Barnsley NHS Hospital

Why green issues are back at the top of the NHS agenda

Image credit: Kristin Greenwood/Dreamstime

As it emerges from the Covid-19 pandemic, careful analysis of how the National Health Service uses energy will help it to save money as well as tackle climate change.

The UK government has set a target of achieving carbon net zero by 2050, with the National Health Service playing its part by striving to be the first national health service in the world to be net zero carbon by 2040.

The moves come as the climate emergency has the potential to become a health emergency. Changes to climate threaten the building blocks of good health, with direct and immediate consequences for patients, the public and the NHS. Recent data from the Met Office confirms that 2020 concluded the Earth’s warmest 10-year period on record; in 2019 almost 900 people died as a direct result of heatwaves in England alone.

The UK’s healthcare sector spends in excess of £400 million on energy every year - more efficient and effective energy solutions would provide better conditions for patients and staff whilst also saving both money and the environment. The NHS estate contains more than 30,000 properties across the UK, meaning it has a significant impact on the country’s carbon emissions. Finding a route to net-zero emissions for a complex system as large as this is challenging, particularly when NHS trusts are responsible for the management of numerous ageing properties that have often been adapted to serve a purpose for which they weren’t designed.

The Covid-19 pandemic has put monumental strain on NHS resources, and energy efficiencies have been far from a priority, but the COP26 summit has refocused minds and put energy efficiency back at the top of the agenda. Change is definitely needed, and it’s encouraging that an investment of £3.7bn has been assigned to tackle major rebuilding projects across 40 NHS estates [PDF] by 2030.

The investment will explore the energy hospitals use for heating, hot water, ventilation, cooling, lighting and running of equipment. Energy use cannot be stopped in a working hospital, but it can be minimised by efficient design. The key piece of the puzzle is whether the energy required can be supplied directly from zero-carbon sources, or investment should be made to offset carbon emissions through equivalent renewable generation elsewhere. If that can happen then the hospital building can indeed achieve net-zero operational carbon.

Significant modelling and analysis is being carried out to minimise energy consumption, reduce associated carbon emissions and maintain occupant comfort. This invaluable knowledge must then be put into practice to develop a strategic plan to rebuild, refit and repurpose the extensive NHS property portfolio.

At first glance, saving the NHS money on its energy bills appears to be an almost impossible task. Energy expenditure and subsequent costs have been steadily increasing for the past decade. However, initiatives such as the one at Southend University Hospital have yielded encouraging results. There, the trust is reaping the rewards of 17 separate - but interlinked – energy-saving projects that have been completed in the last decade. They tackled improving the energy performance of its buildings, focusing on the heating, ventilation and air conditioning (HVAC) systems, the thermal insulation and also lighting. Water consumption wasn’t overlooked, with the fitting of low-water showers included in building updates.

The measures undertaken by the trust resulted in an energy carbon emissions reduction from 29,419 tonnes to 21,759 tonnes over the ten-year period up to 2018-19.

This is of course not the only route forward. The Cornwall Partnership NHS Trust has approached energy saving quite differently; it identified the electrification of its vehicle fleet as a priority to reducing energy costs and greenhouse gas emissions. The trust invested in 40kW of solar panels, installed across two sites, to charge car batteries and make them carbon-neutral.

This investment in renewable energy forms a key piece of the energy-saving puzzle, if the NHS can utilise energy from zero-carbon energy sources – produced either on or off site – then net zero operational carbon is more feasible.

These initiatives and others have helped the NHS to collectively unlock over £1.8bn in lifetime financial savings through investment in energy efficiency. This is obviously positive for the environment, but driving down consumption will always be the most sustainable way to cut energy costs long term. The quicker the NHS acts to optimise its energy strategies, the greater chance it has to mitigate future energy cost rises.

Martin Thirsk is managing director of Energy Technology and Control.

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