The climate emergency is also a looming healthcare emergency unless we see urgent action. As healthcare buildings account for no less than 40% of emissions, reimagining the built environment around us is a priority like never before. The NHS alone produces around 4% of the UK’s annual emissions, so it is clear that it has a critical role to play in improving its own carbon footprint, and the efficiency of its building stock, all while striving to improve healthcare outcomes. This is not a straightforward ‘to do’ list.
As spelled out in its bold strategy to become the world’s first ‘Net Zero’ national health service, sustainable transformation across the NHS lies at the heart of the UK’s climate change response. However, with hospital Trusts in the grip of inflationary pressures and rocketing rises in energy bills, the drive to boost energy efficiency, sustainability, and healthy buildings, runs a real risk of slipping down the agenda – and these aren’t the only barriers to tackling the issues. The NHS has a truly vast and ageing building stock, with wide variation in type, construction size, and legacy systems. Confronting these challenges in all their complexity is an enormous but vital task if we want to see real progress in practice.
Optimising where it matters most
One tangible solution lies in reducing operating costs and optimising in the places where it matters most. Heating and cooling make up almost 50% of a building’s energy consumption in both residential and commercial buildings. To reduce energy consumption and limit costs, our buildings would naturally seem like a good place to start.
Heat pumps are a vital element in reaching a decarbonised future. The Carbon Trust found that heat pumps have the potential to deliver CO2 savings of up to 70% compared with conventional electric heating, and up to 65% compared with an ‘A-rated’ gas boiler. There’s no doubt that delivering better outcomes in energy efficiency is essential if we’re ever going to move from pledges to progress, but what could the future impact be on the provision of healthcare services?
Equally, how do businesses know what’s best for them, and where investments will truly deliver return on investment?
Money matters – the case for transformation
It was announced last year that hospital Trusts in England face ‘eye-watering’ rises in energy bills of £2 m a month each due to the fuel price surge. The government recently announced a six-month emergency energy price cap to help hospitals reduce the price paid for energy, as bills continue to soar, but while this is welcome news, hospitals and healthcare organisations cannot rely on government support alone, nor live in hope that oil and gas prices will fall significantly in the near future
It’s important for the wellbeing of the public that hospitals and other healthcare facilities are operating at their maximum efficiency. There is a definite added benefit for healthcare that benefits both staff and patients. Healthcare environments may be improved with energy-saving innovations like LED lighting by making them more comfortable and manageable. Additionally, reducing emissions will help to lessen the negative effects of climate change on human health; in the UK, air pollution alone is responsible for 1 in 20 deaths, and an increase in cancer, heart disease, and asthma cases.
‘We need to get smart’
To build facilities anchored in efficiency to improve staff and patient experiences, we need to get to ‘smart’ hospitals, where clinics and hospitals are secure, comfortable, and efficient, so that patient outcomes can improve and satisfaction increase. Smart hospitals create healing environments, and improve overall efficiency, through data-enabled solutions that respond to the needs of patients, staff, and visitors. An optimised and integrated infrastructure streamlines communications and workflow, and it’s also an investment that contributes to future outcomes – reducing costs while enhancing patient and staff satisfaction, patient care, and the quality of the hospital.
However, difficulty with limited budgets, and differing views on what smart hospitals are, how to implement them effectively, and how to evaluate them, are some challenges to the development and implementation of smart medical facilities. It is difficult for the NHS to develop holistic, top-level designs when they are not looking at the full 360 degree picture. In some cases, they are pushed into making piecemeal investments in building intelligent systems in specific, individual areas, resulting in fragmented, non-unified plans. Furthermore, many IT/intelligent technologies are not fully compatible with each other; thus each upgrading or retrofitting may create the need to build new systems from scratch.
Finding effective solutions
The key to driving adoption of smart hospitals is to find effective solutions to these problems. There is no one-sizefits-all solution for an effective smart hospital. The varying needs of the different user groups have to be taken into consideration. Equally important is to plan and customise different functional spaces based on what is required of them. When taken together, these considerations will improve the overall experience of patients, doctors, and nurses
Driving the heat pump agenda
The growing momentum towards Net Zero carbon emissions by 2050 is likely to accelerate the replacement of fossil-fuelled boilers with heat pumps. Europe, which is leading the move to be carbon-neutral by 2050, has already committed to at least 40% cuts in greenhouse gas emissions (from 1990 levels) by 2030, and is proposing to increase this ambition to 55% under the European Green Deal (EGD). More recently, it has also put climate change and the energy transition at the heart of its economic recovery from the COVID-19 pandemic, providing economic incentives for the implementation of low-carbon technologies and energy efficiency. Heat pumps are an important part of the equation
The switch to heat pumps is gaining traction in the UK. However, we are still lagging behind many other European countries when it comes to heat pump installations. The availability of gas, price relatives between fuels, and policy frameworks from governments, are effecting a wide uptake in heat pumps in the region. Waitrose recently announced that it is replacing its gas boilers with electric heat pumps in all its supermarkets – to tackle energy costs and bring forward Net Zero plans.
Part L of the Building Regulations states that non-domestic buildings should be moving to low-carbon heat sources. The government has already set a target of 600,000 heat pump installations per year by 2030, and the Committee on Climate Change estimates that 19 million heat pumps will need to be installed by 2050 to achieve the Net Zero goals globally.
Not a ‘one-size-fits all’
The electrification of heat through heat pumps, where the electricity to drive the heat pumps comes from renewable sources, is a key technology in cutting costs and carbon emissions. Heat pumps can be used as a primary source of generation, replacing fossil fuel boilers in the generation of heat. They can now work at higher temperatures, meaning they are a great option for spaces like hospitals and healthcare centres, where there is a high demand for hot water at peak times – removing the need to use a gas boiler.
Choosing which heat pump model is right for a building, however, is not a straightforward decision. The decision is driven by the overall economic case, operator needs, health, safety, and environmental (HSE) requirements, and external factors, such as weather. There might be a need for the redesign of mechanical building services to enable lower supply temperatures, as well as investments into training to develop the skills needed to deliver installation, commissioning, and maintenance. Ultimately, there is no one-size-fits-all solution when it comes to choosing which heat pump is right for a business, as it relies on an organisation’s individual requirements and operating pain points.
To tackle the issues at hand, hospitals need to work with a partner that can deliver the most efficient solution based on these factors. The best partners will design and install solutions based on the business and building needs. The best solution is the one that provides the highest value in terms of cost and efficiency or return on investment (ROI), which any good solutions provider can calculate and advise a business on.
Simplifying the complicated
When external temperatures vary so much, ‘wasted’ energy can be reused in a building by integrating both heat pumps and chiller systems. By utilising hybrid systems, when there is a demand for heating or hot water, and cooling, at the same time, the heat rejected from the cooling process can be extracted and reused for the heating process, resulting in additional energy savings. Hybrid designs are especially useful for buildings that lack the space to install large-scale heat pump and chiller systems.
As with any new technological equipment, there are many complicated configurations that are sometimes difficult to optimise. When you have a very complex building with a complex set of data that needs to be connected and analysed at every level, you need to dig deeper. This is where Artificial intelligence (AI) and Machine Learning (ML) come in.
Model-predictive control
Using model-predictive control, AI and ML can take every possible scenario of a building’s dataset to build an understanding of the actual energy conversion rate for each element of the building. This in turn helps us to understand how to run the system as a whole, rather than in siloes. New data that comes in is automatically added as a scenario, and the AI learns from this to create better recommendations for optimisation. It is also able to add in any constraints or anomalies, which means that we can accurately use the data from the platform to preview optimum operating point – thus enabling us to understand what we need to implement into the system to deliver the energy in the most efficient way.
A new way of operating systems
The UK and the NHS as a whole need new tactics and approaches to forge a way through and make their operations future-fit. With the drive towards Net Zero in need of urgent acceleration, the way we operate systems is key to reducing energy.
Introducing heat pumps is a solution for healthcare services to improve efficiencies, drive down costs, and remain on track for carbon neutrality. Yet we must remember that introducing these new systems increases complexity, so we need to move towards better models, deployments, and set points, to achieve better energy efficiency.
The good news is we don’t need to make the switch alone. Tackling challenges, driving down costs, and building improvements into an entire operation, is at its heart an exercise in collaboration. By choosing a reputable partner to work with, hospitals and other healthcare facilities can implement systems across a whole suite of different buildings with different needs, including hospitals and university campuses. Despite the pain points, we have an urgent prerogative to set a new standard through people, technology, and processes. Let’s make sure we don’t let the potential slip away.
Michael Anderton
Michael Anderton, General manager, UK & I, HVAC Building Solutions at Johnson Controls, has over 28 years’ experience as a managing director / general manager, and Sales and Operations leader, gained in Europe, the Middle East, and Asia. He is experienced in building technologies, HVAC, industrial refrigeration, controls and building automation services, installation, solutions, and product distribution. He has a high level of integrity, and a proven track record in successfully growing large, complex businesses with full P&L responsibility in both mature and developing markets.