NHS pathways to Net Zero

The NHS accounts for 5% of the UK’s emissions - it must reach net zero by 2040. James Garth, a consultant in Engineering Services, outlines how electrifying the estate is the most cost and carbon effective way of reaching net zero

The UK government has committed to the legally-binding target of reaching net-zero carbon by 2050. The National Health Service (NHS) in England has gone further, setting its own targets to be net zero by 2040 for direct emissions and to be the world’s first net-zero carbon health service.[i]

The NHS has the potential to be a net-zero leader; the most cost and carbon effective way of reaching the Government’s targets is through the electrification of heating.

Sector demands

The NHS is responsible for 5% of carbon emissions in the UK and estate emissions comprise approximately 15% of the total NHS carbon emissions profile. As the NHS operates across 25,000,000m² with over 1,000 hospitals and thousands of primary and tertiary buildings - the demand for net zero is significant within the sector.

Part of this challenge involves the diverse and complex nature of the sites. A bespoke approach is therefore required by each trust for their net-zero pathways.

Funding

Funding is one of the most significant challenges in the NHS; before the Covid-19 pandemic, the sector had undergone eight straight years of financial deficits.[ii] Since then, the demands of Covid-19 temporarily made undertaking essential maintenance very difficult, leading to increased backlogs, now valued at over £10bn, adding further financial and operational strain to NHS organizations.

With an aging estate that already requires upgrading, there is an opportunity for Trusts to make true on their objectives to ‘build back better’ and there are more sustainable options available.

Beyond trusts investing in energy efficiency and decarbonisation of their facilities with their own resources, one government funding pathway is the Department for Energy Security and Net Zero. The Public Sector Decarbonisation Scheme (PSDS), delivered by Salix Finance, is a grant scheme that has funded over £600m NHS estate projects of this type across 55 Trusts, with the most popular decarbonisation of heat solutions being the transitioning from fossil-fuel heating sources to electrification via heat pump technologies.

These are combined with energy-efficiency technologies, including LEDs, renewables, insulation, and building management systems demonstrating ‘Whole Building Approach’ to tackling carbon emissions and making environments more comfortable for staff and patients.[iii]

This scheme is supported by the Low Carbon Skills Fund (LCSF) scheme, which provides grant funding for heat decarbonisation plans and crucially in Phase 4 LCSF (launching 26^th April 2023), funding to support the design of decarbonisation technologies such as heat pumps.

Achieving net zero

Based on the evidence gathered by the King’s Trust, electric-energy centres and infrastructure is the most effective way to decarbonise the estate, producing just 15% of the emissions of present-day activity. Although this approach is 2.6 times more capitally intensive initially, over the 20-year life cycle of the project the costs are almost parable.

Whilst Trusts are required to balance their limited financial resources, they have committed to reaching net-zero carbon targets. The centralised electrification of their heating supply offers the best opportunity of meeting this requirement in the most cost effective to carbon saved approach using ‘low-regret’ technologies.

This is due to the efficiency of well-established low-carbon heating technologies, such as heat pumps, the potential for renewable electricity generation to service these, and the continued decarbonisation of the grid providing a clear pathway to this objective.

Deployment of clean hydrogen technology has also been considered with limited progress achieved so far. Therefore, with the latest NHS net-zero targets being just 17 years away and Welsh Health Board targets being just 7 years away, this is not currently a reliable pathway to achieving the carbon reduction objectives mandated.

Action needed

Despite the urgency, many Trusts remain at the early stages in their net-zero journeys. The mandatory Green Plans Trusts have produced provide a high-level starting point on how to improve sustainability in estates. Now more than ever NHS Trusts require partners to support them in reaching their objectives, drawing on specialist expertise and supporting the upskilling of NHS staff with knowledge of sustainability.

This will support the understanding of those managing Trust’s estates by facilitating the use of data to inform the prioritisation of their energy efficiency and decarbonisation investments, helping to outline a pathway through the RIBA stages and sustainability accreditations of an effective net-zero project.

Consequently, this data will support the applications to internal and external funding sources as requests can be evidenced effectively.

It is essential for our communities and our planet that the public sector leads the way in the green transition to mitigate the impacts of global warming. Working with expert partners increases the likelihood of the NHS being successful in its ambitions of being a global leader in tackling the climate crisis.

[i] NHS England (2022) Delivering a ‘Net Zero’ National Health Service
[ii] The King’s Fund (2018) NHS trusts in deficit
[iii] Department for Energy Security and Net Zero and Department for Business, Energy & Industrial Strategy (2023 updated) Public Sector Decarbonisation Scheme