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A Healthcare Engineering Roadmap for Delivering Net Zero Carbon

Challenging targets

While the UK Government has committed to net zero carbon emissions by 2050, and to achieve at least a 68% reduction in UK total greenhouse gas emissions by the end of the decade, the NHS has been rather more ambitious; targeting net zero 10 years earlier and an 80% reduction by 2032 against a 1990 baseline.

It potentially means that in order to meet these target objectives, very significant changes to the delivery of energy infrastructure and associated activities within the NHS are inevitable and will need a very progressive delivery timetable.  

The NHS Carbon Footprint

The targets detailed in the “Delivering a ‘Net Zero’ National Health Service[1]” paper published in October last year are based upon reducing the carbon emissions from activities represented within the NHS Carbon Footprint. This footprint is based upon energy used within buildings, energy used from health service owned and operated vehicles, water consumption, refuse and waste treatment as well as emissions associated with medical treatment procedures.

There is also an aspiration to affect the wider health service carbon footprint that includes upstream and downstream emissions, such as medical devices, business services, construction, food and catering, and manufacturing of products and services used in a hospital or the organisational supply chain.

Net zero

Net zero means that you have dealt with reducing your carbon emissions as far as you are practically able to, and the only emissions left are those that you cannot avoid and so have to be offset. In order for real emission reduction beyond offsets to occur, we need to make material reductions at each of our sites, which calls for variable levels of investment in time and money to implement.

Targeting reductions

The NHS “Delivering a ‘Net Zero’ National Health Service” paper sets out where likely savings proportions may need to come from. It suggests that the greatest proportion of the secondary care estate carbon reductions will have to come from optimising existing facilities and providing them with low carbon / renewable heat and power rather than wholesale building renewal.

Decarbonising electricity verses heat

In the UK, the impact of greening electricity supplies has been significant to date, with electricity carbon emissions having decreased by approximately 75% since 2012. Whereas most heat utilised by a typical hospital estate is delivered through burning fossil fuels, specifically natural gas and fuel oil. These fuels have not decarbonised by any significant amount over the same period and alternatives such as blue and green hydrogen are unlikely to be available as a widespread replacement to the levels needed in the short term.

A roadmap to net zero

If they have not already done so, organisations should now be identifying their carbon footprint in terms of current emissions and how these will sit with targeted reductions within the timescales needed. The position adopted should also take into account any planned expansion, contraction or renewal of particular site facilities and assets. These estimates can then feed into a carbon roadmap for each site.

This roadmap will have an energy infrastructure plan that will consist of initial technology savings measures that are readily available, and which can be invested in and delivered today, followed by further future measures, that might depend on additional investment or perhaps government funding delivered in a second or third stage. This has recently been facilitated by the Public Sector Decarbonisation Scheme (PSDS) that provides grant funding for compliant technology applications, focusing on decarbonising heat as a priority.

The ‘third phase’ of the roadmap should point towards an end game, that positions an organisation close to the chosen target that the roadmap is pointing to, for example the 80% reduction by 2032 or net zero by 2040. It could be that the end game position is going to be ultimately reliant upon technology not yet affordable such as workable scale heat pumps or currently unavailable infrastructure, such as hydrogen.

The road map should therefore show how we get there progressively in stages. Careful planning now should indicate measures we adopt today do not annex us from taking further steps in the future, or push solutions needed now into the long grass. It needs to be a strategy that we can build upon.

If the investments made at each stage are strategically planned and delivered in a way that delivers a guarantee of continued performance and affordability, then getting close to 2030 targets and 2040 net zero become more realistic, and a way forward more believable. From this standpoint can be seen the benefit of strategic investment in the fundamentals of a future-proofed energy infrastructure that can be started now (Stages 1 and 2), and that if carefully performance managed, will maintain savings throughout its life, and can ultimately be adaptable and be capable of taking advantage of future technologies as they come on stream during Stage 3 and beyond. The various approaches and technology applications are covered in more detail within the recently published Carbon & Energy Fund’s Best Practice Guide “A Healthcare Engineering Roadmap for delivering ‘Net Zero’ Carbon[2]”.



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