If it is to become the first net zero carbon national health system in the world, we need to address a complex series of challenges, says Geoff Southern at Arcadis
The NHS, which celebrated its 75th anniversary on 5 July this year, has a bold and ambitious vision to become the first net zero carbon national health system in the world. To get there, it has set targets to reach net zero by 2040 for emissions that it can directly control and by 2045 for those that it can influence, such as supply chains.
Decarbonising the UK’s healthcare service is a complex task given the numerous factors at play. According to reports, the NHS is responsible for 4% of the country’s carbon footprint.
Digging deeper into what makes up that 4% total: 60% of it comes from the NHS’ global supply chain, around a quarter comes from medicines (including anaesthetic gases, most notably nitrous oxide) and 15% is from healthcare buildings and facilities.
As the first step, we need to consider how to shift some elements out of hospitals
Tackling all of the above in tandem is vital to give the NHS the best chance of achieving net zero and to ensure greater resilience, agility and capacity for healthcare provision. It is also important to remember that emission levels and population health are closely inter-connected. What is needed is a truly strategic and multi-faceted approach.
As the first step, we need to consider how to shift some elements out of hospitals. This includes embedding more healthcare services into communities to cultivate a sustainable model of care.
Increasing preventative and accessible outpatient care can reduce the heavy reliance on hospitals, removing some of the pressure and positively impacting public health as well as cutting emissions by lowering the frequency and lengths of inpatient stays.
For example, Arcadis delivered the Bevan Health and Wellbeing Centre in Tredegar for the NHS Wales Planning Framework. This saw the creation of a new “super-surgery” that co-locates various outpatient services that together can help solve local challenges. These include previously outdated GP services, a lack of health and wellbeing services or community-facing care staff, and the pressing need to address the cycle of deprivation in the area that is linked to rising health problems.
Next, we should look at the existing estate, which carries a major environmental burden. Despite plans for 40 “new” hospitals under the government’s Health Infrastructure Plan, which has been beset by delays and funding roadblocks, the initial focus must be on undertaking thoughtful retrofits of existing premises as much as possible. This has the biggest potential to kick-start immediate benefits through modernisation and the improvement of building performance and emissions.
It is critical to implement renewable energy generation, and some encouraging progress is already happening as the estate tries to transition away from fossil fuels
As part of this, it is critical to implement renewable energy generation, and some encouraging progress is already happening as the estate tries to transition away from fossil fuels. Our team worked on the Bay Technology Centre in Wales where we prioritised making the building self-sufficient and “energy positive” through a combination of design features, energy-efficient construction methods and materials, and PV renewable energy generation and storage.
The recently launched NHS Net Zero Building Standard offers detailed guidance for reducing building energy demands and embodied or whole-life carbon, while enhancing patient care. To ensure optimum energy efficiency – a key step to decarbonisation – the role of technological innovation cannot be overstated.
Progress with the digital transformation of the NHS has been labelled slow and “inadequate” by an independent expert panel, especially in overcoming legacy issues to integrate all patient records for a faster, better and data-led solution for diagnosis and care. Separately, real-time data analytics, powered by advancements in AI and machine learning, can support more accurate energy monitoring to give clearer visibility of how the NHS uses its buildings and where meaningful changes can be made.
Collaboration and knowledge-sharing is equally crucial to drive the long-term transformation of both community and in-hospital care. This is where architecture and technology can join forces to help healthcare providers harness the vast amounts of data they are sitting on to deliver value, efficiencies and insight-based decision-making.
Meeting the NHS net zero targets within the set timeframe is a tremendous challenge and will always require carbon sequestration through means such as smart material choices, but it is nevertheless very useful to have such a goal to aim for. It is spurring real action when it comes to setting out a strategy and finding new ways to offset the significant carbon impact of the healthcare industry.
Similarly, while the new NHS Net Zero Building Standard is part of the answer, it is not the whole story. In the case of carbon, like in health, prevention is always better than cure.
Geoff Southern is studio director at Arcadis
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