Using micro-climates takes a cool head

 Hospitals are more like complex infrastructures than individual buildings. Thus when it comes to considering the internal climate of an entire hospital estate, the challenge is that a hospital requires a range of carefully controlled micro-climates, each with differing heating, cooling and ventilation requirements, rather than a standard solution for the entire environment. When one considers the many different specialist areas within a hospital building, from operating theatres and neo-natal units to consultation rooms and offices, it is easy to see why a huge array of different heating and cooling requirements must be taken into account to provide the ideal ambient conditions. However, with many NHS hospitals being older premises, it is likely they are using outdated heating and ventilating equipment. So, as well as achieving significant climate control improvements, investment in modern, energy-efficient technology could also have a major impact on reducing carbon emissions and whole-life running costs. Achieving such reductions is becoming ever more of an imperative, as internal climate control requirements must now be balanced with the wider demands of climate change legislation. New mandatory schemes are setting ever more challenging targets for energy efficiency; targets which will require a seismic shift in the NHS’s performance on carbon emissions. The Carbon Reduction Commitment To understand the true scale of the challenge, it is perhaps worth highlighting that the NHS currently has a carbon footprint of 18 million tonnes CO2 per year1 - comprising 22% energy, 18% travel and 60% procurement – a figure which has increased by 40% since 1990. The Government’s Climate Change Act has set targets of a 26% reduction in carbon emissions by 2020 and an 80% reduction by 2050. This will in part be achieved by the forthcoming Carbon Reduction Commitment (CRC), a mandatory emissions trading scheme launching in April this year, when the “footprinting phase” will begin for many large organisations. The Carbon Reduction Commitment will require the participation of large businesses and public sector organisations – currently responsible for around 10% of UK emissions. The Government’s estimates indicate that around 20,000 public and private sector organisations will be required to participate in CRC in some way – so the scheme will undoubtedly include all public healthcare facilities.

Performance league table

The scheme works by requiring participants to purchase allowances, monitor emissions, and complete an annual report on their energy consumption. The more CO2 an organisation emits, the more allowances it has to purchase. There is therefore a direct incentive for NHS organisations to reduce their emissions. The allowances are then surrendered equal to total emissions, and any unused allowances are sold to receive recycling payments. In addition, the better an organisation performs in terms of reducing its emissions, the higher it will appear in the Government’s annual performance league table, showing the comparative performance of all participants, with the league table position affecting how much of the revenue each organisation receives. The good news is that organisations will also save money by reducing their energy bills; these savings could be well in excess of the costs of participating in the scheme. In 2009, the NHS Sustainable Development Unit estimated that: “For every 1% reduction in energy consumption at 2008 prices, it is estimated that the NHS could save about £4 million every year. This means that many investments in adequate energy management are likely to be costeffective.” However, organisations failing to meet the new targets will not only incur higher fuel bills, but will also have to pay for extra allowances. Reducing NHS carbon emissions In addition to the “carrot and stick” approach of the CRC, the NHS Carbon Reduction Strategy was launched in early 2009 for an April 2010 start, setting out ambitious targets by 2015 for the NHS to have reduced its 2007 carbon footprint by 10%. This will require not only the current level of growth of emissions to be curbed, but equally for the trend to be reversed and absolute emissions to be reduced. While these targets will no doubt be challenging, the consultation process leading to the development of the Strategy showed that 95% respondents were strongly supportive of the NHS taking a lead on this agenda. So, while leading NHS figures share the vision of it being a leading sustainable and low carbon organisation, it is up to individual organisations to decide how to achieve the targets. The onus is now on for NHS organisations to review their energy and carbon management at board level; develop more use of renewable energy where appropriate; and measure and monitor on a whole lifecycle cost basis. In all these areas, modernising a hospital’s heating, ventilation and air-conditioning systems can provide dramatic energy savings, while improving internal climate control. So what are the most effective climate control options for the estates manager?