Net Zero Seminars

The national policy pace of change to drive down carbon emissions has accelerated in recognition of the climate crisis and is seeking action now. This has resulted in NHS targets to achieve an 80% reduction in carbon emissions between 2028 and 2032 and 100% by 2040.
- Here we will explain the Trust Green Plan and use of the current EPC project, coupled with the attractiveness of the Salix Public Sector Decarbonisation Fund (PSDS) enabling the Trust to refresh the technology in order to meet these targets

• Commercial Consideration
o Governance/ procurement and route to market
- Here we will explain the route map, to align the supply chain with the Trusts procurement, financial and estates teams
- We will explain the approach on how we created "Shovel ready" projects in time for the PSDS time constraints

• Hospital stakeholder benefits
o Hospital user benefits
- Here we will explain the benefits to the Hospital users due to the "whole building approach" being taken. This provides improved weather envelope and insulation and windows to improve the patients and visitors experience.
- We will explain the visual impact this has on the Hospital drawing interest and educating the staff and visitors on East Sussex Trust are doing to achieve Carbon Neutral status

• Technical solution
o How to achieve a Carbon Neutral status by 2040
- Here we will explain the use of Low Carbon technology and supporting measures, whilst balancing the impact to the Hospital electrical infrastructure capitalising on an ever-greening national grid.
• Reduce reliance on Gas for heat
• Reducing the grid reliance by installing solar PV and to mitigate higher utility costs
• Satisfying the requirements of the Salix fund award criteria metrics £325/tCO2
• Satisfying N+1 resilience
• Effectively managing and monitoring performance data

Rotherham has recently installed a multi technology estate wide energy project that includes on site-generation, energy efficiency and battery storage. The Estates team are using CEF Contract and Performance Assurance and its bespoke AttesPro software.
This system is currently in operation across 60 hospitals which extracts information from Measured Data Points, CEF currently collects 1,420 channels of data each transmitting at HH intervals, processing circa 25 million individual data values a year in its existing contracts. Data is scaled and checked against the contractual energy requirements, errors identified, corrections and missing data identified and stored to a verified database to be used for performance analysis. This is presented in a dashboard showing Ing the essential project information and the progress of the Trust in achieving it’s 2040 plan.
Whilst achieving Scope 1 and 2 targets Rotherham are seeking to co-develop the tool in a way that will be made available to all Trusts to monitor and report Scope 1, 2, and 3 and implement plans that can be managed through live data monitoring and understanding.
The Trust is seeking for the benefit of all to co-create and assess real time energy and Carbon savings so we as Estates professionals can best manage the ever-changing carbon intensity of the National Grid. This will ensure the best real time carbon savings are achieved within our existing cost envelope.
The Rotherham NHS Foundation Trust seek to talk at IHEEM for discuss the progress of the project and understand the requirements of its fellow IHEEM members to be incorporated to create a tool that works for all.

The NHS and healthcare providers can reap huge benefits from Digital Twins and Smart Buildings in their drive for net zero carbon emissions.

Using a healthcare project case study, Jason Whittall, Director, and Shelby Green, Associate, from ONE Creative environments (ONE), will provide a practical demonstration. This will show how ONE's innovative approach has combined Building Information Models (BIM) with the Internet of Things (IoT) to create easy-to-use and visually intelligent tools that drive insight into a facility's operation and performance.

The session will look at and explain:
• What is a digital twin?
• What makes a building smart?
• Why digitising your assets can unlock access to greater insights, data and analytics and support your journey to Net-Zero carbon emissions.

Through the practical demonstration of a healthcare project case study, the demonstrator will also help you to understand how Digital Twins can further benefit: the NHS, operators, owners, patients and wider society, providing additional opportunities for efficiencies and savings, while reducing risk and enhancing wellness.

The presentation will illustrate the importance and impact of utilising real-time data streams to support the efficient and safe operation of healthcare facilities and the ability to make meaningful interventions. Examples include:

• Critical asset performance monitoring
• Understanding building occupation (rooms, desks, beds)
• Monitoring indoor air quality
• Managing risks to safeguard occupants and property
• Energy management.

Integrated data and visual intelligence are really important aspects of managing the modern built environment efficiently, especially with increased demand for public services, pressure on budgets, the drive for net-zero carbon and data for public good. You cannot manage what you cannot measure!

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.

The NHS Carbon Footprint (emissions under NHS direct control) needs to be net zero by 2040, with an ambition for an interim 80% reduction by 2028-2032.

Birmingham and Solihull integrated care system (ICS) serves a population of 1.3 million people in the West Midlands region. Within the area there are 5 NHS Trusts, 3 Councils and a multitude of GP Practices. We are committed to developing, understanding, and reducing our environmental impact and ensure we progress towards sustainable healthcare. In 2021 we commissioned AA Projects to produce an Annual Sustainability Report which was the starting point in terms of collating the data from across the organisations which sit within the ICS.

It is acknowledged that each of the 5 Trusts are at different stages of their progress towards Net Zero Carbon, the propose of the report was to set a framework for reporting on the sustainability measures which have been achieved annually. The report establishes a baseline for all organisations and maps the progress to date and highlights areas where information may be missing, or further action is required. There are 21 recommendations which cover the short, medium and long term.

The report will be updated annually updated to show the progress we are making at ICS level in terms of meeting the NHS overall target of Net Zero Carbon by 2040.

The ICS has formed a Green Board and has sustainability representatives from all stakeholder trusts and national property companies. Additionally we have local authority members and ICS programme leads for medicines management, primary care, procurement, people and digital. We have developed a communications strategy and trained exec leads on carbon literacy. We have appointed an Exec Lead to Chair the Board.

The objective of the presentation is to inform Healthcare providers of how they can create Sustainable Healthcare Accommodation through the design and build process, utilising modern methods of construction (MMC) for net-zero carbon (NZC) ready buildings.

The presentation details how new healthcare accommodation can achieve NZC, aligned to meet the 2028 NHS government target. In the long term, a broader approach for net-zero whole life carbon will cover all of the emissions associated with the construction, operation, maintenance, and demolition of a building. The methodology provided ensures the embodied emissions associated with products and construction will be measured, reduced, and offset to achieve NZC.

Regarding operational energy, the energy used by the building in operation should be reduced and where possible, any demand is met through renewable energy. Any remaining emissions from operational energy use should be offset to achieve NZC.

A principal step to achieving NZC is Passivhaus - the principles relate well back to MMC due to the ease of incorporating the additional insulation and the naturally higher airtightness of an MMC construction.

Passivhaus buildings achieve a 75% reduction in space heating requirements, compared to standard practice for UK new build (traditional builds). The Passivhaus standard, therefore, gives a robust method to help the industry achieve the 80% carbon reductions that are set as a legislative target for the UK Government.

The overall construction process using MMC provides greater energy efficiency and a reduced carbon footprint when compared to traditional construction, for example, Low U values and exceptional airtightness lead to minimising heat loss.

Currently, operating carbon energy isn't clean which powers the building, so it is imperative to provide the right materials maximising the embodied carbon. As the government targets come into play, it will be more cost-effective to act now rather than retrospectively.

This presentation will focus on how 3D volumetric systems help NHS trusts achieve their Net Zero Carbon goals, by utilising quality controlled offsite manufacturing techniques leading to reductions in energy during manufacture, delivery, site installation and beyond.
Premier will show that by focussing on a fabric first approach utilising lean, clean and green technologies, coupled with end-of-life recycling of modules closing the circularity loop, leads to both operational and embodied Net Zero Carbon energy.
By early client engagement at the pre-design stages and by using energy modelling evaluation, we can ensure buildings achieve the energy performance requirements and assist clients during their decision-making processes at every stage of the project to deliver a more comfortable building with Net Zero operational and embodied energy.
We will discuss our key learning points:
 Fabric First design principles, how improved thermal insulation properties, enhanced thermal bridging detailing and lower air permeability rates require less heating and cooling, saving energy and carbon.
 Lean, Clean and Green principles, how we design and build structures that consume as little energy as possible whilst generating as much as possible from clean, renewable sources
 Whole Life Cycle and Circularity principles adopting a cradle to grave and beyond design methodology.
 Our robust ISO 14001 certified environmental management system and constantly improving environmental performance through more efficient use of resources and reduction of waste.
 Deliveries minimised because products arrive in bulk, rather than individually to disparate sites - up to 83% fewer vehicle movements disruption, congestion and carbon emissions
 Materials are received with minimal packaging to save time and waste on site.
 Recyclable modules and components and our Zero Waste to landfill policy
 Premier's Carbon Reduction Plans helping to reduce the embodied carbon of our products at the manufacturing stage.

In October 2020, the NHS became the world's first health service to commit to reaching carbon net zero, in response to the growing threat to health posed by climate change. The "Delivering a Net Zero Health Service" report sets out a clear ambition and two evidence-based targets to achieve this.
The NHS Greener agenda sets out its ambitions for medicines and the respective supply chain - "By working with our suppliers to ensure that all of them meet or exceed our commitment on net zero emissions before the end of the decade.". This however requires detailed input and then follow up analysis.
MTS is working closely with the NHS NHP Team on equipment advisory for the re- use of equipment in the forthcoming build of over 40 hospitals. Key will be the evaluation of the multiple Medical and Non-Medical Equipment Suppliers and their attitude to Net Zero Carbon.

We working with Parent Company Sodexo and other leading companies to put a set of parameters in place which will constitute the evaluation of the Net Zero Carbon grading. This might include:

- Distance travelled from origin of manufacturing
- % of the item that can be re-cycled
- Specific energy outputs (other carbon rating)
- Commitment that no parts made with slave labour

The health sector is a significant contributor to global carbon emissions, accounting for between 4-5% of total emissions. A large part of this is the supply chain with around 70% of the sector's emissions coming from the production and transportation of medical equipment. UK health service emissions correspond to that global average, accounting for between 4-5% of the UK's total carbon emissions. A clear strategy to work with the leading UK and global suppliers to reduce these emissions will contribute significantly to the NHS Targets.

The NHS hope to be the first health service in the world to achieve zero carbon.

Building a net zero NHS, is allied to post Covid changes and so in all it is an exciting opportunity to change the future for the better.
The Central London Community Healthcare Trust (CLCH) is already on the front foot towards their decarbonisation journey and have developed a Green Plan and Board approved decarbonisation pathway which will be available to showcase in October (at the time of the conference). The presentation will discuss the Green Plan development journey including:

Why?
• Net zero carbon affects every aspect of our lives, so it is cross cutting and relevant.
• As a geographically widespread community trust across eleven London boroughs  and Hertfordshire, CLCH used 5900 tons of carbon in 2019, and needs to reach net zero  by 2040. The context is that the energy grid may be zero carbon by 2033-35. New energy standards for new build standards are soon to be released, so that the cost ‘gap’ between a net zero energy, and ‘standard’ construction is reduced.

How?
The CLCH Green Plan outcome is to reduce energy demand, leading to more environmentally sustainably and financially efficient buildings, and reducing the burden on the UK energy grid. At a time when bills are skyrocketing, the action plan is comprehensive and gets the Trust to net zero carbon across several years, including:
• Engaging with staff, installing efficient lighting and controls.
• Reducing fossil fuel consumption in buildings with heat decarbonisation plans.
• Removing unnecessary journeys for patients and staff, introducing electric chargers, bike racks, encouraging the fleet away from fossil fuel.
• Designing 'Green' spaces.
• Reviewing the commissioning of suppliers and reduction of carbon in medical gases.
• Identifying opportunities to link to local heat networks and battery storage.
• Working with our Integrated Care System partners to identify collaborative solutions across the sector.

Applying a carbon neutral programme approach to the whole estate to address the retrofit challenge; the benefits of cross-sector learning using relevant case studies from Hertfordshire County Council (HCC) and Hampshire.
With a lack of clarity surrounding the roadmap to net zero it is difficult for leaders in public bodies to understand where to begin, what to monitor and how to report progress and maximise the potential of funding. Irrespective of the sector or organisation, a programme approach that examines all estates related functions for the existing and planned new build estate, against the funding routes and Net Zero Carbon aspirations will ensure consistency and maximise outcomes, resulting in time and cost efficiencies.
HCC, in response to the Public Sector NZC target of 2030, and achieving government funding for decarbonisation, invested in the development of the Carbon Neutral Herts programme. In essence this initially recognised the school estate, both existing and planned and the funding pots available to the local authority. This looked beyond the capital workstream for the existing estate to also look at the new school build programme and FM function to create a NZC strategy for the entire property portfolio.
The impact of this approach has been particularly successful for the FM function with a Business as Usual (BAU)+ approach adopted that utilises a variety of funding streams bringing decarbonisation to the heart of delivery. This has been so successful that it has been mirrored across the organisation's wider estate, subsequently also being adopted by other local authorities.

Benefits include:

• Robust data capture and analysis providing a roadmap built on quality data, enhancing informed decision making and enabling progress tracked against targets
• A comprehensive database supporting funding bid, which provides a mechanism for speedy/effective responses to funding submission deadlines i.e., HCC achieved £24m of funding from 3 applications for decarbonisation works across 218 buildings, including window walling, solar panel works and ASHP installations.
• Continuous monitoring and evaluation of progress against performance indicators
• Trend analysis
• Identification of innovation and best practice
• Lessons learnt captured and used to strengthen future delivery
• Achievement of procurement efficiencies

In response to the climate crisis, the NHS has set a target to decarbonise its estate by 2040. A key part of the decarbonisation will be achieved through the transition away from fossil fuels to all-electric heating solutions utilising efficient electric heat pumps for the existing estate. The ongoing decarbonisation of the national grid over time will continue the reduce carbon emissions associated with electricity. Coupled with this, the systematic improvement in the efficiency of fabric and engineering systems will reduce the core energy demand. However, this is a complex and lengthy process with differing solutions for different buildings and sites.