AIR HANDLING UNITS
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Ventilation upgrades must be at the heart of new NHS Investment
Matt Maleki, business development manager and IAQ Specialist at Carrier, discusses turning urgent NHS ventilation upgrades into an opportunity for long-term air quality improvement
L
ast year, a major UK government funding commitment put ventilation firmly back on the healthcare agenda. Announced in the June 2025 Spending Review, nearly £1.2 billion was earmarked for urgent infrastructure repairs across hospitals and schools, including £750 million for more than 400 NHS and mental health facilities. Positioned under the government’s Plan for
Change, the funding recognised that public service buildings had reached a critical state of disrepair. It also opened a valuable window for NHS trusts and estate managers to act on one of the most important, yet often overlooked, aspects of building health: indoor air quality (IAQ). With the NHS estate repair backlog approaching £15.94 billion, investment in air quality is needed to support compliance, patient safety and resilience. Encouragingly, the government’s Estates Safety Fund explicitly identifies new air handling units among eligible works.
Efficient buildings are healthy buildings
In healthcare settings, air quality is a clinical asset. It affects patient outcomes, infection control, staff well-being, absenteeism and long-term resilience. Yet many NHS hospitals still operate with ageing HVAC systems that no longer meet today’s performance, safety or sustainability standards. Leaking roofs, broken windows and poor insulation compound the issue, creating conditions for damp, mould and airborne transmission risks. Poorly ventilated healthcare settings encourage
moisture build-up and biological pollutants, particularly mould. For immunocompromised patients, this can pose a serious respiratory threat. The Building Engineering Services Association (BESA) has highlighted the link between poorly maintained HVAC systems and respiratory illnesses and airborne infections, as spores and pathogens circulate through ductwork and shared airspace. Outdated air handling units (AHUs) and fan
coil units (FCUs) make matters worse. Many now fall short of current air quality expectations, with deteriorating performance leading to inconsistent airflow, inadequate filtration and rising energy use.
HVAC upgrades for immediate IAQ concerns
Full system replacement may be necessary in some cases, but where budgets are constrained, healthcare buildings need a cost-effective, less
26 September 2026
Above: Matt Maleki, business development manager and IAQ specialist at Carrier
disruptive alternative. Retrofitting existing HVAC systems offers a practical route to better air quality. Around 750,000 medium-to-large-scale HVAC units in the UK, including AHUs and FCUs, are currently operating below their potential. Many do not need replacing; they need rethinking. That is where service, repair and refurbishment
come in. Upgrading fans, filters, coils and controls can extend the life of an AHU or FCU by a decade or more. A phased, in-situ refurbishment approach can
improve IAQ and reliability without major disruption, which is essential where operational continuity is non-negotiable.
From crisis response to future readiness
COVID-19 brought air quality into the spotlight, but healthcare has long needed ventilation systems that go beyond minimum compliance. Guidelines such as BS 40102 and Eurovent’s IAQ recommendations are raising the bar on CO2 levels, airflow rates and temperature stability. NHS guidance is also pushing estates toward higher-performance filtration and cleaner, quieter HVAC technology.
Proactive service models
The success of any upgrade depends on how it is managed over time. Carrier’s life cycle asset management approach helps estates teams move from reactive repair to predictive care. Platforms such as Abound HVAC Performance provide real- time system insights, helping managers identify inefficiencies early and plan maintenance around actual performance data. This is not ‘nice to have’ technology; it supports
decisions that reduce downtime, energy consumption and unplanned costs. When trusts must deliver better outcomes with tighter budgets, that foresight matters. It also supports sustainability goals. Refurbishing
existing systems reduces waste, conserves materials and avoids the carbon impact of manufacturing and transporting new equipment. With volatile energy costs and NHS climate targets ahead, retrofitting rather than replacing makes sense.
Turning government funding into long-term gains
With government funding now directed toward fixing healthcare buildings, the timing is right. But this funding will not stretch far unless used wisely. HVAC upgrades that combine refurbishment with smart monitoring and service offer a low-risk, high-impact way to improve care environments. The case for smarter ventilation has never been clearer. Healthy buildings are essential to healthy outcomes. By focusing investment on HVAC refurbishment and IAQ improvements, supported by digital tools and expert service partners, NHS estates can take manageable steps toward safer, more resilient facilities.
Estates teams must now act decisively, identifying
where ventilation and air quality improvements will have the greatest impact. Done well, trusts can turn emergency maintenance into measurable gains in safety, sustainability and performance. At Carrier, we are committed to helping trusts
make informed decisions about HVAC assets, backed by service expertise, reliable data and an understanding of real-world estate constraints. In a sector where every decision counts, our goal is to put the air we breathe at the centre of the conversation.
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