ARCHITECTURE AND DESIGN
Delivering climate-resilient healthcare environments
Against the backdrop of continuing concerns over global warming, Geoff Southern, associate director, Buildings, and Out-of-hospital Care lead (UK) at Arcadis IBI Group, considers some of the key potential ways to make healthcare buildings more adaptable and resilient to climate extremes, and to reduce the environmental impact of both the facilities themselves, and the plant and equipment needed to keep them fully functional, providing optimal care, day in, day out.
As the impact of climate change continues to unfold globally, extreme weather is here to stay – whether in the form of new temperature highs and lows, precipitation patterns, flooding, storms, or wind. The UK experienced its warmest year ever in 2022, highlighted by the red weather warning issued in the summer as a result of record- breaking 40 °C heat. The year before, a series of heatwaves claimed 1,634 lives – one of the highest numbers since the Heatwave Plan for England was launched in 2014. There are also occurrences of serious flooding that are causing damage and disruption to many communities nationwide.
Worsening conditions anticipated Worryingly, experts are anticipating that conditions will continue to worsen, leading to even higher potential mortality rates. According to a Met Office report, UK Climate Projections: Headline Findings, published in August 2022, current climate change trends will lead to drier, hotter summers, and wetter, warmer winters across the UK – with temperatures during the summer months likely to be 3.8 °C to 6.8 °C higher by 2070. Incrementally increasing temperatures and other extreme weather episodes will start to have an even greater impact on public health, and will take a bigger toll – both operationally and financially – on the health system itself. The extremes of last summer demonstrated the severe associated risks of heat, which are especially acute for the most vulnerable in society, including older adults, people with disabilities, and those recovering in hospital. Healthcare facilities need to effectively
withstand and mitigate against the hazards of these extreme climate-related changes, while continuing to provide uninterrupted and high-quality healthcare services. The problem is that our cities, and the buildings within them, were designed around historic average UK weather patterns, leaving them ill-prepared to deal with unpredictable weather. In fact, UK property is in far worse condition than that of many of its
Norway 0.9 °C
UK 3 °C
Belgium 2.9 °C
France 2.5 °C
Spain 2.2 °C
Sweden 1.2 °C
Denmark 1.2 °C
Netherlands 1.2 °C
Germany 1 °C
Austria 1.2 °C
Italy 1.5 °C
Figure 1: Home temperature loss after 5 hours, with a temperature of 20 °C inside and 0 °C outside (based on a sample of over 80,000 European homes).
European neighbours, with poor-quality buildings accounting for considerable heat loss or heat gain (see Figure 1). This is likely due to building standards that have specified lower-performing insulation based on more temperate conditions, and which do not provide resilience to climate change.
Healthcare buildings’ impact on the environment Another key consideration is the big impact that healthcare buildings have on the environment. Globally, healthcare systems are responsible for around 4.6% of all greenhouse gas emissions (GHGs), providing a good opportunity for a combined effort to reduce GHGs and increase climate resilience. To create resilient healthcare facilities, we now need
to design for extremes, rather than for the averages. To quote guidance from the World Health Organization in its 2020 publication, WHO Guidance for Climate- Resilient and Environmentally Sustainable Health Care Facilities, ‘climate resilient healthcare facilities are those that are capable to anticipate, respond to, cope with, recover from, and adapt to, climate- related shocks and stress, so as to bring ongoing and sustained healthcare to their target populations, despite an unstable climate’. We can take it a step further, and say that real climate resilience means not only adapting our buildings to the emerging risks of climate change, but also not contributing negatively to that change in the first place. Designers need to take an innovative, multi-faceted approach to healthcare developments to ensure that
March 2023 Health Estate Journal 39
Chart courtesy of tado
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