Net Zero Block 4 Seminars

Globally, healthcare is significantly challenged by rising antibiotic resistance, hospital-acquired infection, staff shortages, capital, and operational funding pressure. In deploying the Pharmafilter system, hospitals are removing the input of pharmaceuticals, including antibiotics, to the environment via hospital wastewater - a critical point in antibiotic stewardship. In addition, essential support services are automated, benefitting staffing, operations, economics, hygiene, patient and staff safety.

From waste management to water use to the near-zero carbon targets, Hospitals are operating under increasing environmental regulation at a time when demand for care is growing. Hospitals are required and expected to treat and care for patients while also contributing to a healthy society and sustainable environment. The decentralised Pharmafilter approach of combined on-site of hospital waste and wastewater treatment has proven environmental benefits while improving patient care.
The healthcare sector possesses a unique healing purpose. Yet, hospitals are key point sources for specialised pharmaceutical and microbiological residues entering the environment. It is a substantial source of contamination that can endanger ecosystems and the environment and accelerate the development of antimicrobial resistance (AMR) - a severe public health threat.

Up to 90% of orally administered pharmaceuticals are excreted into wastewater as active substances in the faeces and urine of patients. This enables pharmaceuticals and their metabolites to be released into the aquatic ecosystem through hospital effluents. Due to technical and economic constraints, it is not possible to remove these contaminants at a receiving wastewater treatment plant because of the specialist techniques required,
As design intends pharmaceuticals to interact with living organisms, even low environmental concentrations are a concern. While conventional medicines are frequently consumed in the community, more specialised pharmaceutical products, e.g., cytostatic drugs, (restricted)antibiotics, and X-ray contrast agents, are principally administered in hospitals and clinics.

In addition, the generation of waste categories within a healthcare setting and the management, and disposal continues to generate unprecedented challenges in terms of increased volume and increasing cost for all concerned. Moreover, the global waste supply chain is undergoing transformative realignment and adjustment. Given ongoing environmental legislative reform, whereby healthcare risk waste is becoming restricted to the country or jurisdiction it arises, placing limits for official shipping and movement for disposal around the globe, the Pharmafilter system is at the nucleus of resolving these challenges.

The Pharmafilter on-site system and operation method is a combined approach to efficiently and economically managing healthcare-generated wastes and wastewaters at the source. The platform improves service delivery and achieves better outcomes for the hospital, its patients, staff, and the environment.

BDCFT is a small mental health and community Trust with a big ambition: to be recognised as a leader in sustainability and environmental improvements within the NHS and our local community.

We would like to showcase how the Trust is embracing change across a range of departments and staff groups to deliver meaningful change since publishing our Green Plan: Greener Together and our carbon reduction plan.

We will discuss the different activities we have done, including basics like energy efficiency and a Heat Decarbonisation Plan, as well as initiatives such as our Smarter Working programme and Community Estates Review.

We will highlight what our Carbon emissions are, including Scope 3, how we calculated it in-house and actions we are taking to embed change including staff engagement and (Carbon Literacy) training, and embedding sustainability decision making.

We will mention the wider sustainability issues our Green Plan aims to tackle, including climate change adaptation, resource use and use of green spaces and biodiversity.

We will also discuss how we are a key player in a variety of forums, including the ICS Sustainable Procurement Group and the national Mental Health Trusts' Sustainability Network: Green Minds.

We will conclude by summarizing how we are using our position to engage suppliers and contractors and our plans for the future.

Foleshill Health Centre - The UK's First Passive House Certified Primary Healthcare Facility
Completed in June 2021 and in use since August 2021, the proposed presentation will provide an update on in use performance of this UK first. Foleshill's sustainability ethos drove every project stage, focusing Passivhaus goals and overcoming challenges, with all targets achieved to date it is now subject to 3 years of monitoring to evidence its sustainability performance credentials.
Foleshill's new Health Centre is a breakthrough NHS project which stands out from the crowd as an exemplar ultralow carbon health care solution, demonstrating a different way of creating innovative low carbon emission assets and gaining cost, time, safety and environmental benefits from its application of Modern Methods of Construction, use of offsite manufacturing and certification to Passivhaus Classic standard. It is a proof-of-concept project for the application of Passivhaus techniques and certification for NHS primary care healthcare buildings, in the NHS's drive towards zero carbon by 2040.
Sustainability of this BREEAM Excellent project derives from cost and energy reductions over its 60 year lifecycle compared to a traditional building. Initially higher construction costs are offset by energy savings creating a 2.5% reduction in life cycle costs within 25 years and further increase to 8.6% over 40 years. Modelled annual energy consumption will be just 31kWh/m2 GIA compared to 98kWh/m2 for an equivalent traditional build health centre, saving 411 Tonnes CO2. Post occupation, three years of monitoring commence to validate the model.
This presentation will provide a first review of the in-use performance of the building and provide an update on lessons learnt from inception to practical completion and into service.