Refurbishing a practice while it stays open
Staging, dust control and after-hours work, so a practice can be rebuilt around its patients instead of closing for a month.
The question every established practice asks first is not what a refurbishment costs. It is whether they have to close, and what happens to their patients if they do.
A practice that has been trading for fifteen years cannot simply stop. There are appointments booked twelve weeks out, referrers who will send patients elsewhere and not necessarily send them back, staff on salaries, and a lease that keeps charging rent whether or not the doors are open. Against that, the fitout is the easy part.
So the honest answer is that most practices can stay open through a refurbishment, that doing so costs meaningfully more than an empty tenancy, and that for some tenancies it is the wrong decision anyway. What follows is how to tell which one you are.
7 September 2026
Checked against the standards and planning
frameworks current at that date.
How we stage clinical refurbishments, read alongside AS 1428.1 access, the National Construction Code provisions for egress during works, and infection control practice for construction in occupied healthcare spaces.
Every staged program is specific to its tenancy. What can be isolated, and therefore what can be staged, is a question about a particular floor plate and its services.
Can it actually be staged?
Four things have to be true at once. If any fails, staging is either impossible or more disruptive than closing.
A sealable work zone. The area being built has to be separable behind full-height hoarding, with its own access that does not run through the part still treating patients. A work zone reached through your waiting room is not a work zone.
A compliant path of travel, throughout. Whatever remains open still needs an accessible entry, circulation and an accessible WC under AS 1428.1, at every stage. A practice that loses its accessible toilet to stage two has a problem that is not solved by apologising for it.
Egress that still works. Exits and paths of travel to them have to be maintained for the occupied part at all times. This is a code requirement rather than a courtesy, and it constrains staging more often than people expect.
Services you can isolate. Power, data, water and mechanical need to be separable so that work in one zone does not shut down the other. In tenancies where the board, the hydraulic riser or the air handling serve everything from one point, the shutdowns become the program.
Dust is an infection control problem
In an office refurbishment dust is untidy. In a clinical space it is a clinical risk, and it has to be treated as one, particularly where you have immunocompromised patients, an instrument reprocessing area or any procedure room.
That means full-height sealed hoarding rather than plastic sheeting taped to a ceiling grid. It means negative air pressure inside the work zone with filtered extraction, so air moves into the construction area rather than out of it. It means dealing with the return air path, because a base building system with a shared ceiling void will otherwise distribute construction dust to every room in the tenancy including the ones you sealed off.
Then the daily discipline: tacky mats at the threshold, covered routes for material in and waste out, and a clean at the end of every shift rather than at the end of every stage. The practice has to open the next morning looking like a practice.
After hours, and what it really buys
Not everything needs to happen at night, and doing all of it at night is how a program becomes unaffordable.
The work that genuinely has to move out of hours is the work that cannot coexist with patients: anything structurally noisy, core drilling, jackhammering, fire system isolations, main switchboard shutdowns, and anything that breaches the hoarding line.
The work that can usually continue during the day, behind a properly sealed hoarding, is most of the actual construction. Framing, services rough-in, linings and fitting off are not especially loud once there is a real wall between them and your waiting room.
Splitting the scope that way is where a staged program is won or lost. After-hours labour carries a significant premium and productivity is lower at 2am, so the objective is to move the minimum necessary into that window rather than the maximum that feels safe.
One thing worth agreeing in writing up front: who decides, on the day, that something has become too noisy to continue. If that decision has no owner it gets made by whoever complains loudest, usually in front of patients.
Keeping accreditation through the works
The requirements behind accreditation do not pause for construction. If you are a general practice, the RACGP Standards still expect consulting rooms with visual and acoustic privacy, hand hygiene facilities where care is delivered, secure storage for medicines and records, and an appropriate reprocessing flow. Every one of those has to hold for the operating part of the practice at every stage of the program.
The two that catch practices out are reprocessing and storage. If stage two takes your dirty utility, the instruments do not stop needing somewhere to go, and the answer cannot be the staff kitchen for six weeks. If the works displace your drug safe, it still needs to be secure and fixed rather than sitting in a store room.
Work these through at planning stage and tell your accrediting body what you are doing before you start. A staged program disclosed in advance is a conversation. The same program discovered during a visit is a finding.
What staging costs
Staged, practice trading
Hoarding and dust separation, after-hours labour for the noisy scope, additional mobilisations between stages, temporary services, daily protection and cleaning.
Complex staging in a live clinical space can exceed this.
Short full closure
Often the cheaper answer for a small tenancy. Two to four weeks closed, against eight to twelve weeks trading beside a construction zone at reduced capacity.
Compare lost revenue against the staging premium before assuming.
What is excluded
Equipment, GST, council and certifier fees, consultant reports, loose furniture, IT, signage, and rent for the period regardless of whether you trade.
A planning figure, not a quote.
See every published range with its inclusions and exclusions, or read how we handle provisional sums where scope cannot be fixed up front.
Getting the order right
A staged refurbishment is a sequencing exercise with a business attached, which is why it is planned backwards from your appointment book.
Start with the book, not the plan. Which weeks are quiet, which practitioners take leave, and what you can reasonably reduce capacity to. The program is built around that, not the other way round.
Then find the decant space. Staging needs somewhere for a displaced function to go. A spare room, a neighbouring suite, borrowed time in another practice. If there is nowhere to decant to, there is no stage one.
Then split noisy from ordinary. Move the minimum necessary scope out of hours and keep the rest behind hoarding during the day.
Then talk to your accrediting body, and your neighbours. Both before you start. A tenancy above a business that needs quiet is a program constraint you would rather discover now.
Then agree the stop rule. Who calls it, on the day, when something is too loud or too dusty to continue. In writing, before anyone starts.
Questions
Can my practice stay open during a fitout?
Usually yes, if the work is staged and the tenancy has somewhere to stage it into. The practical test is whether you can give the builder a sealed work zone with its own access while keeping a compliant path of travel, a working accessible WC and your egress for the part still trading. Where that is impossible, a short full closure is often cheaper and less disruptive than a long staged program.
How much more does it cost to refurbish while trading?
Expect a premium of roughly 15 to 30 per cent over the same scope in an empty tenancy. It buys hoarding and dust separation, after-hours labour, extra mobilisations as the crew moves between stages, temporary services, and the protection and cleaning that lets you open the next morning. Complex staging in a live clinical space can exceed that.
How is dust controlled in a working clinic?
Full-height sealed hoarding rather than plastic sheeting, negative air pressure in the work zone with filtered extraction, sealing or isolating the return air path so the base building system does not distribute dust through the tenancy, tacky mats at the threshold, and daily cleaning. In a clinical space this is an infection control measure, not housekeeping.
Does staged work affect accreditation?
It can, and it is worth raising with your accrediting body before you start rather than after. The requirements that gate accreditation, such as consulting room privacy, hand hygiene facilities, secure medicine and record storage and a compliant reprocessing flow, all have to hold for the part of the practice still operating, at every stage, not merely at the end.
Is it better to close for two weeks or stage over eight?
Do the arithmetic rather than assuming. Compare lost revenue from a short closure against the staging premium, the extra weeks of disruption, and the appointments you lose anyway while operating beside a construction zone. For small tenancies a short full closure very often wins. For larger practices with separable zones, staging usually does.
Sources and further reading
Standards for general practices, 5th edition. The physical-practice requirements behind general practice accreditation.
The National Construction Code: building classification, fire separation, egress, sanitary provisions and access.
Source for AS/NZS 4815 and 4187 reprocessing, AS 1428.1 access and AS 1668.2 ventilation. The standards themselves are purchased, not free.
Room-by-room design guidance and standard components used across Australian health projects, including consulting, treatment and sterilising rooms.
Send us the floor plan
A site assessment tells you what the tenancy can take and what it will cost to get there, ideally before you have signed for it.