The project involved constructing a new Hybrid Theatre adjacent to the existing main theatres at Birmingham Heartlands Hospital. This state-of-the-art facility was essential for the Trust's vascular surgical directorate, enabling comprehensive treatment of vascular pathologies in a world-class third generation Hybrid Theatre. Prior studies had determined that upgrading an existing theatre to a hybrid theatre was impractical. This new facility filled a critical gap in the Midlands, replacing outdated second generation interventional radiology suites with advanced capabilities. Its integration into the main theatre complex enhances patient safety during major arterial operations and optimizes theatre session allocation across surgical specialties, thereby increasing overall theatre capacity. The building, situated within an enclosed courtyard, spans existing underground ducts, housing essential facilities on its ground floor, which included the plant room, UPS/IPS rooms, and general storage, designed to minimize impact on existing hospital infrastructure.