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Managing Healthcare Facilities – Net-Zero Hospitals

Managing Healthcare Facilities – Net-Zero Hospitals
19 August 2021

The carbon footprint of healthcare could triple by 2050, leading to worse health outcomes, increased chances of pandemics and a more unstable climate. 

Healthcare as a sector makes up more than 4.4 per cent of net global climate emissions, equivalent to the annual greenhouse gas emissions from 514 coal-fired power plants. If it were a country, it would be the fifth-largest climate polluter on the planet.

As one of the largest and fastest growing segments of the world economy, what changes are needed in healthcare facilities to accelerate net-zero growth?


“NHS-owned primary and community care estate suffers from many of the same problems, including inappropriate buildings; wasted space; inadequate space for expanded services; over-specified rooms; and facilities that are unused for large parts of the week.”

–Nigel Edwards

Senior Fellow, The King's Fund



NHS’ Carbon Footprint


The NHS is the most significant public sector contributor to climate change, responsible for around 20 million tonnes of carbon dioxide emissions annually.

An NHS Sustainable Development Unit report from 2012 shows that 59 per cent of NHS carbon emissions are linked to procured goods, 24 per cent to direct energy use in buildings and 17 per cent to patient and staff travel. 

The NHS estate in England has a floor area that would cover the City of London ten times over. The land it owns totals 6.9 million hectares while the total floor space of trust and primary care trust buildings is estimated at 28.4 million square metres. According to Nigel Edwards in his paper “NHS buildings: obstacle or opportunity?”, there has been little real attention given to how NHS estates could help to improve efficiency.

He writes: “The NHS estates management function has been largely concerned with the maintenance and operation of buildings; there has been little development of more entrepreneurial property management skills.

“NHS-owned primary and community care estate suffers from many of the same problems, including inappropriate buildings; wasted space; inadequate space for expanded services; over-specified rooms; and facilities that are unused for large parts of the week.”




A Global Decarbonisation Roadmap


In order to address these issues, Arup and Health Care Without Harm (HCWH) have produced the world’s first decarbonisation road map for health care globally.

The report suggests that to decarbonise, the health care sector must ultimately run on 100 per cent renewable energy. This will require the installation of onsite renewables such as:

  • Solar panels on hospital roofs
  • The development and implementation of new technology for thermal heating and cooling
  • The innovation of ultra-energy-efficient buildings and medical devices
  • The deployment of onsite renewables to power supply chain factories
  • Decarbonization of the grid from which both hospitals and supply chain manufacturers purchase their electricity


By targeting electricity use and onsite generation while employing lower carbon and more circular construction practices, action on emissions from health sector buildings and infrastructure can lead to a cumulative emissions reduction of at least 17.8 Gt CO2e between 2014 and 2050.


Opportunities from the Pandemic


The COVID-19 pandemic presents an additional challenge and opportunity for the healthcare sector to move toward zero emissions buildings and infrastructure. 

Deployment of COVID-19 vaccines will require major infrastructure and building investments. These projects could be channelled toward affordable, energy-efficient, resilient buildings.


Climate-Smart Buildings


The adoption of green building design tools and accreditation mechanisms, including tools specifically for health care buildings may also help to decarbonise the healthcare estate. 

Such tools have also been successfully deployed in numerous countries. One study conducted by the Harvard T.H. Chan School of Public Health found that buildings designed with the LEED green building tool in the United States, China, India, Brazil, Germany, and Turkey, averted 33 million metric tons of CO2 from entering the atmosphere, resulting in $2.7 billion in health savings.

You can download Arup’s report in full here.

Picture: a photograph of a hospital corridor, showing someone pushing a hospital bed, two healthcare workers walking together and a patient using a wheelchair

Article written by Ella Tansley | Published 19 August 2021


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