NET ZERO
Air source heat pumps installed on the exterior of a building.
Steve Heape
Steve Heape is chair of the IHEEM Environment and Sustainability Advisory Platform and a leading figure in the UK’s healthcare decarbonisation landscape. He has spent over a decade developing and delivering large- scale low-carbon energy infrastructure across NHS estates, including heat pumps, geothermal, solar PV, CHP and energy performance contracts. Steve is deeply involved in innovation around Net Zero hospitals, district energy, and new clean-energy business models, and is passionate about turning complex energy challenges into deliverable, investable solutions.
plant. No emitter upgrades. Just turning it down and seeing what happens.” That evidence does more than save energy. It builds confidence across estates, clinical teams, and senior management that change is possible without compromising patient care.
The unfashionable work that makes projects viable Much of the most important preparatory work is not particularly eye-catching. Replacing constant-speed pumps with variable-speed drives. Removing three- port valves that short-circuit systems. Improving BEMS optimisation, zoning, and temperature compensation. Fixing insulation and reducing distribution losses. “These aren’t the things that get headlines,” Hilliard admits, “but they’re the things that make low-carbon systems affordable to run and manageable day to day.” Poor control and inefficient hydraulics can undermine
Andy Yates
Andy Yates is a Chartered Mechanical Engineer and head of projects at the Carbon and Energy Fund, leading the development and delivery of complex NHS decarbonisation programmes. He
specialises in large-scale energy infrastructure, procurement, and Net Zero strategy, with a strong track record over the last 32 years of delivering multi-million- pound heat, power, and efficiency projects across public sector estates.
even the best-designed low-carbon heat source. Without addressing these fundamentals, trusts risk transferring inefficiency from one energy source to another. Yates is clear on the financial implications. “If you try to
bolt low-carbon heat onto an inefficient estate, you can end up with eye-watering revenue costs. Capital might be grant-funded, but operating costs still land with the trust – and that’s where projects quickly become unpopular.” Many of these interventions are self-funding, delivering immediate operational savings while quietly creating the conditions needed for future decarbonisation.
Where backlog and Net Zero meet One of the strongest themes to emerge from the discussion is the opportunity to align decarbonisation with the NHS’s critical estates backlog. “Plant replacement is happening anyway,” Yates says.
“Boilers, pumps, controls – a lot of this kit is life-expired. The question is whether you replace like-for-like, or whether you use that moment to future-proof the estate.” Too often, backlog replacement and decarbonisation are treated as separate – or even competing – priorities. Yet in practice, they are closely linked.
44 Health Estate Journal May 2026
Hilliard sees the consequences when that alignment is missed. “We sometimes arrive at sites where trusts want low-carbon heat, but the surrounding infrastructure is fundamentally unfit for purpose. You’re not removing risk – you’re just moving it.” When planned together, backlog replacement becomes an enabler rather than a constraint. Life-expired pumps can be replaced with variable-speed systems sized for lower temperatures. Obsolete controls can be upgraded to allow zoning and sequencing. Distribution upgrades can reduce losses and unlock lower flow temperatures. “It’s often about spending the same money more intelligently,” Yates reflects. “And avoiding spending it twice.” This alignment also reduces operational risk – a critical consideration for estates teams already managing fragile infrastructure under intense pressure.
Strategy over short-term fixes Both Yates and Hilliard are clear that technology-led projects without a long-term strategy are vulnerable. Hospitals are dynamic environments. New clinical buildings come on line, older buildings are repurposed or demolished, and service models evolve. Without a clear long-term heat strategy, decarbonisation risks becoming reactive – responding to funding opportunities rather than following a coherent plan. “You need to understand the end state,” Hilliard says.
“What does heat distribution look like in 2035 or 2040? Which buildings are long-term assets? Which systems should be adapted, and which should be retired?” Without that clarity, there is a real risk of investing in solutions that limit future options or lock in inefficiencies for decades.
The role of data Data – or the lack of it – remains a persistent frustration. “Poor data is where projects come unstuck,” Hilliard notes. “If you don’t really know your loads, flows and returns, you’re designing blind.” Reliable metering, monitoring, and asset data underpin
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