The Hospital Energy Project

Source: NHE Sept/Oct 2018

The Hospital Energy Project is an ambitious engineering scheme to replace outdated systems at Oxford University NHS FT’s hospitals and reduce the provider’s reliance on the national grid. Claire Hennessy, its head of operational estates and facilities services, summarises what steps were taken to save money and, better yet, cut down on emissions.  

The boilers at the Oxford University Hospitals NHS FT’s Churchill and John Radcliffe (JR) hospitals dated back to 1963 and 1973. They were unreliable, polluting, inefficient, costly to maintain, and they drained resources. In addition, patient care was often interrupted because the heating or cooling had broken down. However, replacements had to be futureproofed and flexible to meet the trust’s anticipated needs well into the future.

The trust was advised by the Carbon and Energy Fund (CEF) and went to tender for a combined heat and power (CHP) generator solution with a financial model that did not use our capital funds.

The chosen company’s proposal for a CHP at the JR and an energy link between the JR and Churchill hospitals was selected because it provided the most adaptable solution and best financial model. We pay for this £14.8m project from savings guaranteed by the bidder and, if the savings are not met, the firm pays the difference.

Then and now

The project involved a number of changes, including new boilers at both hospitals; a 4.5MWe CHP at the JR to provide Churchill Hospital with 24/7 electricity, running power at the JR, and heating and hot water at both sites; a 2.2km underground Energy Link that connects the two hospitals to transfer electricity, hot water, and communications around both sites in a continuous loop; more than 6,400 updated light fittings; and new £2.5m chiller equipment to replace JR’s 1970s chilling plant.

In addition, the company has removed asbestos, defunct infrastructure, inefficient hot water boilers, High Temperature Hot Water systems, oil tanks, 1940s generators at the Churchill, and 1970s boilers and pipework at the JR.

This is all being financed over 25 years out of guaranteed savings, not from the capital budget. The building management system has also been optimised so that it uses energy in the most effective way, whilst also allowing for easier budgeting and forecasting.

As a result, the trust saved £1.5m in the first six months on like-for-like energy bills in the retained estates, and is guaranteed to save more than £450,000 on energy every year for 25 years. Our CO₂ output will be cut by 10,000 tonnes per year – equal to 4,000 homes’ CO₂ emissions – and the new lighting is 90% more efficient, with the trust using approximately 3,200 fewer lightbulbs a year. The estates team, who were permanently changing lightbulbs, are now being employed in more proactive tasks, and patients and staff have commented on the vastly improved brightness in wards and corridors. There has also been a significant reduction in backlog maintenance over the next three years.

What sets it apart

The trust’s project team was led and run by operational estates’ own project managers and engineers because they had to be closely involved in planning shutdowns, since they know how everything links together in the hospitals and this is not something that a new contractor could easily pick up.

Reporting was also clear and unambiguous. The project managers, Vital Energi and the CEF had weekly progress meetings for problem-solving and planning, and the trust’s project board met monthly to discuss progress, contractual and financial issues.

The close collaboration on the project between operational estates and the chosen company has been very important, because the firm is responsible for the maintenance and performance of the new engineering for the next 25 years. We could not have built up such a good operational relationship without working together on the installation.

When this project began, it was the single biggest infrastructure project in the NHS at the time. Its ambition was to deliver savings, reliability, efficiency and futureproofing. I am very proud of what we have achieved and, in particular, that we delivered the entire project without interrupting a single minute of patient care at either hospital.

When I am asked what advice I can pass onto other trusts thinking of embarking on a similar project, I would say: get the best advice you can from the outset; futureproofing is essential; involve operational estates as they are the people who know your mechanical and electrical engineering the best; and never underestimate the need for early stakeholder engagement.

In conclusion, Mark Neal, executive director of estates corporate services management costs, said: “Although the financial savings are currently exceeding initial predictions, there are other factors, such as the weather and the price of gas, which will affect savings going forward, so we need more data before we can see definitive trends.

“However, for the trust the real benefit is going to be in the longer term, because we know that our hospitals are getting busier every year – and therefore demand for heating, chilling, and energy will also increase. Now that we have reliable infrastructure futureproofed for 25 years, we are better placed to plan for expansion.”


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