SUSTAINABILITY
Shona Baugh
Shona Baugh is a senior capital project manager at the Shrewsbury and Telford Hospitals NHS Trust with a background in the private sector risk management and keen interest in sustainability. She is also the lead energy security and decarbonisation programme manager and has been pivotal in ringfencing internal and external funding for the Trust to deliver its ambitious decarbonisation strategy.
The #NetZeroNHS initiative aims to make the NHS the world’s first Net Zero health system.
Dominic Clarke
Dominic Clarke, project manager at the Carbon and Energy Fund (CEF), is a senior energy professional with over 20 years’ experience in the specification, development and delivery of low-carbon and decentralised energy infrastructure. His expertise spans district heating and heat networks, energy centre design and build, own-and-maintain and ESCO delivery models, and the deployment of onsite renewable and low-carbon technologies across industrial and public sector environments.
Estates teams in acute hospitals are already operating under intense pressure. Fire alarms, plant failures, infection control, statutory compliance – these demands do not pause for decarbonisation projects. Asking the same teams to absorb major capital programmes without additional resource can quickly become unrealistic. “There’s a tendency to drop these projects into estates teams and assume they’ll just get on with it,” Clarke observes. “But if no one individual has the bandwidth to own it and equally buy into its purpose, it’s very difficult to keep things moving.” Baugh agrees. “If I wasn’t doing this role full time, it would be difficult to manage the scheme,” she says. “Running projects like these needs focus, persistence and follow-through.” The Trust created a dedicated Energy Security and Decarbonisation (ESD) programme, sitting between capital and operational teams. This hybrid structure helped bridge the gap between strategic ambition and day-to-day delivery – but it also required explicit recognition that sustainability work could not be treated as ‘extra’.
Passion, authority, and the confidence to push Beyond formal structures, the human dimension plays a critical role. Projects succeed, those involved suggest, when there is someone with both the authority and the confidence to push them forward – and to hold colleagues to account when needed. “It’s not just about having a sustainability role on paper,”
Clarke says. “You need someone who actually wants to see it happen, who’s prepared to ask the awkward questions inside and out of the organisation and maintain pressure on colleagues for the requisite support.” That can be uncomfortable in organisations built on consensus and caution. But without it, momentum is easily lost.
Baugh is candid about the demands of the role. “You
do have to be willing to rock the boat a bit,” she admits. “Not in a destructive way, but to keep things moving. Otherwise, it’s very easy for projects to slip down the priority list.” Interestingly, both note that exposure to commercial
project environments – where time, cost and accountability can be more explicit – can bring different mindsets to complex programmes.
40 Health Estate Journal March 2026
Governance: too much, too little, or just too slow? Governance is often cited as both a safeguard and a stumbling block. Sustainability projects frequently cut across traditional boundaries: estates, finance, procurement, sustainability, clinical operations. Without clear ownership, decisions can become fragmented. At SaTH, governance was deliberately structured to
provide clarity. Sustainability performance is reported through established channels, with visibility at senior executive level. That visibility matters. “The project gets exposure because I’m reporting into a senior executive,” Baugh explains. “That makes a huge difference.” By contrast, projects that sit awkwardly between departments – owned by everyone and no one – are more likely to stall. Clarke describes situations where too few individuals carry too much responsibility, often without sufficient authority. “That’s when we get nervous,” he says. “Because if the
right people aren’t in the room, decisions are deferred – and projects can suddenly be paused which can lead to programme delays and additional contractor costs.”
The hidden burden on estates teams One of the least visible challenges is the impact of major projects on operational estates teams. Sustainability schemes often require isolations, shutdowns and intrusive works – all of which fall on teams already stretched by operational demands. “Every project impacts operational estates,” Baugh
says. “Every isolation request, every shutdown – it all goes through the same people who are keeping the hospital running.” Without careful planning and early engagement,
this can create barriers/blockers – not because teams oppose decarbonisation, but because they simply lack capacity. At SaTH, early engagement helped mitigate this.
Estates staff were involved during procurement, not just informed after decisions were made. Contractors were introduced as long-term partners rather than short-term visitors. “That sense of partnership really helped,” Baugh notes.
“People understood that our contractors were here for the long term.”
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