CARBON REDUCTION AND NET ZERO
The UCLH Proton Beam Grafton Way Building at University College London, designed by Cagni Williams in association with Scott Tallon Walker, with designated green spaces for wellbeing, and solar shading to reduce overheating.
Laura Carrara-Cagni
Laura Carrara-Cagni RIBA, is director of Cagni Williams Associates, a practice specialising in sustainable healthcare design, and co-founder of Cagni Williams Energy, a consultancy delivering Net Zero strategies for healthcare estates. With over 30 years’ experience, she has led numerous projects across the civic, cultural, educational, and residential sectors, integrating energy- efficient strategies to achieve Net Zero Carbon (NZC) goals. She is committed to
advancing sustainability in the built environment, notably through innovative solutions in healthcare, such as the Midland Metropolitan University Hospital and La Spezia Hospital in Italy. A passionate advocate for reducing carbon emissions in architecture, she serves as Co-Chair of the Urban Land Institute Europe – Life Science and Healthcare Product Council. She also takes up speaking engagements, writes, and serves as a juror for architectural and art awards.
Masterplanning Masterplans by CWA increasingly include: n Green corridors and biodiverse landscaping. n Low-traffic or pedestrian priority zones. n Improved cycle and public transport links. n Flood resilience and overheating mitigation.
One of the key challenges in achieving Net Zero Carbon within the NHS is overcoming the fragmented nature of policy implementation, siloed operations, and the lack of continuity across projects. NZC requires whole-systems thinking. Achieving NZC isn’t just about efficient equipment – it’s about integrating architecture, systems, and behaviour. Architects shape the building form, orientation, materials, daylight access, and natural ventilation – all of which have profound long-term energy implications. Early design decisions on new-builds can either drastically reduce or lock in high energy use for the building’s lifetime. As leaders of the project vision, architects ensure:
n Renewable integration is architectural, not bolt-on. n Embodied carbon is accounted for in material choices. n Circular economy principles are embedded in detailing.
n Post-occupancy feedback loops improve future performance.
Leading on embodied carbon reductions Even with retrofit situations, architects with energy expertise can lead on embodied carbon reductions through smart material choices, coordinate renewable energy integration (e.g. PV panel placement), and collaborate across disciplines for Net Zero-ready design. With their holistic understanding of design, systems integration, and project management, architects are thus ideally placed to bridge these gaps. By collaborating with clinical leads, Estates managers, engineers, and other stakeholders, architects ensure that sustainability and operational efficiency are balanced. While engineers are crucial for detailed system design, an architect with energy expertise plays a strategic, early-stage role in minimising carbon emissions before mechanical systems are even considered. This foundational role in early design decisions is
why such architects are often better suited to lead NZC healthcare projects. This collaborative approach ensures that each project phase – from design to post- occupancy – is undertaken with the goal of achieving long-term sustainability, financial savings, and improved environmental performance. This approach helps reduce risk, fosters greater buy-in from stakeholders,
48 Health Estate Journal September 2025
and ultimately leads to more successful, future-ready outcomes. By coordinating across estates, engineering, and clinical operations, architects ensure the whole system moves toward resilience; not just the buildings.
Conclusions: from carbon reduction to financial resilience The NHS and private healthcare institutions face an urgent dual challenge: to deliver high-quality care while reducing their carbon footprint and operational costs. Net Zero strategies, when led by informed architects, are not just about compliance. They are about creating future-ready buildings that cost less to operate, are resilient to climate stress, and support better health outcomes. Architects, and particularly those with expertise in sustainable design, offer a strategic solution to this challenge. Through careful planning and the integration of Net Zero Carbon strategies from the design phase through to post-occupancy in both new-build and retrofit, they can help all their clients organisations reduce carbon emissions, lower energy costs, and future-proof healthcare facilities. As energy prices continue to rise, and climate change
accelerates, the role of architects in achieving a Net Zero NHS, and the voluntary pledge of Net Zero Commitment, will only grow in importance. The transition to a Net Zero world is not just a distant ambition; it is an urgent necessity. By making the right investment decisions now, NHS Trusts and private healthcare providers can unlock significant financial and environmental value, ensuring a healthier future for both people and the planet. Ultimately, the long-term benefits of transforming
all healthcare estates into low-carbon, energy- efficient assets extend beyond financial savings. These transformations enhance local environments, create jobs in the green sector, and position the UK property sector as a leader in sustainability, setting an example for others to follow. We established Cagni Williams Energy to help our clients with their climate targets, drive deep carbon reductions, and unlock significant long-term savings. Let us seize this moment to re-think healthcare design, not as a burden, but as one of the most impactful ways to deliver social, environmental, and economic value.
References 1 NHS Net Zero Building Standard. NHS England, 22 February 2023.
https://tinyurl.com/2aavxb4v
2 Mills M. NHS Estates: Cost Modelling for Operational Net Zero. Gardiner & Theobald, 4 June 2021. https://tinyurl. com/4ejez6kh
Agnese Sanvito
Paul Raftery
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