile crane, using 115 tonnes of ballast weight. Designed with two or three open sides, the modules created the necessary internal spaces for wards, specialist medical equipment, circulation areas, and surgical suites. All modules were prefabricated offsite to ensure precision and efficiency.
The floors are fully HTM-compliant, constructed with a concrete slab specifically engineered to meet stringent vibration criteria. This solution was developed to address the challenge of locating the operating theatres on the first floor instead of the ground level, necessitating a structure capable of supporting the heavy medical equipment while effectively controlling vibration levels critical to the performance of sensitive surgical technology.
Click below to be taken to a short video from the site visit.
Project Benefits
Sustainability
The CASIC project was designed with sustainability in mind, targeting BREEAM Excellent certification. MTX conducted Net Zero Carbon studies to improve energy efficiency and reduce environmental impact, supporting the Trust’s carbon reduction goals while enhancing long-term operational performance.
Value for Money
MTX delivered strong value by conducting extensive value engineering to align the project with the £50 million budget. Cost savings were achieved through design changes, including repurposing the basement for key infrastructure and optimising layouts, all without compromising quality. Repeated market testing ensured cost certainty and transparency.
Operational Benefits
The new facility streamlines workflows with six operating theatres, a 19-bed short-stay ward, and a pre-assessment hub, all designed for efficiency and connectivity. The project will boost capacity by 7,000 surgeries per year, helping reduce waiting times and improving patient care across the region.
Learnings for Industry
The Cancer and Surgical Innovation Centre (CASIC) project at Royal Surrey County Hospital, delivered by MTX, offers several valuable insights for the construction industry—especially for healthcare infrastructure development.
- Early Engagement and Collaborative Design Deliver Better Outcomes
MTX’s involvement from RIBA Stage 0 through a Pre-Construction Services Agreement (PCSA) demonstrated the benefits of early contractor engagement. By contributing to site selection, feasibility studies, and conceptual design—free of charge in early stages—MTX helped the Trust make informed decisions and align on the project’s scope and budget early on. This collaborative approach minimized delays, reduced redesign risks, and built a solid foundation for stakeholder alignment.
- Value Engineering Without Compromising Quality
The CASIC project illustrates how thoughtful value engineering can deliver major cost savings without reducing quality or functionality. MTX successfully redesigned a previously unused basement to house vital infrastructure, relocated the plant room and substation to reduce modular build and M&E costs, and explored alternative materials and layouts. This proactive cost management ensured the project remained within its £50 million cap while still achieving a high standard of healthcare delivery.
- Designing for Efficiency and Future-Proofing
The facility’s layout—particularly placing operating theatres on the first floor to match existing theatre levels—demonstrated how smart spatial planning can streamline patient and staff workflows. Engineering a vibration-resistant concrete slab to support robotic surgery on an upper floor also shows how structural innovation can overcome traditional constraints. By future-proofing the design for advanced technologies and aligning it with Net Zero Carbon goals and BREEAM Excellent standards, MTX ensured that the hospital will meet both clinical and environmental demands for years to come.
These learnings highlight the importance of integrating construction innovation, cost control, and long-term performance from the earliest project stages—an approach that can be replicated across complex healthcare infrastructure projects nationwide.
Get Involved
The Offsite Manufacturing and Technology group is but of the Constructing Excellence groups that host a range of online sessions and site visits across the year. If you’d like to find out more, visit our Groups page, or head over to our Events page to sign up to attend one of our upcoming events.
