Design for the Frontline: Our Path to PPE Production

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Design for the Frontline: Our Path to PPE Production

On 6 April, Foster + Partners shared its design for a general-purpose face visor. The practice went on to manufacture and distribute over 40,000 visors to hospitals across London. Production at the firm’s London offices ceased on 22 May, but the design continues to be manufactured at participating facilities across the country. Eager to assist in the fight against Covid-19, and acutely aware of the lack of PPE within the local healthcare community, colleagues from across the practice came together in one of the organisation’s most unique design projects to date. The +Plus editorial team spoke to a few members of the extended taskforce to discover how it was pulled off.


Within weeks, Covid-19 drastically altered our way of life, and the practice’s way of working. Alongside organisations around the world, we made sweeping changes to our operations in order to safeguard our staff and the greater public. By 19 March, 80 per cent of our global workforce had started working from home. After the UK prime minister’s lockdown announcement on 23 March, 100 per cent of our London office had made the transition.

As a practice, we have always been proud to contribute to and engage with our community – whether through charitable partnerships with local food banks, our participation in the annual Open House London weekend, or our design of local primary school playgrounds. And so, as the growing scale of the public health emergency became more apparent, we began exploring how we might extend our capabilities towards fighting the spread of Covid-19.

In mid-March, we started work on a design for a general-purpose face visor. Visors provide combined protection of the eyes, nose and mouth against respiratory droplets (the most common form of Covid-19 transmission) released either through patients coughing or via medical procedures including the suctioning of airways. Produced in response to a severe lack of PPE (personal protective equipment) for healthcare workers across London, our visor was designed and manufactured, and distribution lines established, in a matter of weeks. By the end of March we were supplying hospitals across London, and on 6 April we released our design as an open asset. On 13 May, we received EU standard CE certification EN166 for the design – the visor is now available and approved for use in all settings in which a form of personal eye protection equipment is required.


Our final visor design comprises a transparent plastic shield, polypropylene headband, adjustable silicone strap and optional foam insert for comfort. The design was released as an open asset on 6 April and received official CE certification on 13 May. © Aaron Hargreaves / Foster + Partners


The story of this design project is a special one, not only due to the exceptional circumstances of its origin, but for its transformation of our role as architects and designers to one of procurement, manufacture and distribution of an end product. The ability to redirect our resources and reinvent ourselves in this way is entirely down to our unique organisational structure, which calls upon an incredibly broad range of expertise and depth of knowledge. A few of our colleagues share their experience here.

 

The design world was characteristically quick to react to the events unfolding across the world earlier this year. At what point did discussions surrounding how Foster + Partners might channel its resources towards fighting Covid-19 begin? And how did the team arrive at designing PPE?

David Nelson, Co-Head of Design – Talks began a week or so before lockdown, when our staff had largely been transferred to working from home. Early discussions saw multiple options put forward, including repurposing some of our buildings and 3D printing ventilator parts. The government had already made an appeal to manufacturers with 3D printing capabilities – unfortunately, our capacity and the type of materials our machines could handle was limited, and so we realised it wasn’t the best use of our resources. The topic of visors came up quite early on – lots of designers were looking at PPE, but it was a personal connection that provided the impetus to investigate this further.

Grant Brooker, Head of Studio – Many of us at the practice have friends or family who work for the NHS. My son is a doctor at a hospital in East London; by mid-March most of the wards in the hospital were dedicated to Covid-19 patients and the operating theatres had been repurposed to provide more intensive care beds. The speed of change was unprecedented and consequently frontline healthcare workers across the country were fast running out of PPE. Considering our expertise, as well as the equipment and materials at our disposal, designing a visor seemed an obvious point of entry for us.

 

There was much discussion around – and enthusiasm for – the potential for 3D printing PPE within the design community. The visor takes a digital cutting approach, what were the steps that led in that direction?

Neil Vandersteen, Head of Modelshop – Early on, a member of our modelmaking team contacted me to say he had seen designs for 3D-printed visors and face shields online. We immediately began looking at ways we could adapt these designs to work with our own 3D technology – it was a very intense week. We experimented with straps and visor bands that could be used to hold a Perspex visor in place, reworking and refining them to suit our machines. But we quickly realised that the printing process was way too slow, with one strap taking hours to print.

Initial experiments in the design of our visor included 3D printing the straps and bands used to hold a Perspex visor in place. However, the team soon realised that the printing process was way too slow, with one strap taking hours to print. © Aaron Hargreaves / Foster + Partners

The visor design went through multiple iterations in the space of just a few hours; here, a small sample of the thirty plus prototypes. © Foster + Partners


Mike Holland, Head of Industrial Design – It was clear that we needed a design that was more efficient in speed and volume of manufacture if we were to help fulfil the immediate need for PPE. While the Modelshop team experimented with the 3D printing process, my team had been working on the product itself and its core requirements – something light and comfortable that maximised protection, but which allowed for full movement. Early experiments using cardboard, string and tape naturally evolved into flat-pack polyethylene and polyester parts. All of which could be cut on our incredibly fast digital flat-bed cutters.

Neil Conley, Industrial Designer – Alongside speed of production, reuse was a key focus for our design. Given the global nature of the crisis, there was a huge demand for all materials associated with PPE and so these were often difficult to get hold of. We also discovered that the standard issue NHS visors are single use, with a very high daily burn rate. We developed some thirty prototypes over a forty-eight-hour period, tweaking the parts so that they were quicker and simpler for the machines to cut, and as easy as possible to assemble.

GB – By replacing the 3D-printed headbands with an alternative made from the same material as the visor itself, the team produced a design that was not only easier to assemble, disassemble and clean, but which could be cut entirely on one machine. The change in manufacturing time was extraordinary – we reduced the production time from three hours to 3D print a single headband to thirty seconds to cut all the components for one visor. We saw this as proof of concept so quickly shared this approach as an open asset on the web for those with access to digital cutting machines.

The visor design – shown here without the optional foam insert of the final design – can be manufactured using one digital cutting machine, with all components taking just thirty seconds to cut. The flat-pack form ensures ease of distribution, assembly, disassembly, cleaning and reuse. © Aaron Hargreaves / Foster + Partners

 

Feedback from frontline staff was invaluable in tweaking the design. Once an initial design had been agreed upon, how were links established between the practice and health centres in the community to go about testing the prototypes?

Roxy Guellmeister, Architect – While the Industrial Design team developed the visor, I was looking into how we might safely pass it to end-users for feedback. Being part of some networks in the tech and innovation scene, I had a few useful connections. Matt Pattison – a very experienced healthcare product innovation consultant – was of great help with regards to possible routes into the NHS, as well as advice on re-use, cleaning, release and liability. Through my links to Consultant Anaesthetist Dr Vishal Nangalia at the Royal Free, we were able to test designs as they were being produced, getting immediate feedback and incorporating this into our product.

Alexandra Johnson, Senior PA – In my role as coordinator I began reaching out to various hospitals, hospices and GP networks in our local area. Other institutions came to us; some through staff contacts and others who had heard of our project through their colleagues at different hospitals.

GB – We reached an agreement with University College Hospital (UCH) to provide them with the first prototypes for testing. Early on we had been looking for a sterile space for visor production (we didn’t realise at this point that this would not be required) and approached The Francis Crick Institute about securing a laboratory space. When we told them what we needed it for they immediately connected us with the procurement team at UCH as they had been looking for visors. They agreed to take our first prototype samples and test them among their various teams. 

MH – Now we were able to adapt the design further to make it more comfortable – changing sizes, material and levels of adjustability. It is the input from the healthcare workers that ultimately brought about the final design and its CE certification.

GB – We were also approached by Chelsea and Westminster Hospital, who took half of our first batch of prototypes. They tested them on their intensive therapy unit and provided immediate feedback, which fed directly into our design. Our first contact with the hospitals was targeted at testing the visors, collating feedback and incorporating this into our open asset design for manufacturers. But it was becoming clear that our own production line was capable of supplying PPE in significant volumes – we could harness our own facilities to rapidly produce enough visors to make an immediate difference.

A page in Grant Brooker’s sketchbook documents the feedback received from one of the doctors at Chelsea and Westminster Hospital, given immediately after finishing her night shift. The holes in the headband of our initial prototypes made circular marks on the doctors’ and nurses’ forehead, and so these were subsequently removed from the final design. Image courtesy of Grant Brooker © Foster + Partners

 

It is one thing to produce a design for a face visor, quite another to launch and sustain its manufacture. Particularly in the context of scarce materials, a largely remote workforce and a limited manufacturing capacity. Talk us through this process.

GB – We had not planned to move into large-scale production – we hadn’t realised that we had the capacity. But the urgency of the situation, and our realisation that we had the right equipment and resources, resulted in the total transformation of the project.

NC – Once ‘Version 1’ of the visor had been agreed upon we scaled up production in our workshop. Myself and other members of the Rapid Prototyping team and the Sketch Modelshop managed cutting, assembly, boxing and collections. Members of the Industrial Design team soon joined the assembly process along with Print Room staff, allowing us to increase the volume of visors being cut.

Diane Teague, Assistant Head of Modelmaking – It took us days to secure the materials needed to manufacture our visor in bulk. All PPE-associated materials were in short supply, but particularly the transparent plastic (PETG – Polyethylene Terephthalate Glycol) required for the clear shield. I contacted our usual suppliers first – PETG is a material we often use in modelmaking, and we thankfully had a small amount in stock for trialling designs – but they all said the same thing: they had none available and any potential delivery would be months away. The material was like gold dust and most stock coming in was understandably reserved for NHS supply chains.

After a lot of false starts, we had a breakthrough. One of our regular suppliers, Creative Office, got back to us with two options: a bulk order from one manufacturer scheduled for delivery in six weeks’ time or another from a different company consisting of daily deliveries of smaller quantities. We agreed to both. By the second week of April, just as an improved visor design was finalised (‘Version 2’), the material was coming in.

MH – On the first day of production we cut and assembled some 400 visors. As we evolved the design, processes and flow of production, and once supply lines were established, we were able to increase this to 1,200 per day. About eight to nine people were on shift at any one time during our busiest period.

Members of the extended taskforce form a production line at our London campus; cutting, assembling and boxing visors to be sent to hospitals across London. At its peak, the team produced 1,200 visors per day. © Aaron Hargreaves / Foster + Partners

 

There was clearly overwhelming demand for the visors from across the capital, which must have been difficult to coordinate. Have all requests been fulfilled, and what was the response from NHS workers?

RG – We received a lot of requests but managed to streamline the process and were typically able to send out deliveries two to three hours later. We prioritised frontline staff at hospitals but, once they started receiving equipment from typical supply routes, we were also able to supply local GP practices and medical centres.

The flat-pack design enabled us to further streamline delivery. At the Royal Free and Nightingale Hospitals, groups of volunteers assembled the visors on site (we filmed and supplied an instructional video). This gave us more time to build visors for other institutions. The response we received from the staff both at the Royal Free and elsewhere has been overwhelming: ‘robust, protective, comfortable with good visibility. All you could want in a visor’ / ‘the best we’ve had so far’.

GB – We have been able to respond positively to every request we have received, from GPs and community outreach teams, to refugee centres and schools. We supplied our local GP network in Wandsworth and established links with the procurement and clinical care teams at many London hospitals including UCH, Chelsea and Westminster, The Royal Free, Great Ormond Street, St George’s, Kingston, St Peter’s, NHS Nightingale, Homerton University and Croydon University.

AJ – The key workers I have spoken with have all been so grateful for our contribution. The feedback from the Emergency Medicine team at Kingston Hospital was especially constructive, as well as encouraging:

‘The team found that the fit was really good overall, and that the adjustability of the visor was excellent. Other visors we have used have not been fully adjustable and team members with smaller heads found that your visor did not slip during use, which is crucial. In summary, the team felt that they preferred the visor produced by yourselves over previous stock. We feel that your team should be congratulated on producing a really functional piece of kit. We were really impressed!’

Healthcare workers pictured wearing our visors. The response to the design was overwhelmingly positive. Images courtesy of Croydon University Hospital & Royal Free Hospital

At Croydon University Hospital, staff store our reusable visors in their pigeonholes between shifts. Image courtesy of Croydon University Hospital

 

The initial intention was to produce a design that could be manufactured and distributed by anyone with the appropriate capabilities, leading to its release as an open asset. Have you seen pick up of the design elsewhere? How far have you been able to assist others?

MH – The visor’s flat-pack design meant that it could be taken up by manufacturers and smaller facilities around the world, including TRB Lightweight Structures based in Cambridgeshire, where my brother Richard Holland is the managing director. Using our design and materials they were able to use their machines to cut thousands of visors that were supplied direct to NHS Nightingale. Through Richard we established a contact with Williams F1, who are also now producing our visors.

DT – Our success in procuring material with Creative Office meant that we have been able to re-divert some of our supplies. Having established a daily delivery for our own production line, we were able to supply TRB with the extra order of PETG. Our own daily supply chain turned out to be beneficial on many levels. The manufacturer of the material, Gardiner Graphics, was unable to produce their usual product due to Covid-19, and so were happy to be rediverting their capabilities in this direction. 

NC – It’s been great to see the reach of the design since its publication online. We’ve had contact from light aircraft associations, hobbyists and many others looking for ways to support the cause – from as far afield as India, Mexico and Colombia.

AJ – We have also been working with The Kelvinside Institute in Scotland and their ViseUp initiative, an enterprise established to help reduce PPE shortages across the country. They have been using our design to manufacture and supply a very wide range of users in Scotland and we believe they have now produced over 30,000 of our visors.

Visor production underway at TRB Lightweight Structures in Cambridgeshire. Using our design and materials the team were able to use their machines to cut thousands of visors that were supplied direct to NHS Nightingale. Image courtesy of TRBLS

 

This is clearly a poignant moment in Foster + Partners’ design history. How does it feel to have played a key part in this effort?

RG - The most powerful thing for me was seeing such a successful collaboration between various people across multiple teams. I’m incredibly impressed with how well it worked – we took a product from sketch to market in just four weeks.

NV – This is a moment in time I feel very proud to be a part of, especially as a lot of this was organised via our homes and remote working. As modelmakers in a design office we often have to react very quickly but this had another level of intensity. It was a race against time to supply our local hospitals as quickly as possible.

GB – It was such an extraordinary time. We took our approach to design – involving collecting data, building an understanding and finding a solution – and were able to focus it on an entirely different kind of problem. The result was ultimately a valuable service provided at a critical moment. A service we believe we were uniquely positioned to provide and of which we are all incredibly proud.

DN – With every design project, our intention is to improve the users’ experience, to make life better. But design that directly saves lives is another story altogether; the relative effort is minimal compared to the reward. The attitude of the team and their tremendous dedication led to problem solving at a remarkable speed – it just goes to show what we’re capable of when we all put our heads together (even virtually).

It is important to say that this project was not about Foster + Partners – the design we produced is effective, yes, but there are many other designs out there that are just as useful. Rather, it’s an exercise in how companies like ours can divert resources to provide help at the earliest possible opportunity, whether to our local community or further afield. Our team was just one cog in a machine that ultimately served our healthcare workers – they are the true saviours here.

Healthcare workers at nearby Battersea Respiratory Clinic wear our visors as part of their PPE. Image courtesy of Wandsworth GP Network

Demand for visors has now thankfully eased, and so production at Foster + Partners has ceased for now. But by sharing our design and securing official certification, we hope that others can continue to manufacture the product for as long as required. At this time, our Print Room is producing cutting patterns for the charity For the Love of Scrubs, which is providing the NHS with much-needed supplies. As with many design studios and businesses around the world, we will continue to monitor ongoing developments, and remain poised to direct our resources and capabilities where they are needed most.

 

Extended Team
David Nelson
Grant Brooker
Katy Harris
Neil Vandersteen
Rhian Deakin
Mike Holland
Iwan Jones
Diane Teague
James White
Gregor Anderson
Sarah Wai
Neil Conley
Liam Griffin
Roxy Guellmeister
Aaron Hargreaves
Tarela Higson
Naomi James
Alexandra Johnson
Mrinal Rammohan
Alex Roberts
Alan Seall
Ryan Trimmer
Tony Wenban
Janet Affran
Peter Jones
Ollie Knights
Adam Thomas
Matthew Wilson
Yasin Ali
Franz Cosentini
Angel Garcia Rodriguez
Nikola Gaytandjiev
Hristo Georgiev
Jamie Harrington
Bartek Lewandowski
Patrick Mawson
Thomas Misse
Dan Morrow
Anthony Nolan
Louis Oakes
Gary Ovenden
Luisa Pietrini
Natalia Troppova
Shey Vincenzie
Yishai White
Lily Zhou

 

 

Editors: Anna Watson and Tom Wright

Date

14 July 2020

Author

Interview by +Plus

Featuring Grant Brooker (Head of Studio), David Nelson (Co-Head of Design), Neil Vandersteen (Head of Modelshop), Mike Holland (Head of Industrial Design), Diane Teague (Assistant Head of Modelmaking), Neil Conley (Industrial Designer), Roxy Guellmeister (Architect) and Alexandra Johnson (Senior PA)