BIODIVERSITY
Luton and Dunstable Hospital has seen substantial redevelopment.
Amy Norman
Amy is a senior civil engineer at Perega with extensive experience in civil design and statutory adoptions. She focuses on the early integration of sustainable drainage systems (SuDS) to enhance site biodiversity. Amy’s expertise in drainage design is vital for delivering cost- effective, nature-based solutions within sites.
perhaps the most efficient route to meeting BNG requirements while
managing carbon and cost. The NHS Dorset Health Village demonstrates this approach at scale.3
A
former department store was transformed into a modern primary care facility, with 70 per cent of decommissioned materials and equipment from a former Nightingale Hospital repurposed on site. This circular economy approach avoided the
SuDS features to be positioned where they can function naturally, using hydrophytic planting to support aquatic life and enhance local ecology without requiring complex pumping or attenuation infrastructure. Foundation design also plays a critical role in
preserving the existing ecological baseline. Root Protection Areas around mature trees can represent significant biodiversity units. Where site constraints demand building near established vegetation, smaller diameter piles, or cantilevered ground beams can be designed to allow for root zones without compromising tree health. This sensitive approach preserves existing units, making the 10 per cent biodiversity net gain calculation considerably more achievable. The Midland Metropolitan University Hospital2
serves
as a benchmark for integrated external works. In this instance, the drainage strategy was connected directly with the local canal network. This approach transformed a regulatory requirement into a genuine landscape asset, creating wetland habitats while managing flood risk and reducing reliance on grey infrastructure.
Charles Rothnie
Charles is a chartered senior structural engineer at Perega with over a decade of experience across diverse sectors. Notable projects include the rebuild of Huws Gray in Stockport following a large fire. Charles is also dedicated to advancing sustainable, low-carbon engineering, and recently achieved Chartered Engineer status with the Institution of Civil Engineers.
Navigating clinical and operational priorities For NHS estate managers, BNG is one consideration among many competing demands. Clinical safety, infection control, operational resilience, and whole-life costs must all be balanced alongside ecological targets. The challenge is finding solutions that serve multiple objectives simultaneously. This is where the timing of engineering involvement becomes critical. When structural and civil engineers are brought in after the strategic brief has been finalised, options become limited. BNG features are squeezed into whatever space remains. By contrast, early engagement allows the building’s structural DNA and surrounding site to be shaped around integrated ecological solutions. Phased development programmes offer opportunities
to protect biodiversity during construction. Careful sequencing of works can avoid vegetation clearance during bird nesting seasons, helping to maintain ecological corridors through the site and establish new planting ahead of demolition. These measures require minimal additional cost when planned from the outset, but become prohibitively complex when retrofitted into a locked-down programme. The adaptive reuse of existing structures represents
66 Health Estate Journal September 2026
carbon and ecological cost of new-build construction, freeing up capacity to invest in meaningful ecological enhancements to the surrounding landscape.
The clinical case for green infrastructure Beyond regulatory compliance, there is a growing evidence base linking biodiversity integration to improved patient outcomes. Several studies suggest a positive correlation between access to natural light and green spaces and improved patient recovery, including reduced hospital stays and decreased analgesic requirements.4 This evidence builds on pioneering research showing that patients with views of nature recover faster post-surgery.5 For estate managers facing pressure to improve patient experience and staff wellbeing, ecological design offers tangible clinical benefits. Maggie’s Leeds Centre6
provides a compelling
exemplar. The facility’s accessible green roof functions as a therapeutic sanctuary, with 17,000 plants that patients are encouraged to care for as part of their recovery. The structural design carefully positioned the roof garden to maximise natural light penetration while managing dead loads through strategic placement over zones with inherent structural capacity. For acute hospital settings, where outdoor access may be limited by operational constraints, carefully positioned courtyards, healing gardens, and views onto biodiverse landscapes can deliver similar benefits. The engineering challenge is creating these spaces without compromising clinical adjacencies or operational flow.
Redefining value engineering The traditional approach to value engineering viewed green features as discretionary costs to be stripped out when budgets tighten. With BNG now a statutory requirement, this mindset must shift. The question is no longer whether to deliver ecological uplift, but how to do so most efficiently. This requires engineers to move beyond the ‘bolt-on’ sustainability approach. Instead of adding green roofs and SuDS features to a conventionally designed building, we must embed ecological thinking into the fundamental civil and structural design. Integrating the structural grid with landscape vision from the outset creates multi- functional elements that minimise material waste. Early site appraisal, working closely with arboriculture experts, can inform building placement and foundation strategies that protect existing biodiversity units.
Alan Bennett, Media Imaging Solutions
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