CARBON AND ENERGY REDUCTION
bacteria in water systems) is of particular concern, due to the ability of a large number of different microorganisms, biotoxins, and other contaminants, to cultivate in water. The Health and Safety Executive (HSE) advises that hot water should be stored at least at 60 °C, and distributed so that it reaches 55 °C at point of use in healthcare premises to reduce the risk of Legionella.7 Associated with this is the need to avoid the risk of scalding and burns, particularly for the protection of vulnerable patients. Temperature control will need to be provided at hot water outlets used by persons at risk of being scalded. The British Health Technical Memoranda HTM 04-018 (SHTM 04-01 in Scotland and WHTM 04-01 in Wales) set out best practice to keep hospital water supplies in a safe, clean, and hygienic condition. Further statutory guidance to support hospital Trusts in achieving the Net Zero ambition is set out in the Delivering a ‘Net Zero’ National Health Service report.1
Best
Figure 1: Baxi said: “The direct electric approach is more likely to be the option of choice, but would involve higher volumes of stored DHW – compared with low-storage direct gas-fired water heaters, which the building may previously have relied on.”
heatwaves of 2019, according to Public Health England. The NHS believes that taking action to reduce carbon emissions would bring direct benefits to public health. Following a Net Zero pathway, it estimates, will see 5,770 lives saved per year from reductions in air pollution alone.
World’s first Net Zero national health service The NHS has formally adopted two targets to achieve its ambition to become the world’s first Net Zero national health service, set as the earliest possible credible dates to achieve Net Zero emissions. The first, for the NHS Carbon Footprint (emissions under direct control of the NHS), is to achieve Net Zero by 2040, with an ambition for an interim 80% reduction by 2028-2032. The second is for the NHS Carbon Footprint Plus, (including the NHS’s wider supply chain), which sets a target for Net Zero by 2045, with an ambition for an interim 80% reduction by 2036-2039. The NHS has reduced its carbon
footprint considerably in the last 10 years, with an estimated 62% reduction in emissions from 1990 to 2020, and an approximate reduction of 26% in the wider Carbon Footprint Plus.1
However, clearly, considerably more work remains to be ‘‘ done.
Significant opportunities have been identified to reduce emissions from energy use in buildings, waste, and water, and to transition to new sources of heat generation. Given the high demand for hot water that is frequently associated with healthcare premises – from comfortable conditions and catering to in-house sterilisation and laundry – this service is a clear target for efficiency improvement and emissions reduction. However, it’s one that comes with certain challenges for NHS Estates and Facilities managers.
Unique requirements In no other environment is access to an efficient and sanitary supply of water more important than in healthcare. Ensuring an adequate, reliable hot water supply is key to the whole operation, creating comfortable conditions for patients and staff, and maintaining clinical standards, as well as being essential for treatment purposes. Hospital hot water distribution systems
are highly complex. Their design and function must ensure that water is adequately stored, cycled, and distributed to prevent a build-up of harmful bacteria. Preventing the risk of bacterial build-up (mostly related to the control of Legionella
The NHS has reduced its carbon footprint considerably in the last 10 years, with an estimated 62% reduction in emissions from 1990 to 2020, and an approximate reduction of 26% in the wider Carbon Footprint Plus
54 Health Estate Journal June 2023
practice guidance helps stakeholders – including Estates and Facilities managers, suppliers, and NHS management personnel – to mitigate the risks associated with the large, complex systems found across UK hospitals, clinics, and surgeries.
The scale of the challenge The vast scale of the NHS estate, the diversity of buildings, and the differing heating systems within the NHS estate, add to the complexity of the challenge. Certainly, new hospitals and NHS buildings will be designed to require less heat for operational use, and to be optimised for a decarbonised electricity grid. In buildings like these, a fully electric approach to DHW based around renewable solutions, such as heat pumps and direct-fired electric water heaters, is likely to be the favoured approach. However, these new hospitals are just the tip of the iceberg, accounting for less than a fifth of the secondary NHS care estate. It’s the older stock that is the real challenge. The reality is that transitioning a huge hospital premises from gas-powered steam or high temperature water heating systems to a low-carbon solution can be a hugely complex task for Estates and Facilities managers. The same applies to the primary care
estate, with its 7,000 GP practices in England, spread across 9,000 buildings, many of which currently rely on high temperature heating systems for heating and hot water provision. Moving to a low carbon system will likely require careful planning and budgeting – as well as support from heat experts.
Identifying the financially and technically feasible Identifying the financially and technically feasible opportunities to drive down
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