Estates and Facilities

Emissions from the NHS Estate are responsible for over 60% of the NHS Carbon Footprint. There are significant opportunities in energy use in buildings, waste, water and new sources of heating and power generation to reduce emissions and provide financial savings.

UCLH have used some of the actions below to reduce their annual energy bill by between 72 and 83% - if emulated across the NHS this could cut the NHS wide energy bill from £576 million to £98 million (based on 2019-20 figures).

Investing in buildings will eliminate 3.1 million tonnes of carbon every year from energy and water use. This can be accomplished in the secondary care estate by:

  • Installing onsite renewable energy sources
    • Royal Manchester Children’s hospital explored an option to invest in an on-site renewable energy project to save £80,000 in energy costs and 380 tonnes of carbon
  • Upgrading heating, lighting, and ventilation systems
    • For example, every £1 million invested in energy performance will deliver a 1.33ktCO2e and pay for itself over a 3.8-year period
    • Other interventions include shifting to LED lighting and preparing for electricity-led heating to improve energy efficiency
      • A 100% shift to LED lighting, with an initial investment of £492 million NHS-wide, would pay for itself over a 3.7-year period and save £3.0 billion over the next 3 decades
  • Ensuring estates are digitally integrated
    • Real-time energy monitoring (utilising AI) could contribute up to 2.3% of total required reduction in carbon emissions, with the investment paying for itself over a 2-year period.

Investments must also be made in the primary care estate to reduce emissions in line with the above goal. These interventions, across the approximately 9000 buildings in the primary care estate, include:

  • Engineering interventions including building insulation, lighting, and heating to save up to 59ktCO2e annually
  • Improvements to building equipment and management could save up to 34ktCO2e per year
  • Installation of on-site renewable energy sources could save up to 7ktCO2e annually.

Please also see our resource bank for specific resources on how to accomplish some of the measures outlined above.