By Royal Appointment

AECOM’s vice president of buildings for the Middle East, Anthony McCarter, tells The Big Project about coordinating, building and future-proofing the Kingdom’s largest healthcare mega-project

However successful a company is, it’s not every day a project with a total phase one built up area of 1,000,000m² is awarded by a government ministry based in one of the most lucrative construction markets in the world. But on July 10, that is exactly the
announcement AECOM shared with the world.

Following nine months of feasibility studies and masterplanning, multidisciplinary global construction powerhouse AECOM announced its appointment to a $1.24bn project with a contract value of $27.85m, to undertake consultancy design services for the largest health care project in both Saudi Arabia’s and its own history.

King Khalid Medical City will be built on a 700,000m² greenfield site and will comprise a 1500 bed hospital; six Centres of Excellence; research offices; residential staff accommodation; gardens; a community centre; and its own utilities plant.

This phase, the first of two planned to date, will be functional by 2017 but is due to reach full capacity by 2022. When that happens the city will grow again to include additional housing; a hospice; medical education facilities; and a hotel. A third phase has not been ruled out.

“This is a very important project for AECOM,” says vice president of buildings for the Middle East, Anthony McCarter, who was personally responsible for finalising the contract and who will now steer the execution stage, liaising between the Kingdom’s Ministry of Health, project managers and other project partners.

“Clients look for the best international expertise, coupled with local knowledge, and AECOM has been in the Kingdom for more than 45 years in one form or another.

Far from replacing existing medical facilities, King Khalid Medical City (KKMC) will support its neighbouring hospitals and clinics while providing the specialist tertiary care they cannot, with a remit to “set new standards” for the delivery of complex health care for residents of the Eastern region.

Now in the schematic design stage, tenders for the enabling works will be awarded before the end of this year with construction contracts awarded, and beginning, early 2013.

“I am excited to be continually involved in this project because it is such a high profile and high quality development,” he adds with an air of excitement that is measured yet evident as he explains that while AECOM’s other regional flagship healthcare project – Clevelend Clinic, Abu Dhabi – may be more expensive than KKMC, this far exceeds it in terms of built up area.

AECOM’s contract commenced on March 3 this year and will last 24 months – a tight deadline, but one McCarter reassures will need nothing but expertise, global support and collaborative technology.

Having already hit the ground running, he comments: “It will be a challenge but luckily we’re a large company with a lot of resources and we will draw on those, getting the teams to work very efficiently. We will utilise BIM platforms that were specified in the tender but are used as an AECOM standard. This will allow us to draw on the significant experience and expertise of our staff who have worked on healthcare projects around the world.”


The centre piece of it all is the main hospital facility, housing 1500 beds and six Centres of Excellence, which will specialise in cardiovascular, neuroscience, metabolic and genetic diseases, oncology, multi organ transplants and ophthalmology.

“The Ministry of Health was very clear in terms of wanting to ensure the medical city has an identity, rather than being a large hospital. So it has been carefully planned to achieve that level of character,” McCarter says, explaining that design is based on function, rather than form.

“A number of different concepts were developed in terms of look but function has driven the whole planning of the project,” he adds, naming efficiency and future maintenance of the built asset as key aesthetic drivers.

The curved and coloured roof is one such demonstration of the “character” specified as essential to the project, and master planning has ensured the built environment is punctuated with ‘healing’ gardens, landscaped to provide outdoors facilities for those patients able to enjoy them, and similar features brought inside through the channelling of natural light to entrances and public spaces.

“The buildings are designed to be attractive and to create a statement, but equally it’s a healthcare facility very much designed with the patient and end user in mind. There will be very attractive buildings and there will be very appealing spaces, but their purpose is that they are designed to be very efficient,” says McCarter.

Aside from the efficient and aesthetic elements of design, KKMC is also planned to be self sufficient in terms of utilities provision, with full onsite power and safety infrastructure covering electricity, water, fire prevention, district cooling, waste water treatment, waste transfer, medical gases and steam generation.

Despite the complexities of coordinating a construction project of such scale, it is these elements that present the greatest challenges during the execution of healthcare projects; along with building services designed to prevent the spread of bacteria and disease; and the future proofing of facilities in order to accommodate the next generation of medical equipment: considerations that are all achieved through the use of evidence based design.

“Building services need to be very well planned, as do power services in terms of uninterruptable supply. The challenges are, in addition to the medical and equipment planning, future proofing the design and being able to incorporate the latest equipment technology within that design,” comments McCarter, exemplifying the recent developments in bedside technology used by patients that is more akin to an inflight entertainment system than a hospital ward.

“Equally significant is the move towards electronic records because those IT systems need to be very carefully designed. Healthcare projects do present many interesting challenges for the design team.”

Healthy outlook

While the building systems themselves are the underlying factor in achieving a sustainable development, the sustainability of KKMC isn’t solely about the technology that will be used within the city, but the technology used to build its individual components and the feasibility of that building programme as a whole.

While the feasibility study itself identified the main facilities KKMC would require to serve the local population (see box), further studies took into account travel distances between facilities, the materials used to build the facilities – in particular, facades – and the orientation of them. Well rehearsed steps that when combined, could in future contribute towards a LEED certification.

It’s a subject for which McCarter is an advocate, having spoken publically on everything from the frequency of lifts in a building to the importance of modern engineering techniques, in order to promote sustainability. Recruited by AECOM two years ago, he first arrived in the region in 1994, initially for a two year period, but ended up staying due to the continuity of “once in a career” projects.

“The region has great opportunities from a projects perspective and also from an overall economic perspective,” he comments.

“But the ambition is what is appealing. It is the scale and the nature of the projects and from a personal point of view I thought the project I initially came here for back in 1994 would be the pinnacle of my career.

“That’s the benefit to our staff and for us as a company. The scale of the projects does provide an opportunity to bring that talent to them,” he says.

Now heading the AECOM division currently working on Yas Mall and Etihad Towers, Abu Dhabi; UAE University, Al Ain; healthcare projects in Sharjah; Barwa  City and Barwa Commercial Avenue, Qatar; he rightly describes the team as “active and diverse”.

The talent required to execute this project will be drawn from almost every AECOM office globally, with architects in America and engineers in the Middle East. Combined, this network of offices employs around 50,000 personnel who are connected via Revit, the BIM platform used in every AECOM project.

“King Khalid Medical City is a multi-location project, which presents a challenge, but all our skills come from the international AECOM network, so it’s a truly international collaboration,” McCarter says, continuing to explain that talent working specifically on healthcare and equipment planning has been tapped from American offices, with engineering drawn from throughout AECOM’s network and project overview provided by the global healthcare leader in Australia.

In turn, these people then support the 3500 workers already based regionally, who are working directly on AECOM’s other current projects, including the Jeddah stormwater drainage project, designed to prevent another occurrence of the floods that have caused dozens of casualties and deaths over recent years.

Other active projects include Doha Port and Saadiyat Island; the experience of which will be used to leverage new, similar contracts in the region.

“I think the scale of the development reflects the fact that these countries are growing very quickly. We are seeing a greater emphasis on these types of projects now, for example healthcare, schooling and housing, particularly in places like Saudi. Those are very strong growth areas and that is why this is such a great project for us,” McCarter concludes. 

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