CARBON REDUCTION


to the delivery of energy infrastructure and associated activities within the NHS are inevitable, and will have to happen at pace.


Health service footprints The targets in the NHS paper are based upon reducing the carbon emissions from activities represented within the NHS Carbon Footprint. This footprint can be applied to most health service organisations, and primarily consists of energy used within buildings, energy used from health service-owned and operated vehicles, water consumption, and refuse and waste treatment, as well as emissions associated with medical treatment procedures.


There is also an aspiration to affect the wider health service carbon footprint that includes upstream and downstream emissions – such as medical devices, business services, construction, food and catering, and manufacturing of products and services used in a hospital or the organisational supply chain. The NHS paper calls this the ‘NHS Carbon Footprint Plus’.


What does Net Zero mean? Net Zero means that you have dealt with reducing your carbon emissions as far as you are practically able to, and the only emissions left are those that you cannot avoid, and so have to be offset. Offsets are usually by way of the organisation responsible for the unavoidable emissions paying to implement the equivalent emissions reductions by other means, such as purchasing the equivalent carbon emission reductions from green energy certificates, or funding other carbon emission reduction projects elsewhere, that achieve the equivalent reductions to get the organisation down to zero.


35000 30000 Historic emissions 25000 20000


NHS 2020-2040 reduction target (targeted potential impact of all NHS Carbon Footprint actions related to gas and electricity)


Total site energy carbon emissions – with Energy project


Total site energy carbon emissions – without Energy project (but including National Grid decarbonisation)


700 600


l Natural gas boiler l Resistive heater l Heat pump


500


400


300


200


100


0 1990 2000 2010 Year Figure 2: Emission intensity of heat (Source: www.ukerc.ac.uk).


Why worry when we can simply offset our emissions?


Importantly, we cannot all rely on offsets for reducing all of our carbon footprint, and do nothing to make any reductions from each of our facilities and activities. If we all do this, we would make no material impact to either our total organisation emissions, or those of our country; as such there would have been no additionality taking place. Therefore, in order for real emission reduction beyond offsets to occur, we need to make material reductions at each of our sites, which calls for variable levels of investment in time and money to implement.


Targeting reductions The NHS Delivering a ‘Net Zero’ National Health Service paper identifies that in order to meet the NHS 2040 Net Zero


emissions target for the secondary care estate, we need to achieve 20% of the required reduction from new building upgrade construction, 24% from optimising the way we use existing buildings, and a further 25% needs to come from providing our buildings with low carbon and renewable energy. This is implying that more of the built estate carbon emission reduction has to come from optimising the existing facilities, and providing them with low carbon and renewable heat and power (49%), compared with wholesale building renewal (20%). These proportions have been determined for the entire NHS secondary care footprint, and in practice, the target level of emission reductions required at organisational and at site level will vary, depending on the clinical delivery scope, and the extent, age, and condition, of the associated estate portfolio.


15000 Gas CHP operating 2017 to 2032 Do nothing 10000 80% reduction from 1990 5000 0


2008 2011 2014 2017 2020 2023 2026 2029 2032 2035 2038 2041 2044 2047 2050 Year


Figure 3: Pathway to Net Zero for NHS Carbon Footprint. Scope (energy only). 28 Health Estate Journal June 2021


How green is your energy supply? In the UK, the impact of ‘greening’ electricity supplies has been significant to date, with electricity carbon emissions having decreased by approximately 75% since 2012. This is great news for existing facilities and assets run from electricity, as they have been decarbonising by themselves! However, increasing effort will be needed over and above this impact if we are to achieve the strategic carbon reduction targets by the end of this decade. For one thing, most of the heat utilised by a typical hospital estate is delivered through burning fossil fuels, specifically natural gas, and, to a lesser degree, fuel oil. These fuels have not decarbonised by any significant amount over the same period, nor are they likely to decarbonise to the levels needed in order for us to achieve the 2032 80% reduction target.


2020 2030 2040


Annual site energy carbon emissions (tCO2


e)


Emission intensity of heat (gCO2


/kWhth)


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