The NHS has published a building standard to help it deliver a Net Zero Carbon health service by 2045. Phil Kelly and Sarah Chipchase from the Sustainability team at Ridge unpack what it means for healthcare projects.

What is the NHS Net Zero Building Standard?

NHS England has made a significant commitment to reducing its carbon footprint, across scope 1, 2 and 3 emissions. For its huge, 25 million sq m estate, it is targeting an 80% reduction by 2028-32, and Net Zero emissions by 2040. The NHS Net Zero Building Standard applies that overarching commitment to the healthcare estate. It requires NHS Trusts to report on all their embodied and operational emissions throughout the building lifecycle, and it sets carbon limits for new builds, major refurbishments and extensions.

No two healthcare facilities are the same, so the standard generates bespoke targets for a building’s energy use intensity, and the carbon emitted through constructing and maintaining it, based on the size and type of building and the equipment it contains.

The current standard is just the first of three versions: version two is due to be published in 2025, and version three in 2030. They promise to become increasingly stringent as the Net Zero deadline nears.

Does it require all-electric healthcare buildings?

Switching from fossil fuels to fully electric systems is necessary, because it will allow buildings to be powered by renewable energy as the grid decarbonises. But that’s not enough to qualify as Net Zero. The standard also requires that energy is used efficiently, because the grid does not, and will never, have an unlimited amount of renewable energy. This is the purpose of the Energy Use Intensity target (EUI) – to ensure that demand is reduced as far as possible.

How will this affect healthcare projects?

Over the last five years, it has become the norm to make accurate predictions of energy consumption and to calculate embodied carbon. But to achieve the standard, it will be necessary to think about them much earlier in the process.

The key thing is that it will significantly affect the brief that a healthcare client gives to their design team. If sustainability consultants become involved at the very earliest point in the design stage, we can suggest some relatively easy solutions. If you don’t think about energy or carbon until later on, trying to superimpose the standard on an existing design is much more difficult and potentially more costly.

How does the Net Zero Building Standard change the brief for a healthcare building?

A healthcare brief always needs to evolve, as different staff members and stakeholders provide their input. It can never be set in stone at the outset. But it will probably need to include a lot more information about technical feasibility and financial viability, and it will be necessary to work much more closely with the supply chain. Where do they get their materials from, how far do they have to travel, how familiar are they with modern methods of construction? Otherwise, there’s a risk that embodied carbon isn’t considered until a contractor is brought on board.

Similarly, ‘predictive energy modelling’ is not something that every consultancy is capable of. People used to talk about the performance gap between design and reality, where compliance-related calculations didn’t reflect the actual energy or carbon profile of the building. This is something the Net Zero Building Standard addresses. By using more robust tools to analyse energy and embodied carbon, we’re be able to make good design decisions that will produce the right outcome in reality. At the same time, it will fully enable lifecycle carbon decisions over a 60-year period, not just a 60-week period.

It’s also important that each NHS Trust has an overarching Net Zero strategy, which includes output specifications and performance criteria for its buildings. That way, the design team and contractor understand the parameters they need to meet, and the Trust can more easily evaluate their proposals.

What about BREEAM?

Achieving BREEAM is still an NHS requirement, but it’s more of a compliance tool – it shows that a certain standard has been achieved, but it doesn’t mean that the overall solution is the lowest in terms of Net Zero Carbon. But Version 7 of BREEAM promises to have much more focus on lifecycle thinking and making the right design decisions from the perspectives of energy and carbon. If Trusts are already used to Version 6 of BREEAM, they are in the right mindset for adopting the NHS Net Zero Building Standard. And the earlier they engage with the standard, the easier it will be to work with the new version of BREEAM when it comes in.

The nuances might be a little different in places, but the overall ethos and design targets are exactly the same. And for both, early engagement is the way to get the best outcome.

Phil Kelly is a Partner in the Sustainability team at Ridge. Working closely with all disciplines, Phil brings an expert focus to Sustainability, Net Zero and Circularity. Contact Phil at: philkelly@ridge.co.uk.

Sarah Chipchase heads up a team of specialists delivering sustainability projects from concept design through to construction in many sectors including defence, healthcare, education, industrial, commercial, public sector and residential. Contact Sarah at: sarahchipchase@ridge.co.uk