How we help to develop a carbon-neutral healthcare estate

These strategies involve rationalisation of complex property portfolios through masterplanning, often proposing the removal or disposal of substandard estate, and focussed phased redevelopment, including new build or retrofitting existing facilities where appropriate.

Each project we have been involved in is unique, but there are lessons learned in each project that can be applied as we move from one challenge to the next. The existing NHSScotland estate is large and hugely complex with a variety of buildings still in use. The estate includes key heritage examples (buildings designed by noted architects over the past 150 or so years), projects in the more recent past delivered via D+B, PFI, NPD and Frameworks Scotland initiatives, alongside an array of examples that were designed as temporary buildings and that have now outlived their originally proposed lifecycle. All of this, allied to infrastructure that is also often in need of upgrade and replacement, means that the redevelopment of complex acute hospital sites, in particular, is challenging enough without overlaying the requirements to achieve a carbon neutral estate by 2045.

This challenge to meet carbon reduction targets is an opportunity that can be embraced to ensure that there is a fit, flexible, lean and sustainable estate for many generations to come.

This can be delivered through the effective leadership of the Scottish Government, the Scottish Futures Trust (SFT) and NHS Scotland through a range of policies and initiatives that will continue to be refined and developed under the Climate Change (Emissions Reduction Targets) (Scotland) Act 2019 through increasing the ambition of Scotland’s emissions reduction targets to meet net zero by 2045. 

SFT have now published a suite of Net Zero Public Sector Buildings Standard documents (the Standard) to help Scottish public sector organisations achieve net zero outcomes for their new buildings or major refurbishment projects. This will help address carbon emissions at all stages of a public building’s life cycle.

The Standard has been developed by SFT in partnership with the Scottish Government, Zero Waste Scotland and NHS National Services Scotland with input from across the construction industry and support from many of Scotland’s public sector bodies.

CASE STUDY - WGH EDINBURGH

Working as part of the Thomson Gray Lead Advisor team, the key part of the work Core Associates has been involved with at the Western General Hospital (WGH) Edinburgh has been in the development of the long-term site masterplan. In order to facilitate this masterplan, reduce carbon emissions, and carry out essential replacement of aging plant and infrastructure, a suitable parallel energy masterplan has been developed in conjunction with Hulley and Kirkwood (H&K) and this is now being delivered on site through a multi-phase contract, under the Frameworks Scotland initiative, by RMF Health.

To facilitate the net zero emissions target by 2045 the energy masterplan aims to achieve the following:

• minimise energy demand for new and existing buildings as far as practically and economically possible
• maximise the utilisation of high efficiency sustainable sources such as heat pumps and wastewater heat recovery with back up from gas boilers (in the medium term and compatible with a lower carbon gas supply should this become viable)
• buildings operating at lower flow and return temperatures with the district heating network operating on a maximum flow and return temperature of the district heating network of 70oC flow and 40oC return but ideally varying its temperature and DHW temperatures achieved through local top up
• PVs utilised where feasible to reduce electrical grid consumption
• develop a plug and play strategy for the new energy centre that allows new technologies to be integrated as they become economically available
• a robust and cost-effective means of offsetting the residual carbon emissions associated with the electrical grid energy consumption is in place.

To achieve Scottish Government’s Net Zero Carbon targets, a robust Business Case process needs to be adhered to. Zero Waste Scotland have provided technical support on behalf of Scottish Government to carry out due diligence on the developing proposals at initial business case level and technical reviews are being carried out at project delivery stage by NHSScotland Assure.

Core Associates’ role has also included supporting the business case process together with attendance at meetings with Scottish Government and Zero Waste Scotland and their consultant team. We have also facilitated multi stakeholder workshops in the development of the strategy and more detailed workstreams. These were associated with the energy infrastructure networks and the proposed new Energy Centre, together with strategy reviews and reporting.

Allowances have been made for EV charging for public vehicles on site, which results in a significant proportion of the predicted electrical consumption. In order to inform the demand for EV charging, a transport/mobility strategy and green travel plan is being developed for the site. This will help to understand the flow and projection of EV public transport and private ownership vehicles arriving to site, as well as NHSL owned EV vehicles that may require charging.

Another developing part of the work we have done in masterplanning complex sites generally has been to review the potential of enabling simpler future site development through the introduction of ‘plug and play’ nodes for Energy and Non-energy infrastructure together with FM support services. The principles of this strategy are:

• Achieving Net Zero Carbon targets - The site can be made future ready for the introduction of new technologies during incremental development over the next circa 25 years leading towards net zero carbon targets as set by Scottish Government.
• Future Flexibility - Some technologies to achieve these targets are still very much in their infancy and as such there needs to be flexibility for their future integration.
• Reduce site disruption and associated costs during future development - There is a drive to do things once wherever feasible to reduce interim / temporary solutions and associated multiple infrastructure diversions.
• Incremental site development – Implementing the strategy now for the existing estate so that, as buildings are demolished and infrastructure is rerouted, there are interchange points developed that the new site services and buildings can relatively easily plug in to.

An important part of the jigsaw in planning redevelopment of complex sites is using a range of data sets to help inform the performance picture of the estate.

There are several disparate methods of recording information which need to be brought together when analysing the health estate. The type of information currently utilised includes backlog maintenance, Statutory Compliance, Building Management System (BMS) data, facilities management information, lifecycle data, functional suitability and utilisation, and energy use.

As part of the development of a pathway to net zero carbon for 2045, the application of digital twin modelling using BIM is becoming more prevalent and this is being used to assess the real world performance of buildings against the digitally modelled version to help optimise the energy use performance in particular.

Core Associates is currently looking at ways that all the collected data can be collated to help inform the decision making around the existing estate and to ensure that there is a robust audit trail that tracks relevant outcomes. The advantage of this would be to allow deeper reviews to be undertaken where decisions rely on multiple facets of data such as space utilisation, backlog maintenance requirements and energy use when determining how they can effectively support the clinical strategy and ensure optimum space utilisation within the most functionally suitable facilities.

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