At the Queen’s Medical Centre (QMC) in Nottingham, the last of 12,000 new double-glazed windows has just been installed. This is only stage one of an energy efficiency project that aims to reduce running costs and get the hospital to net zero by 2040, but it’s already delivering benefits. “Previously the hospital was draughty and noisy as parts of the site back on to the busy A52,” says Mike Soroka, QMC’s head of estates. “These windows have made it warmer in winter and cooler in summer. And that will benefit our patients.”
Energy efficiency and good health have an interesting circularity. The air pollution that contributes to climate change has also been linked to conditions such as heart disease, stroke, lung cancer and the worsening of asthma. And while the NHS treats patients with those conditions, it’s also a high emitter of CO2 – in England it’s responsible for about 4% of the total carbon footprint. Ageing buildings and cost pressures have added to the challenge.
To tackle this, the government has set a legally binding target for the NHS in England to reach net zero by 2040 for its direct carbon emissions.
E.ON is among the partners working with QMC to boost the hospital’s energy efficiency by installing a range of energy saving technologies. As well as replacing windows, the 15-year partnership will see E.ON build and operate a £15m energy centre to provide a more environmentally friendly source of heating and cooling for the hospital. The new energy centre replaces natural gas heating and cooling with high-efficiency heat pumps that extract heat from the air and from the ground using boreholes up to 250 metres deep. The new heating and cooling system is expected to cut CO2 emissions by 10,000 tonnes a year – the equivalent of taking more than 2,200 cars off the road – while reducing running costs and making the hospital a more comfortable place for patients and staff.
“We needed somebody with design expertise to help us as part of the process,” Soroka says about working with E.ON. “There’s been lots of collaboration with our clinical colleagues of course, but E.ON has helped us improve what we’re trying to achieve. They’ve had a lot of input.”
There’s been growing awareness, more broadly, of the link between people’s health and their ability to keep warm. Fuel poverty affects an estimated one in seven households in England and Wales, and accounts for an estimated 10,000 deaths a year. Living in a cold home doesn’t just affect someone’s physical health – making chronic conditions such as arthritis and asthma worse – but their mental health too. Citizens Advice estimates that carrying out a major retrofit of the millions of poorly insulated homes around the country to make them warmer would have “a profound impact” on health standards and save the NHS £2bn over the next five years.
Glen Burley, CEO of the Foundation Group, which encompasses four NHS trusts in the West Midlands, says its healthcare employees are finding this a growing issue. “A lot of our community staff see this because they’re visiting people in their homes. We’ve been keen to push [fuel poverty] as one of the issues around the wider determinants of health. The majority of our admissions are older people admitted as emergencies. When you look at the root causes, it’s often people not being warm enough, not being fed, not being able to manage their general wellbeing, which leads to a health-related issue.”
There have been a number of interventions to tackle this problem. Energy companies, through government-mandated schemes such as the Energy Company Obligation, have delivered more than 2m improvements to homes over the past decade.
One particular project was the Homes for Living initiative, a pioneering effort over three years to enhance the lives of more than 2,000 older people by installing aids and home adaptations.
The programme focused on improving independence, wellbeing, and mobility and was an extension of E.ON’s existing offer of free or partially funded home solutions such as insulation, solar panels and air source heat pumps, and built on its existing energy efficiency schemes.
Working with Newcastle University, E.ON undertook research that showed significant improvements in both physical and mental health, with 50% of participants reporting a reduction in feelings of loneliness. Additionally, 14% of those who were previously dependent on others regained full independence. E.ON estimates that there could be savings of £1.7bn from health and social care budgets if the programme was scaled further across England.
Burley says this is work that needs buy-in across the public sector: “Making it one of our big priorities [within healthcare trusts] has really got people focused on it. There are hundreds of priorities in the NHS, so you do need to signal this is really important, and you’re going to put effort into it. In addition to it being a good thing to do, and an efficient thing financially, the public health benefits of reducing demand upon health providers are significant.”
At QMC, Soroka says that, alongside securing the necessary funding for its decarbonisation projects, the biggest challenge has been keeping the hospital running at the same time. “It’s a very busy site. We had to make more than 100 car parking spaces unavailable for weeks to drill 64 boreholes for the heat pumps, which was tough for our staff and our patients. We also created a whole empty ward so we could move beds around while we replaced the windows.”
For other NHS leaders embarking on their net zero journey, Soroka recommends getting buy-in from the various trust stakeholders at the start. “It’s not the estates team delivering this, it’s everyone. A lot of effort comes from the clinical teams that have to move wards and look after patients. Above all, you have to remember why you’re there – it’s not a construction site, it’s a hospital.”
Find out more about E.ON’s pioneering work to create a more sustainable world
