Carbon emissions play a key role in contributing to global warming and climate change. Climate change, of course, not only affects the environment, but also our health, contributing to, and indeed worsening, conditions like cardiovascular disease, cancer, and respiratory diseases such as asthma. By working towards a smaller carbon footprint, we can simultaneously reduce the burden of disease from factors such as air pollution. The NHS estate can play a big part in reducing carbon emissions and helping to tackle climate change, but how much does the NHS estate contribute to our carbon footprint?
As a whole, healthcare buildings belonging to the NHS contribute 15% of the total NHS carbon footprint, and the NHS is responsible for around 5.4% of the UK’s total carbon emissions across all its activities. The NHS is aiming to achieve a Net Zero carbon status by 2040 through the COP26 Health Programme, which aligns with the Government’s ambition set out in its Build Back Greener strategy.
A ‘pioneer in green estate design’
Last October, we saw the £365 m Public Sector Decarbonisation Scheme open – a funding scheme to support organisations, including the NHS, to invest in low-carbon heating and energy innovations.1,2 The goal of this scheme is to help the UK reach its carbon reduction targets while reducing energy costs and supporting energy resilience. A couple of months later, in December 2022, NHS Property Services (NHSPS) opened a new sustainable health centre to patients in the heart of Wiltshire. Belonging to a very small group of sustainable facilities across England, Devizes Health Centre is a pioneer in green estate design.
Unsurprisingly, many properties in England and Wales do not have great energy efficiency, with an average Energy Performance Certificate (EPC) rating of D. This has a significant impact on the UK’s carbon emissions, as buildings are responsible for nearly a fifth of UK emissions. However, the Devizes site has an energy EPC rating of A+, which achieves a BREEAM (Building Research Establishment Environmental Assessment Method) rating of ‘Excellent’. The positive rating of the health centre is a significant achievement.
The latest ‘green’ technology
Alongside this, the site utilises the latest green technology, including heat pumps and solar panels that generate heat and electricity, to enable it to be self-sufficient and reduce reliance on fossil fuels. While retrofitting existing buildings with, for example, new HVAC plant, lighting, or insulation, to improve their energy rating is a key part of estate sustainability, we should also build efficiently for the future – the Devizes Health Centre is a prime example of this.
The building of the new integrated healthcare centre, which meets the needs of over 16,000 people, has been the centre of conversation among the local community for some time. In May 2021, we saw the £10.9 m centre being constructed, after plans for the new build were approved following much deliberation over many years. We are the team behind this pioneering green build. We look after roughly 10% of the NHS estate, supporting care for six million patients daily, and managing over 3,000 NHS properties across England – from GP practices, to hospitals, to state-of-the-art health campuses. We aim to be at the forefront of sustainable real estate, creating an NHS that is both consistently fit for delivering excellent patient care, and that supports greener and healthier communities.
Concern over energy and heating costs
There is no doubt that the energy and cost of living crisis is a key topic of conversation in the media, high on the government agenda, and of increasing concern for society generally. It is also unsurprising that there is considerable concern about the impact of energy and heating costs on the quality of healthcare. The Devizes Health Centre’s reliance on renewable energy sources is a good example of the stringent and committed work going into reducing the carbon footprint of the NHS estate. The provision of renewable energy not only ensures a constant supply, but also enables us to better manage budgets, which is especially important during times of economic uncertainty when energy prices are continuously rising. This need for reliable and affordable energy is more critical than ever during a period like this.
Improving access to care
The opening of the Devizes Health Centre – it has been built by Kier – has provided much-needed additional space for health services in the area, making it easier for patients to access the care they need locally, and all under one roof. A number of local health and care providers share the building, and provide a range of services that you would find at a GP practice, as well as hospital outpatient and mental health services, creating a hub where patients can get urgent primary care. With the pandemic resulting in unprecedented demand on healthcare providers, and a record high of 7.21 million people waiting for treatment, centres like Devizes can facilitate efficient and effective services for patients, which all supports work to tackle the NHS’ backlog of care.3
Same or next day care
The Devizes Health Centre now allows patients from four local GP surgeries to access same-day or next-day medical care within the most state-of-the-art healthcare centre. The services currently provided by Wiltshire Health and Care at the Devizes Community Hospital are moving to the new centre. Royal United Hospitals Bath, meanwhile, will be providing outpatient services including audiology, elderly care, paediatrics, rheumatology, and urology. Not only will patients be directed to the centre for specialist support, but they can also visit it for routine blood tests and medical reviews for more common conditions such as asthma and diabetes. Some community services previously provided by The Avon and Wiltshire Mental Health Partnership will be supplied by the new health centre. In fact the new Devizes Health Centre highlights the benefits and advantages of a collaborative effort and joined-up thinking from different teams to provide the optimal patient care.
Additionally, it is important to routinely assess how our estates across the NHS portfolio can benefit from ‘green strategies’, no matter where they are, and how long they have been there for. In doing so, we encourage colleagues to make sustainability a key component of their decision making, and therefore help drive a greener NHS.
Maintaining open dialogue with stakeholders
Of course, we must remember that a key aspect of becoming greener is to maintain an open dialogue with all stakeholders. From healthcare professionals to government ministers, and from porters to local community members, every person should have a say in how we make our sustainable estates work for them. With most of the tenants of the NHS estate being healthcare providers who have patient care at the forefront of their mind, sustainability will rarely come top of the priority list. If we bring together our tenants, we can highlight the role that sustainability plays in creating a safe, energy-efficient, and green environment, which will have a positive impact on patient care. It has been fantastic to work with the local people of Devizes on the health centre through the town planning and other processes, to ensure that the new site is fit-for-purpose and works best for them.
A small but mighty cog
Working towards a Net Zero NHS is complex, but for NHSPS, Devizes is just a small, but nevertheless, mighty cog in the green machine. NHSPS is continuously working to improve patient care while delivering a greener NHS. Last year, we published our new Green Plan for the period up to 2025, which is part of our wider Delivering a Greener NHS programme. It includes plans, actions, and timescales detailing how we help reduce carbon emissions, supporting NHS England’s Greener NHS campaign.4 The Green Plan is divided into eight areas of focus – from workforce and leadership, and digital transformation, to supply chain and procurement, estates and facilities, transport, and more. Across the areas of focus, we support our customers in their transition to Net Zero through decarbonisation.
We believe that sustainability values should be embedded in everything that the NHS does. There is great hope on the horizon, with Devizes showing green building credentials that will set a standard for future projects. With the NHS’ 75th birthday on the horizon, this will be a time to celebrate the best of the NHS, including the incredible progress we’ve made in creating a greener service, and to showcase our continued commitment towards Net Zero, with the Devizes Health Centre being at the epicentre of the focus.
Climate change has been widely recognised as one of the greatest threats to public health, and we at NHSPS are committed to reducing our environmental impact and promoting sustainable healthcare, enabling the NHS to deliver excellent patient care now and in the future.
Andrew Strange
Andrew Strange (MRTPI) is a town planning expert who has transferred his skills to lead property strategy work at NHS Property Services (NHSPS). His previous roles have included working in town planning in local government and NHS estate, and as regional director of a built environment consultancy. He has been involved in the disposal of much surplus NHS estate across the country, including major developed green belt sites and former institutions, and major investment proposals, including residential, mixed use, and healthcare schemes.
At NHSPS, in his role of Regional Partnership director for the Midlands, he is charged with seeking to facilitate the effective, efficient, and economic use of the organisation’s buildings to support NHS service delivery for the benefit of patients, carers, and staff. He works across the 11 Sustainability and Transformation Partnerships and Integrated Care Systems in the Midlands, including with NHS commissioners and NHS and other provider organisations, to deliver savings and identify investment priorities across the NHSPS portfolio. He is currently leading proposals to develop two new integrated care centres, and projects to ensure the best use of NHSPS health centres and community hospital sites across the Midlands.
References
1 NHS. Drive for energy efficient healthcare is delivering for patients and planet. ‘Blog’ by NHS England. 18 October 2022.
2 Public Sector Decarbonisation Scheme. 2022. Department for Energy Security and Net Zero / BEIS. 1 October 2020. https://tinyurl.com/299wrxv7
3 British Medical Association. NHS backlog data analysis. 2022. Available at: https:// tinyurl.com/49y3mkyp
4 NHS Property Services. The NHSPS Green Plan 2022. Available at: https://tinyurl. com/ptm8vdmh