It is one of eight makeshift wards being constructed at hospitals across England, with the Preston hub to provide 100 beds for recovering patients from across the North West.
Health Secretary Sajid Javid said he hopes the hubs will never be used and says they are "a last resort" to ease pressure on hospitals at risk of running out of beds.
"While this is a contingency plan, and one we hope we will not need to utilise, it is something we are putting in place to ensure it’s there if we need it," said a spokesman for Royal Preston Hospital as work began on site today.
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This morning, the hospital welcomed a fleet of lorries and works vehicles as the giant Nightingale tent and building materials were delivered.
You can watch footage of work getting under way on the new ward in the visitor car park, opposite the main entrance, in our video player above.
The car park (car park B) has been shut to create space for the new hub, but with visiting now suspended, the hospital trust does not expect the reduced number of spaces to be much of an issue.
On Tuesday (January 4) Royal Preston Hospital also closed its staff restaurant to make space for a second temporary overspill ward for up to 50 Covid patients. You can read our report here.
You can read our explainer on the Nightingale Surge Hubs and how they will operate here.
NHS England has not said how the Nightingale Surge Hubs will be staffed, as Lancashire's under-pressure hospital trusts struggle with a growing number of staff absences due to sickness and self-isolation requirements.
Chris Hopson, chief executive of NHS Providers (the membership organisation for NHS trusts in England) said staffing them will be a "major challenge" and "will add further stretch to an already hard pressed NHS".
But he has backed the roll-out of the hubs, saying it is the "right move to make these preparations now".
He added: "Building on lessons learnt from earlier in the pandemic, trusts are identifying extra capacity on existing hospital sites that could be turned into super surge capacity should it be required.
"Trust leaders hope this back up insurance policy will never be needed, as with the original Nightingales. But it must be the right ‘no regrets later’ move to make these preparations now.
"Given the other pressures on the NHS and the current level of staff absences, staffing this capacity would be a major challenge. But co-location on existing hospital sites maximises the NHS’s ability to meet that challenge.
"We also need to recognise that this will add further stretch to an already hard pressed NHS."
NHS England has been approached for comment on staffing.