Decarbonising the NHS Estate in 2023

The NHS is aiming to become the world’s first net-zero health service by 2040, through reducing the harmful gases it puts into the atmosphere, decarbonising the NHS Estate and reaching an 80% reduction in carbon emissions by 2028 to 2032

A Green Plan is to be produced by each NHS Trust and will provide a huge opportunity to enable each health authority to collaborate at scale across the public sector to address estate-wide priorities whilst building on existing estate strategies and approaches.

The plan allows each Trust to look the huge challenges that they face, some of which are increasing energy costs, carbon reduction targets and upgrading their aging infrastructure, financial constraints, and skill shortage. All of these are forcing the NHS to reconsider opportunities to change the way they design, operate, optimise, and fund renewable technologies which reduce and eventually remove the generation and consumption of fossil fuels.

We’ve interviewed E.ON’s Tony Orton, to get his insights into Decarbonising the NHS Estate in 2023.

How will it help in decarbonising the NHS estate? What evidence do you have for this?

A green plan in isolation won’t decarbonise the NHS. The NHS is no different to the private sector in the race to net zero, today there is no ‘quick fix’ to deliver zero carbon across an organisation. What it does do is allow Trusts to understand their current carbon footprint, build a strategy which can then be combined with a people and technology plan.

When working with our partner hospitals on actioning their Green Plans, we always start with an energy audit to begin to understand where the hospital is using and wasting the most energy and where improvements are needed to the estates. We then use a technology called Optimum to analyse the data and review energy usage, which then helps to improve their building management systems (BMS). This information is critical in understanding where the inefficiencies are, what can be done to improve, and then providing valuable information into how much energy will be required both now and in the future.

With that data we can then begin to visualise which solutions they should be focusing on, for example, building fabric improvements, LED lighting, heat pumps, solar, HVAC, battery storage and/or hydrogen-fuelled technology.

The critical element is understanding how their energy needs are generated and distributed as it allows them to clearly identify the areas of improvement and, by taking an approach that considers the whole building, it provides a design, plan and implementation strategy that delivers the right level of renewable technologies needed to provide a sustainable low carbon future, which includes the decarbonisation of not only the heat and the electrification of buildings, but also transport.

In what ways is the NHS being impacted by climate change?

The biggest impact to the NHS if climate change continues will be on health, with the effects of extreme weather, such as heatwaves and flooding, potential food shortages and drought, and rising costs, which will all have impact on physical and mental wellbeing (e.g. injuries and trauma, heat-related illness). Cost is also a key consideration in the reliance on fossil fuels to heat and cool the estates, which could continue to escalate in the coming years. This means a transition to low temperature hot water systems, such as through heat pumps, and a substantial move towards electrification will be needed.

The Climate Change Act commits the UK Government by law to reduce greenhouse gas emissions by at least 100% of 1990 levels (net zero) by 2050. The NHS, like any other organisation, has a commitment and an obligation to support efforts to reach these levels. In the journey towards decarbonising the NHS estate, the NHS itself has set its own target to reach net zero by 2040, with an ambition to reach an 80% reduction in carbon emissions by 2028 to 2032.

Are customers genuinely invested in the transition to net zero? What does E.ON do to encourage this?

Absolutely! I don’t think there are many people out there that dispute that the transition to net zero isn’t just an important one, but a critical one.

Obviously, there is the undeniable imperative of saving the planet, but alongside that, another important element is the financial savings that can come from switching away from fossil fuel dependency, and from reduced carbon emissions, particularly through greater energy efficiency and less energy waste.

There may be a need for investment upfront but support can often be found for this and the savings that come from changes year-on-year can be well worth the time and effort, as well as the impact that positive steps can have on health and wellbeing for patients and staff.

Trusts also have a desire to improve their resilience and reducing their reliance on ‘grid’ energy. A hospital can’t afford to lose power or heat under any circumstances and they know that they can be both sustainable and resilient with technologies such as solar panels using otherwise empty roof space, and with battery storage they can generate and store electricity to use when you need it the most.

What are the key challenges currently facing the NHS?

The NHS estate is made up of 217 NHS trusts all with their own individual ‘Green Plans’ across 1,228 hospitals, so without one, clear overarching strategy it can seem a complicated task.

Some of the biggest challenges include investment in real estate, with disparity in terms of age, style, and function alongside years of potential underinvestment and poorly insulated buildings, increase in costs of fuel, the need for electrification upgrades and the challenges in reducing the CO₂ associated with scope 3 emissions, such as anaesthesia and other medicines.

Clearly investment and funding are going to be a key requirement and should form part of the strategy to ensure key stakeholder engagement, but it absolutely shouldn’t be seen as a barrier to your net zero journey. There are a host of funding options out there and it’s something in which we at E.ON have a great amount of experience, applying for and successfully securing significant amounts for our customers.

I don’t think anyone will argue that net zero is a significant challenge, but through collaboration, knowledge sharing and people investment, it’s something that can be achieved.

Building the green hospitals of the future requires ambitious, collaborative long-term partnerships across the whole of the public sector where low carbon energy can be delivered as a total managed service, linked to excellent levels of service, higher standards, safely, on time and on-budget.

What does 2023 hold for energy services and decarbonising the NHS Estate?

Collaboration, communication, upskilling and sharing ideas across each Trust will need to be a priority throughout 2023 if we are to build and manage the necessary energy services across each estate in the future.

The exploration of partnerships is something I think all trusts should investigate throughout 2023, whether it be connecting to a local university, local public buildings and/or council properties through the installation of a decentralised low-carbon energy centre, which can then supply low- carbon heat, cooling and/or power to several buildings.

Or, developing strong partnerships with experienced private companies that have the necessary resources to design, install, operate, and maintain and fund the necessary infrastructure upgrades to reduce their carbon footprint, reduce their operating costs, help towards decarbonising the NHS estate, and/or provide additional revenues to fund the initial investment, using innovative funding options.

It’s also worth noting that financial rules are changing in April 2023, where any benefit trusts receive from assets that sit on their estate may need to be itemised on the balance sheet, and capital funds from central Government are drying up or look to be non-existent in 2023 and if not in 2024 for energy infrastructure projects. There are ways around this though, as E.ON are continually looking at how we help customers deliver “funded” solutions that will deliver and get you on your journey towards net zero.