What the Americans would call "remodelling" is well underway at the Tunbridge Wells Hospital at Pembury.
What used to be the Chief Executive's office will soon be a ward of 38 beds - a novelty in a hospital whose major selling point when built was that each patient would have their own room.
In other words, A&E should have more capacity to cope in winter because patients who might have come in there will be looked at here instead.
The idea of the ward is not that it will be used for long term treatment but rather that it's an assessment area for people coming in who are referred by their GPs with some unknown ailment. After a maximum of 48 hours they'll either be sent back home or elsewhere in the hospital for treatment.
And experts like Steve Inett of Healthwatch Kent say it's a good idea: "When you've got a situation where someone needs care urgently and they need very close monitoring, I think an open ward is possibly a better way to go so I think it will be beneficial."
But in a hospital which only opened five years ago, isn't new building now a sign of poor design in the past?
"No, I don't think anything went wrong." insists Douglas. "Some of the things that were assumed during the course of the business case that made the original hospital - that's several years old now."
He goes on: "It's twofold: the rise in demand for this hospital generally - the increase in population has far outstripped what was in the plan - but also the reach of this hospital, so we're treating people from much wider than we actually projected at the time."
A victim of its own success perhaps; the new £5m ward is expected to open by January.
Watch the video report by David Johns here: