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How can healthcare reach net zero and what are the NHS’s decarbonisation plans?

In the final part of this decarbonisation series, Dave Archer looks at the healthcare sector and the NHS decarbonisation plans.

The NHS is one of the largest organisations in the world. It employs 1.2 million full-time equivalent staff and deals with 1 million patients every 36 hours.

The NHS estate reflects the scale of that undertaking, with 24 million square metres of property under its management.

Around 14% of those properties date from before the formation of the NHS in 1948, and 46% are over 33 years old.

Little wonder that it is responsible for 4% of the UK’s carbon emissions every year.

High-temperature heat pumps can now meet requirements for the high demand of sanitary hot water

Dave Archer Dave Archer National M&E Manager

Future targets

The NHS started to measure its carbon footprint back in 2008 and, since that time, has successfully achieved a 62% reduction in emissions. Now, however, it must go further. There are two key targets:

  • The NHS Carbon Footprint – emissions controlled directly by the NHS to reach net zero by 2040
  • The NHS Carbon Plus Footprint – emissions that the NHS can influence (i.e. in its supply chain) to reach net zero by 2045.

Achieving these goals would make the NHS the world’s first net zero national health service. But there is some way to go. The NHS must remove 6.1 million tonnes of CO2 equivalent (MtCO2e) from the NHS Carbon Footprint and 24.9 MtCO2e from the NHS Carbon Footprint Plus.

NHS Estates and supporting facilities services comprise 15% of the total carbon emissions profile.

There are plans for 40 new ‘net zero’ hospitals as part of the government’s Health Infrastructure Plan. These will be built to a new Net Zero Carbon Hospital Standard to be released soon.

But existing buildings, as those in the industry know, are the real challenge when tackling emissions.

Decarbonising heat

Decarbonising existing buildings in the healthcare estate has found some quick wins, such as switching to LED lighting. But a range of other areas for decarbonisation have been identified, and building services are high on the list:

  • Air conditioning
  • Space heating
  • Hot water
  • Ventilation

The NHS is already removing coal, gas and oil heating from hospitals, aiming to phase out these fuels soon.

Decarbonising heat is an important step, particularly in older hospitals designed to run on steam boilers.

Heat pump technology provides an excellent opportunity for many buildings in the NHS to switch to using electricity as the source for their heating, cooling and hot water needs. One of the reasons for the government’s strong support of heat pump technology is its energy efficiency.

Generally speaking, for every 1kW of electrical energy used, a heat pump can produce at least 3kW of heat energy.

While the UK’s electricity is becoming ‘cleaner’ every year, the government regards efficient use of this supply as crucial for long-term success in achieving net zero targets.

Without efficient technologies, it will be challenging to meet electrical demand from renewables and low-carbon sources alone.

How we can help

In the past, heat pumps were regarded as highly effective for supplying low-temperature space heating.

But recently, high-temperature heat pumps (such as our own QAHV model) have entered the market, offering hot water supply up to 90°C.

This means that heat pumps can now be applied in projects with requirements for the high demand of sanitary hot water with high peak demands, such as hospitals or busy GP surgeries.

The scale of change required in NHS hospitals and other buildings is significant. But by adopting low-carbon heat pumps wherever possible, there is a considerable opportunity to decarbonise heating, hot water and cooling.

The added benefit is financial help (through Salix funding, as I discussed in previous articles) for public sector buildings to access grants to adopt these technologies.

Climate change brings heatwaves, the easier spread of infectious diseases, and more intense storms and floods.

Higher air pollution is another problem exacerbated by rising temperatures, reducing our air quality and affecting thousands of lives every year. 

The NHS net zero goal is important not just because of the scale of the organisation but because the climate crisis is also a health crisis waiting to happen.


Dave Archer is National M&E Manager