Getting NHS property to net zero

The article was originally published in RICS Property Journal here.​

As the pandemic begins to relent and we look to the future, the UK's net-zero carbon ambitions must remain in the spotlight. Decarbonising healthcare is a significant objective for the NHS, following its announcement last year to become a net-zero organisation; a commitment recently reaffirmed by its chief sustainability officer, Dr Nick Watts. 

As the NHS is responsible for around 4% of the UK’s carbon emissions every year, it is vital that it achieves its goal of reaching net zero by 2040. To do so, every part of the health system will need to focus its efforts on becoming more sustainable and energy-efficient – and the NHS estate is no exception. 

As owners of around 10% of the estate, including hospitals, health centres and clinics, we at NHS Property Services (NHSPS) are in a prime position to lead the way in reducing the organisation's environmental impact.

Energy

Switching to renewable energy is a key step in reducing the carbon footprint of the NHS estate. These energy sources must also be reliable, because hospitals are running 24 hours a day 365 days a year. 

When we recently arranged a new energy supply deal, we were able to negotiate contracts that introduced 100% renewable electricity across our building portfolio. These changes have helped to offset more than 37,000 tonnes of carbon dioxide a year, and reduce costs by 12%, equating to around £8.9m over the first two years, and this money can be invested back into the NHS.

More than 70 of our sites have so far been upgraded with LED lighting as well. Over two years, we have invested more than £6m in stand-alone LED projects, as well as maintaining existing installations, saving £2m and offsetting 2,500 tonnes of carbon a year. 

While switching to renewable energy is a great step forward, it is also vital to reduce the health estate's overall energy consumption. To do this requires communication and collaboration with building occupiers – most of whom are healthcare providers – on the benefits of energy efficiency. As such, NHSPS launched a programme that involves upskilling a cross-regional group of frontline colleagues, including engineers and technicians, and giving them energy packs containing documents such as reports and a list of possible actions, that they can use to advise tenants on becoming more energy-efficient. 

These colleagues, called energy leads, then commit to regular reporting. They mark big consumers and poor performers against our benchmarks and identify sites with large gaps between the ratings on their energy performance certificates (EPCs) and display energy certificates. The first two years of this programme have resulted in around 11,800 tonnes of carbon being saved, and we are hopeful that the programme will continue to be a success. 

Net zero

With the ever-growing UK population and increasing pressure on the NHS as a result of the pandemic, capacity will need to increase across the health estate. However, this must be done sustainably to achieve the ambitious goal of net zero by 2040. 

To support this much-needed extra capacity, the government has committed to building 40 new hospitals, all of which must be net-zero carbon buildings. This means that carbon reduction must be considered from the outset; we are currently reviewing how to make our new health centres and GP surgeries net zero. 

Devizes Health Centre will be the first such building that is net zero. Devizes is an integrated care centre, and will provide space for Wiltshire Clinical Commissioning Group to offer primary care to the local community. It is currently awaiting final-stage design sign-off, seeking an EPC rating of A+, going beyond BREEAM's rating of excellent to be net zero in operation.

Decarbonising heat

Finally, a huge and – unfortunately – expensive step that needs to be taken across the NHS estate is the decarbonisation of heat, particularly at older hospitals that are designed to run on steam boilers. 

Electricity is currently seen as the best alternative given that the technology is readily available, but this can be several times more expensive than gas. It also requires costly upgrades to electrical infrastructure to improve capacity, and if sourced from the grid will still generate carbon emissions.

Therefore, we see power purchase agreements (PPAs) – long-term electricity supply arrangements, which are usually made between a generator and a customer – as a way to minimise cost and carbon. As PPAs are off the balance sheet, they are a cost-effective way of increasing supply on site, if installed locally, removing carbon from the grid and ensuring running costs are kept to a minimum. This is because under a PPA, we will lease roof space to an energy supplier to install solar panels and buy the energy produced back. As such, we can further utilise our assets and support the move to green energy, without the need of a large capital outlay.

Although the end goal would be to remove gas entirely, we know this is unlikely until hydrogen or a high-temperature electrical heat source becomes a widely available, cost-effective option. While we await this, we are committed to finding ways to reduce reliance on gas. 

For example, in the warmer months, energy from solar power and heat pumps can be used as a better-value way to meet heat demand, with gas from a biofuel used to top up the heat to the necessary temperature. It is worth noting that these technologies do have their own challenges, though, particularly with an ageing estate: in the case of solar power, for instance, the condition of the roof, water quality and access to maintenance all need to be considered before installation.

We know that it will be a long road to net zero; however, NHSPS is working hard to meet this goal. The technologies to make it happen are already available, so what we need to do is ensure that organisations and individuals can access them. The government should also provide adequate funding to help achieve these targets – and sustain net-zero operation once they are met.