Over the last few years, Energy and Commercial Modeller, Millie Cooney, has worked with NHS Trusts across the UK on exciting decarbonisation projects which harness the latest technologies. Below, she highlights some of the key challenges faced by the NHS on the road to net zero, and explains some of the solutions.
Decarbonising NHS estates presents a complex challenge, shaped by the realities of ageing infrastructure, clinical operations, and tight capital and operational budgets.
Many NHS sites continue to rely on legacy steam distribution systems for heating and domestic hot water, which are designed to operate at high temperatures on the secondary side. These systems are often incompatible with modern low carbon technologies such as heat pumps and geothermal solutions, which perform more efficiently at lower temperatures.
Replacing steam systems typically involves significant infrastructure upgrades, as NHS estates often comprise buildings constructed over decades, with infrastructure of varying age and condition. Site layouts can be inconsistent, plant space is often limited, and electrical capacity may be inadequate to support new systems, particularly with a growing shift towards the electrification of heat.
Addressing these challenges requires skilled and forward-thinking design and delivery teams to ensure that new low temperature systems are carefully integrated into the existing estate with minimal disruption.
Operationally, most hospitals must maintain 24/7 services with no tolerance for disruption. Any interruption to heating, hot water or electricity supply can directly affect patient care, especially in critical departments. As a result, decarbonisation works must be carefully phased and meticulously planned in close collaboration with clinical and estates teams. New systems must also offer the same level of resilience as legacy steam boilers, which can be costly to achieve with low carbon alternatives.
We often adopt a fabric first approach to reduce energy demand before introducing low carbon technologies. Some fabric measures and secondary side elements such as emitter replacements often require working in patient facing areas within sensitive healthcare environments. These works can involve disruption to occupied spaces, including wards and treatment rooms, where maintaining patient comfort, privacy, and safety is the priority. As a result, careful planning and continuous communication with clinical teams are essential to minimise the impact on day-to-day operations and patient care.
Arguably the greatest challenge NHS Trusts face in decarbonising is managing both the upfront capital investment and the ongoing operational costs. Where Capital Departmental Expenditure Limit (CDEL) limits apply, accessing the right funding is key to achieving net zero targets.
There are a number of grant funding schemes available to support NHS decarbonisation initiatives and help ease the burden of upfront capital costs. In recent years, the Public Sector Decarbonisation Scheme (PSDS) was a key enabler, allowing many Trusts to take their first significant steps towards net zero. With PSDS now concluded, attention has turned to alternative funding streams such as the Green Heat Network Fund (GHNF), Low Carbon Skills Fund (LCSF), and the Heat Network Efficiency Scheme (HNES), among others, which continue to offer valuable support for decarbonisation projects.
Securing the right funding solution, whether grant funded or another off balance sheet solution, is key to progressing these projects. With experience in aligning technical solutions with eligible funding options, Vital can help shape deliverable and cost-effective decarbonisation pathways.
While grant funds have enabled Trusts to fund the upfront investment, the shift to electric heating amid high electricity tariffs can significantly increase operational costs. We often compare it to winning a Ferrari - it works, looks impressive and is great to talk about, but you can't afford to fuel it.
To make decarbonisation financially sustainable, a more holistic approach is needed. Energy conservation measures such as BMS upgrades and optimisation, solar PV and fabric improvements can reduce energy demand and offset operational costs, making the transition more viable in the long term.
A clear, long term decarbonisation strategy that combines both low carbon technologies and energy conservation measures with suitable funding options is key to driving carbon reductions. It is essential that all levels are bought into the strategy, from finance directors, estates teams and clinical staff, to ensure the success of these projects. Decarbonisation is rarely achieved in a single step; a phased approach is often more manageable and effective in the long term. With this mindset, net zero becomes a reality and not just a goal.
If you’d like to discuss an upcoming project or available funding options, please email [email protected].
