The NHS has an estate of over 3,000 properties and accounts for around 5% of the UK’s total carbon footprint. Managing these properties and their energy and environmental impacts is a complex affair; how do they do it?
“You have to consider the entire landscape of physical buildings and the internal and external impact on environment, cost and efficiency,” says Cameron Hawkins, head of energy and environment at NHS Property Services. “It’s a balance between supporting clinical services and ensuring that assets are fit for purpose and meet requirements. Working across a 360-degree environment can often present complex challenges.”
Cameron Hawkins, head of energy and environment at NHS Property Services, leads the team responsible for NHS estate sustainability and is driven by the need to be net zero by 2040. “You have to consider the entire landscape of physical buildings and the internal and external impact on environment, cost and efficiency,” Hawkins says. “It’s a balance between supporting clinical services and ensuring that assets are fit for purpose and meet requirements. Working across a 360-degree environment can present complex challenges.”
New Zealand-born Hawkins has specialised in environmental management since he left university overseeing end-to-end energy efficiency upgrades, audits, business case plans, supply chains, pricing, commissioning, project management and system maintenance. Key to success is the need to take an all-round view. “What may look good on paper can fail to work in practice,” he says. “So you have to take into account, and work with, the whole commissioning process to create an entire sustainability framework that meets all needs and practicalities involved.”
Across the NHS estate Hawkins and his team manage sustainability and carbon reduction upgrades, energy supply, water quality, vehicle access and use, internal and external environmental elements, property re-purposing and all the many legacy issues involved. It is not just hospitals there are hundreds of office buildings and commercial spaces, thousands of GP practices, NHS trusts and health centres, from 21st century buildings to Victorian-era properties and all with their own requirements and challenges.
Sustainability requires teamwork integration
“Many hospitals, trusts and buildings have their own sustainability and carbon-reduction frameworks to meet their own unique needs, so we work with multiple estates teams, sustainability leaders and departments,” Hawkins continues. “NHS Estates and our For a Greener NHS programme oversee the main framework, guidance and processes that join together all the different assets, stakeholders and partners to ensure we’re all working towards the same thing within standard parameters.”
Sustainability is more than just an estates challenge, Hawkins says from experience. “Clinical services generate a big carbon footprint across the NHS so we work to identify sustainability and efficiency issues and to harmonise programmes. Resource is scarce and the many assets and stakeholders involved must work closely to ensure it is put to best possible use. Elements such as backlog maintenance, asset improvements and end of life replacement of equipment is expensive so we have to look ahead to measure the whole impact. For example, the cost of replacing a gas boiler could represent 80 per cent of the cost of installing a heat pump that would deliver multiple environmental benefits.”
Hawkin’s team has been involved in successes such as the new Devizes Health Centre, NHS Property Services’ first net-zero building, and the move to renewables across the estate. Ten per cent of NHS buildings are now powered by renewable electricity, offsetting over 37,000 tonnes of CO2 per year, and all properties will follow suit over time. “We undertook a major review of energy procurement to facilitate a move to renewable electricity, but making such change comes at a cost; as more people move to renewables the price is increasing,” he explains. “Using a new flexible procurement and risk management strategy we can offset these costs, save money and still deliver the benefits with cost savings passed back to individual properties.”
Cultural buy-in to sustainable goals
“The transition to sustainability has been incremental,” Hawkins adds. “To start with there were many existing plans, strategies and processes in place and not a great deal of cultural buy-in. But since the introduction of centralised strategies, compliance requirement and new three-year targets it has really focussed minds across the NHS from board level to ground floor and there’s now a greater cultural buy-in and acceptance of sustainability issues.”
NHS sustainability strategy is focussed on reducing the environmental impact of its operations, reducing costs and ensuring compliance with ESG requirements. New laws are coming, and Hawkins is confident the NHS will be ready. “We have an environmental compliance manager to ensure we meet all existing and new ESG requirements,” he says. “We fully researched costs, impacts and compliance issues surrounding the forthcoming CSRD, identified many parallel and recurring elements and it was clear we could do in-house most of what will be required. We identified any knowledge, technology and skills gaps along with a process to ensure new knowledge and skills are secured within the organisation. Change costs money so we want to retain intelligence gained and grow such learning going forward.”
Data key to sustainability strategy
“You can’t research, build and implement a sound strategy and comply with legal requirements if you don’t have relevant information,” Hawkins explains. “Data is key to finding out what you know and what you don’t know so we spend a lot of time gathering baseline data and historical data. We clean it up, validate it and standardise quality and reporting formats.
“We use a basic system for data capture and reporting to meet existing compliance but a more complex solution will be required There are a range of ESG and data reporting products available but there isn’t one that covers everything the NHS needs to comply with CSRD. One may be good on Scope 3 emissions; one good on measuring performance and another may be good for procurement and invoice validation. Right now organisations are faced with integrating a number of different systems or building their own custom solution.”
Net zero hampered by legacy issues
When it comes to technology there are existing platforms and solutions that go a long way to meeting sustainability and ESG needs with more being developed all the time. “Our biggest challenge is legacy issues, retro-fitting existing technologies and re-engineering buildings and assets, making known solutions fit for purpose across an ageing dynamic estate,” Hawkins says. “Some of our buildings were designed to use steam power, for example, so migrating to sustainable technologies and infrastructure can be a complex equation.
“Across the NHS there is a need to improve energy efficiency as our electricity infrastructure was originally designed just for heat and power. There are greater demands being made upon it now, such as moving to an all-electric transport fleet. The challenge is simple; if we fail to reduce energy demand and fail to increase capacity we won’t have enough supply to meet operational needs let alone meet carbon-reduction targets.”
Hawkins and his team work hard to avoid unnecessary complexity in their sustainability journey. “We’re taking big strides towards smart-working environments but one of the key learnings on our journey to date has been the need to keep things simple; major cost savings can be achieved by the correct commissioning of a building, but costs rise and savings are reduced by over-complexity,” he concludes. “The Internet of Things, for example, can add layers complexity that are often not needed and can lead to greater costs and negate the core objectives and benefits.”
“My advice to anyone engaged in sustainability? Use data to improve processes and operations to maximise money and resources in order to make the changes required.”