SUSTAINABILITY
Why great sustainability projects stall
Despite their importance to both the NHS and the public sector more widely, many sustainability and Net Zero projects fail to get past the drawing board. To discover why some of these projects succeed while others stall, Steve Heape, leader of Project Development at the Carbon and Energy Fund (CEF), spoke with two leading experts in the sustainability space.
Across the NHS and wider public sector, sustainability is no longer a fringe concern. Boards sign off Green Plans, carbon targets are embedded into national policy, and estates teams are under increasing pressure to decarbonise ageing infrastructure while keeping hospitals operational around the clock. And yet, for all the ambition, many sustainability and Net Zero projects struggle to progress beyond feasibility studies and outline business cases. The paradox is striking. The case for action is often compelling: volatile energy prices, mounting maintenance backlogs, and the growing operational risks of obsolete plant. But even when the technical and financial arguments stack up, projects can still stall – quietly, incrementally, and without a single obvious point of failure. Those involved in delivering complex energy and decarbonisation programmes say the reasons are rarely simple. Cost is frequently blamed, but in practice it is only one factor among many. More often, the real constraints lie in governance, organisational capacity, confidence in delivery, and the sheer human effort required to push large projects through already overstretched systems. A recent conversation between highly experienced figures involved in NHS sustainability delivery offers a revealing insight into why some projects succeed while others falter – and what makes the difference.
Leadership matters – but only if it is sustained One of the most consistent themes to emerge is the importance of senior leadership. Not just formal approval, but active, ongoing engagement. At The Shrewsbury and Telford Hospital NHS Trust
(SaTH), sustainability has been elevated beyond a technical estates issue and embedded into governance structures at board level. According to Shona Baugh, senior sustainability manager at the Trust, this has been fundamental. “You need a board and a finance director who
understand why this matters,” she explains. “If that understanding isn’t there at the top, it becomes incredibly hard to deliver anything meaningful further down.” But leadership support, on its own, is not enough.
Projects can still stall if that support is passive or intermittent. What appears to matter most is sustained involvement – senior figures who remain visible, informed and engaged as projects move from concept to delivery. Dominic Clarke, who works on sustainability
programmes across multiple NHS trusts, has seen the contrast firsthand. “The projects that move most smoothly are the ones where senior leaders stay involved or make a point of being kept informed,” he says. “Where decision- making is close at hand, rather than something that happens at arm’s length.” When leadership engagement drops away, delays creep in. Decisions are deferred or take longer to make. Risks are left unresolved. And projects that once had momentum can gradually lose it.
The myth of ‘business as usual’ Another reason projects stall is the persistent assumption that sustainability can be delivered alongside existing workloads, rather than as a programme in its own right.
Royal Shrewsbury Hospital – a Shrewsbury and Telford Hospital NHS Trust site.
Even when the technical and financial arguments stack up, projects can still stall – quietly, incrementally, and without a single obvious point of failure.
March 2026 Health Estate Journal 39
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