Navigating the NHS Net Zero Building Standard

Published in February 2023, the NHS Net Zero Building Standard (NHS NZBS) represents a critical step towards sustainable, energy-efficient healthcare facilities in the UK, supporting the NHS’s goal of achieving Net Zero carbon emissions by 2040. The scale of the sustainability challenge facing the NHS is underlined by the fact that its estate currently accounts for 15% of all of the organisation’s annual emissions, while the NHS itself makes up more than 40% of all public sector emissions each year. 
To address the organisation’s carbon footprint, the NHS NZBS provides detailed technical guidance for the development of new buildings and major upgrades to existing facilities. This guidance aligns with the UK Government’s sustainability targets, requiring adherence to specific criteria for energy efficiency and resilience. 

The NHS NZBS is mandatory for every investment in new buildings and upgrades to existing facilities that are subject to the HM Treasury business case approval process, making compliance with the NHS NZBS a cornerstone of project planning and execution. However, the lack of a widespread public roll-out has left many NHS Trusts unaware of the standard, which could potentially stall vital infrastructure projects, as it risks them not getting the sign-off they need. 

The Net Zero Carbon Coordinator

A crucial aspect at the heart of the NHS NZBS is the role of the Net Zero Carbon Coordinator (NZCC). The NZCC’s responsibilities are both technical and multidisciplinary, requiring extensive knowledge of operational energy management and experience within healthcare design teams. The NZCC ensures that all projects comply with the NHS NZBS, utilising the appropriate tools and effectively communicating complex technical requirements across various disciplines.

Without the involvement of a qualified NZCC, NHS Trusts risk having their business cases rejected, leading to significant delays and wasted resources. This makes the NZCC not only beneficial, but essential for the successful progression of any construction or upgrade project subject to a business case. 

The Standard itself is the overarching document that must be applied to every aspect of the design and business case stages. It has been designed to be used throughout a project’s lifecycle, from preparation and briefing, through to handover and in-use. In this way the NZBS becomes a throughline for a project from RIBA stage one to seven. 

The NZBS provides the following tools to be used during the process:

• Whole Life Carbon (WLC) Compliance Tool.
• Operational Energy and Carbon (OE&C) Compliance Tool.
• Design Management Tool.

Table 1 (overleaf) has been developed by Drees & Sommer UK to provide clarity around the tools and the other elements of the NZBS and the necessities of implementing tools and developing reports at specific points in the business case process.

Challenges and implications for NHS Trusts

NHS Estates teams are already operating under significant strain due to budget constraints and recruitment challenges. The additional requirements of the NHS NZBS, including the appointment of a NZCC, have the potential to further stretch these teams. Given these constraints, many Trusts may need to seek external expertise to ensure compliance, which adds complexity and cost to their projects. Despite these challenges, adherence to the NHS NZBS is mandatory, and needs strategic planning and resource allocation.

The NHS NZBS dictates the appointment of a ‘suitably qualified’ NZCC to oversee the implementation of the guidance, but doesn’t clearly define what constitutes ‘suitably qualified’. This may pose issues for NHS Trusts when appointing someone to the role, leaving room for interpretation, which could result in non-compliance.

Given the complex nature of NHS estates, Trusts should look beyond the NZCC role as a requirement, and re-frame the position to be an essential component of the wider project team. Choosing individuals who have experience across various disciplines, such as design, funding and finance, asset management, and wider property solutions, bolsters the chance of project success from inception. 

This wider knowledge application also adds value in other areas, in addition to ensuring that the NZBS requirements are met. NZCCs that have extensive experience can collaborate and communicate effectively with all stakeholders due to their broad knowledge base; this advanced specialist knowledge allows for holistic support, ensuring that other priorities linked to the NZBS – such as the adoption of new technologies, are not overlooked, but rather are considered by all involved as the project progresses. 
Working with and actively learning from the NZCC means Trusts can embed decarbonisation principles into everyday thinking. With the deadline to becoming Net Zero fast approaching, changing individuals’ outlook and creating behaviour change become key to meeting targets. There are many industry standards and qualifications for decarbonisation specialists from CIBSE, RICS, and the Energy Institute, and seeking these out for the NZCC role-holder should also be a priority. 

Implementing the NHS NZBS

At Drees & Sommer UK, we’ve worked with NHS Trusts to ensure that their infrastructure projects align with the NHS NZBS, integrating tools and guidelines according to requirements. Through this experience, it became apparent that having a dedicated NZCC is vital to navigating the standard’s complexities – thanks to the pivotal role this position plays in ensuring compliance with the NHS NZBS while also contributing to the broader goal of Net Zero emissions.

In addition, coordination between different stakeholders and design team members is central to any project’s success, and this is no different when it comes to NHS NZBS compliance. The NZCC creates a central focal point for design updates, thereby smoothing out this process and ensuring adherence to the standard. 

A central part of the NZCC’s role has been to assign space types, which requires the careful consideration of the difference in energy limits for various areas – ranging from staff spaces to wards and circulation areas. These energy limits drive the M&E designs and feed into upfront carbon limits, so it is important to be thorough when identifying and classifying varied spaces.
Relaying the design parameters to the wider Design Team is also a vital element of the NZCC’s function, as well as tracking changes throughout to ensure seamless communication, and recording any derogations and reasoning as to why targets and limits cannot be met under current plans. It can be a challenge to meet the set targets with a limited budget, especially where existing spaces are being upgraded, so having these conversations early on and throughout the planning process makes sure teams are not blindsided by potential pitfalls, leaving room for more design revisions than anticipated.

The cost implications of meeting the limits are further emphasised by the fact that there is currently no additional funding allocated for projects such as these. This makes it challenging for NHS Trusts to understand the payback on their decarbonisation programmes. The benefit of having interdisciplinary experts on board, working across different sectors, is the ability to provide clarity around the potential return on investment of decarbonising these estates. Rather than just weighing up the cost of the decarbonisation works against the projected energy cost savings, it can help to take a holistic approach to measure the wider, harder-to-quantify metrics through an ROI mindset. For example, benefits such as improved health outcomes for local communities due to decreased air pollution, and the socio-economic benefits from using the local economy to install new technology, should all be considered alongside the financial ROI.

Multifaceted demands

The multifaceted demands of the NHS NZBS mean multidisciplinary teams are highly advantageous. Our experience shows that including Whole Life Carbon Assessors, who can assist the design team throughout the business case, and share in-depth carbon reduction knowledge, is especially important. Non-Domestic Energy Assessors and Low Carbon Consultants should also be on hand to lend their experience in assessing building performance, along with in-house M&E experts and team members with BREEAM qualifications. Often, public sector projects use many of the methodologies and approaches outlined in the NZCC role, meaning that team members with this background can apply their knowledge and provide useful insights.  
For NHS Trusts aiming to align their estate management and construction strategies with the NHS NZBS, several steps are crucial:

1.  Awareness and education: Raising awareness about the NHS NZBS within Trusts is the first step, to educate teams about the Standard’s requirements and implications.
2. Appointment of qualified NZCCs: Ensuring that a sufficiently qualified NZCC is appointed for each project is vital to navigating the technical requirements and ensuring compliance.
3. Resource allocation: Trusts need to assess their current capacities and identify areas where external capacity or expertise might be necessary. Strategic resource allocation will be critical in meeting the standards without overburdening existing teams.
4. Continuous monitoring and adaptation: Compliance with the NHS NZBS is an ongoing process. Regular monitoring, and the ability to adapt to new guidelines and requirements, are essential for long-term success.

As the NHS NZBS is mandatory for all investments in new buildings, and upgrades to existing facilities that are subject to HM Treasury business case approval, it’s advantageous to bring HMT Green Book-certified professionals on board during the strategy and business case stages. Having these insights into the overall business case process and potential challenges from the outset helps ensure that the concept is robust and stands a realistic chance of progressing. 

Conclusions

The NHS Net Zero Building Standard is a significant step towards sustainable healthcare infrastructure. While its implementation presents challenges, particularly in terms of awareness and resource allocation, the role of the Net Zero Carbon Coordinator is indispensable in achieving compliance. By strategically planning and leveraging both internal and external resources, NHS Trusts can successfully navigate the requirements of the NHS NZBS and contribute to the broader goal of Net Zero emissions by 2040. As the NHS continues to evolve and adapt to new sustainability standards, the lessons learned from early adopters will be invaluable in guiding future projects towards a greener, more sustainable future.