NET ZERO
Off-site techniques drive decarbonisation
Hospital heating and hot water strategies must balance patient safety and clinical performance with Net Zero ambitions and long-term resilience. Tony Falconar, national sales manager at Baxi Packaged Solutions, looks at how modular off-site fabricated solutions can help hospitals overcome these challenges, enabling them to decarbonise and modernise their estates in a controlled, phased, and future- ready way, reducing disruption while supporting refurbishment and expansion.
Healthcare in England is a significant contributor to the country’s carbon footprint, contributing between four and five per cent of national emissions, and around 40 per cent of all emissions generated by the public sector.1
Responding to the clear responsibility to minimise
its environmental impact, the NHS has set ambitious targets for reaching Net Zero from its directly controlled emissions by 2040, and the emissions it can influence by 2045. The high demand for heating, hot water, and cooling associated with hospital and healthcare premises make heating and hot water systems a critical target for efficiency improvement and carbon reduction. But decarbonising and optimising these systems can be complicated by legacy infrastructure and 24/7 operational demands.
The world’s first Net Zero national health service In 2020, the NHS became the world’s first national healthcare system2
to commit to becoming Net Zero,
setting two targets to achieve this ambition. The first, for the NHS Carbon Footprint (emissions under direct control of the NHS), is to achieve Net Zero by 2040, with an ambition for an interim 80 per cent reduction by 2028-2032. The second is for the NHS Carbon Footprint Plus (including the wider NHS supply chain) which sets a target for Net Zero by 2045, with an ambition for an interim 80 per cent reduction by 2036-2039. The NHS is on track to achieve its interim target of an 80 per cent reduction in direct emissions by 2032. Recent investments in solar power, battery storage, and efficiency are anticipated to further reduce emissions, but clearly there is much more work to do. Accelerating low carbon heating deployment in
hospital facilities is a critical priority to achieve the Net Zero goals. By replacing fossil-fuel heating and hot water systems – which heavily drive the 15 per cent of carbon emissions originating from healthcare estates – facilities can significantly lower greenhouse gases while enhancing energy security. But this comes with certain challenges.
Unique challenges and requirements New hospitals buildings will be designed to require less heat for operational use and optimised for a decarbonised electricity grid. In buildings like these, a fully electric approach to heat based around renewable solutions – such as high temperature and four-pipe heat pumps – is likely to be the favoured approach. However, these new hospitals are just the tip of the
iceberg, accounting for less than a fifth of the secondary NHS healthcare estate. It is the older stock that presents the real challenge. Transitioning a huge hospital premises from gas-powered steam or high temperature water heating systems to low-carbon heating can be a hugely complex task for estates and facilities managers. Similarly, carrying out energy-efficient retrofits while maintaining 24/7 patient care with no disruption is a major operational feat for NHS estate teams. Cost pressure, ageing infrastructure, and the diversity of building types and ages – including differing heating systems - across the hospital estate further increase the complexity of the challenge. Historically, these factors have frequently resulted in estates managers needing to settle for short-term fixes rather than a strategic redesign. This has led to projects that have been ‘shoe-horned’ in over time, and hospital plant that is significantly oversized due to risk-averse design and like-for-like replacement. So how best to resolve this? One solution might be to
use off-site fabrication, a technique that allows systems to be built, tested, and delivered as needed, reducing time on site and helping maintain continuity of operation. As such it offers a practical route to replacing or upgrading plant with minimal disruption.
October 2026 Health Estate Journal 85
Craning a packaged plant room into position.
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