Changes to the design, relating to the facade of the inpatient building and how it is heated, were approved last month in a resource consent variation granted by the Dunedin City Council.
Health New Zealand Te Whatu Ora (HNZ) had last year delayed signing the final contracts for the inpatient building, as its efforts to find savings moved beyond finding more efficient ways of building to cuts that would affect the level of patient care.
Other cost-saving measures under consideration at the time included reducing the number of backup generators and changing the way the building was heated and cooled.
The changes approved last month included switching from ceramic tiles in opaque sections to glass for the curtain wall cladding, moving the location of emergency power generation to the roof and replacing the heat pump system with a supply from the district energy centre.
An ancillary non-clinical services facility had been proposed to be situated on the Bow Lane block, although it was understood this component of the development was "no longer being progressed", a report said.
An HNZ spokesperson said obtaining resource consents for the internal design of the inpatient building was "one of the key steps in ensuring the project remains on track".
"With pile capping successfully completed, substructure work is now under way, including forming the basement and ground-floor concrete slabs.
"Preparations are also advancing for the arrival and installation of the structural steel framework, with mechanical, electrical and plumbing co-ordination progressing in tandem."
Internal design work remained ongoing and no further changes to the project scope were required, the spokesperson said.
Work on the steel structure would begin from mid-2026.
