Doctor in hospital corridor

The future of heat in hospitals

With hospitals and healthcare buildings comprising 15% of the NHS’s total carbon emissions, changing the way in which hospital estates and facilities use heating and hot water is an essential step in the journey to reach net zero. Furthermore, a recent discussion about decarbonising heating, led by elemental UK, revealed that while there are quick wins to be found, achieving them will require initial changes to both the scope of the work and the workforce undertaking  delivery.

The UK runs mostly on gas with up to 74% of UK homes heated by gas and fossil fuels. Hospitals in the UK have been dealing with different types of legacy heating systems, some of which are more than 40 years old. Unsurprisingly, most are running inefficiently. On average, NHS organisations consumed 75% of their energy from fossil fuels, according to a 2021 BMA survey of NHS organisations. As of 2019, coal was still being burned at two hospital sites in the UK.

The cost of living crisis has prompted a step-change. While gas prices may drop in the short term, volatility is here to stay. So today there is a real need, within both the public and private sector, for educative and informative advisory services to help guide senior management teams especially when looking at procurement of clean technologies. Through our work running and administering three clean technology frameworks and supporting clients to develop heat decarbonisation plans for their healthcare estates, we have become acutely aware that decarbonising heating in hospitals is the linchpin to achieving net zero.

The hospital of 2040

Hospitals are well-suited to host heat networks - providing a cost efficient and low carbon heating solution for the communities they are located within. Their 24/7, multi-season demand makes them an ideal anchor load for the network, and the economies of scale they offer to suppliers is another advantage. They can be fuelled by waste heat, or run on clean energy sources, and optimise the distribution of heat.

Today, hospitals have the potential to be the proving ground for scaling and growing clean technology. If we think ahead to 2040, a net zero hospital could be a hub of the heat network, solving the energy challenge within its footprint and serving its local community. It can even become a hub for charging electric cars and providing energy to nearby neighbourhoods.

Through collaboration between healthcare estates and their neighbours, hospitals can go net zero all together and all at once with their communities - flipping the difficult problems of decarbonising a carbon intensive site, to using that site as the anchor load for local low carbon heating and hot water.

How do we get there?

But before this is realised, we need to reframe both the work and the workforce.

Access to the necessary electrical capacity is a core issue familiar to so many, yet often overlooked in national conversations about the topic. A recent session between Lexica’s clients and MP Chris Skidmore focused on Mission Zero: A Net Zero Review of the UK Energy System and it was obvious the breakthrough opportunity that the local energy plans present. Put quite simply, planning ahead for local generation, transmission and distribution isn’t yet the modus operandi (and reflects the wider knots of devolution, local government mandates and their ever-stretched budgets), but it’s certainly the obvious trajectory.

As always, it’s then about the people. The NHS is the world's first health service to set net zero targets and has ambitious plans to achieve them. The enthusiasm is palpable. And so, the success of achieving these targets will depend on the workforce's ability to perform in green jobs. Research from the Resolution Foundation into the skills required for green jobs found that the workforce must embrace new skills and approaches that prioritise non-routine analytical skills over routine manual skills.

The employees of the hospital of 2040 need to be able to pick up the phone to answer a plethora of enquiries, have a wide network both locally and beyond, be able to lead large teams and project manage major infrastructure. Getting our people there will require a shift in recruitment, skills and training, and career progression around the sector.

The journey towards a net zero hospital will be a people-powered revolution, driven by the existing ambition and dedication of the NHS workforce. What used to be niche and nerdy, is already mainstream. Understanding energy technology is the base, but reframing the work and the workforce will get us there.

Image credit: iStock

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NHE May/June 2024

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