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Planning for Net Zero Healthcare Estates

Planning for Net Zero Healthcare Estates

Robert Dibden 06 Mar 2023
In July 2022, the NHS became the first health system in the world to embed net zero into legislation, through the Health and Care Act 2022. Identifying a route to net zero emissions for a complex system as large as the NHS is particularly challenging. The targets set are ambitious, and include reducing NHS emissions to net zero by 2040, with an ambition to reach an 80% reduction by 2028 to 2032. To support the co-ordination of these carbon reduction efforts, the 2021/22 NHS Standard Contract set out the requirement for trusts to develop a Green Plan to detail their approaches to reducing emissions.
The subsequent ‘Delivering a Net Zero National Health Service’ report published by NHS England in July 2022 provides a detailed account of the NHS’ modelling and analytics underpinning its latest carbon footprint, trajectories to net zero and the interventions required to achieve that ambition. The report serves to illustrate the huge scope and range of areas and interventions which form part of the NHS’ overall net zero targets but, as a town planner, also shines a light on the extent to which the continued development of healthcare estates must play a critical role. Along with specific guidance in terms of travel and transport, the supply chain, medicines, research, innovation and offsetting, estates and facilities are top of the list of direct interventions required to decarbonise the NHS.
Pathway to net zero for the NHS Carbon Footprint

Delivering a ‘Net Zero’ National Health Service, NHS England, July 2022

 

This largely reflects the fact that the estates and their supporting facilities currently comprise 15% of the total carbon emissions profile of the NHS. Delivering a net zero health service will therefore require work to ensure new hospital buildings are net zero compatible, as well as improving the existing estate.
Planning is a key component in the implementation of these changes. At Lichfields our work over recent years spans the full breadth of the healthcare estates sector, from masterplanning new healthcare campuses to obtaining planning permission for new hospitals and other, more fine-grained, development management projects. Based upon this experience, a number of trends are becoming apparent which could each have a crucial role to play in the transition to net zero estates. Broadly, and with a few examples, these fit into one of three key categories:

1. New Build

The most obvious, but also complex and expensive, means of creating new low carbon facilities for the future is to build new state-of-the-art energy efficient buildings. Lichfields obtained planning permission in 2021 for the redevelopment of Berwick Community Hospital in Northumberland on behalf of Northumbria Healthcare NHS Foundation Trust. Located in the heart of Berwick's historic conservation area, this new hospital designed by P+HS Architects will extend to around 10,000 m², costing £30 million and re-providing all existing hospital services currently available in the town, as well as an accredited endoscopy suite and GP practice.
The Environmental Impact Assessment prepared by Lichfields explained that the development adopts a fabric first approach to utilise ‘passive’ measures in the design of the hospital building. This includes measures such as enhanced U-Values, natural daylighting, exposed thermal mass for temperature stabilisation and natural or assisted natural ventilation where possible. The low and zero carbon technologies utilised will include a combination of heat pumps and photovoltaic panels. In addition, a gas supply will not be required for the building as the proposed ‘ambient loop’ system moves from traditional gas burning plant to de-carbonised in the future. Therefore, there will be no on-site emissions produced by the central plant in the future, which also helps to improve local air quality.

Berwick Community Hospital (Copyright P+HS Architects)

 

2. Refurbishment and Reconfiguration

Secondly, an alternative to the comprehensive demolition and redevelopment of brand-new facilities is the repurposing of existing buildings, whilst upgrading and updating their environmental performance. Lichfields has worked with Bam Construction Ltd and NHS Property Services on one such scheme at Whitby Hospital, which opened in September 2021.
The previous Whitby Hospital was constructed in 1979 as a comprehensive centre for all major health services. As service models have changed and evolved over the years, delivery in the community, in people’s homes and the creation of specialist centres have each reduced the activities which are undertaken in a generalist community hospital. At a cost of around £13 million this scheme, designed by Medical Architecture, sought to refurbish and configure the existing site and reduce its extent to around 4000 m². Again working within the constraints of a Conservation Area, the scheme demolished the surplus accommodation across part of the site, and focused development on the existing hospital tower, which was comprehensively refurbished and modernised to provide 21st century healthcare accommodation for 19 in-patient beds. A purpose-built extension to the tower provides a new entrance to the consolidated hospital, with better accessibility and legibility for those using the site. The resulting development was designed to achieve BREEAM ‘Very Good’.

Whitby Hospital, by Bam and Medical Architecture (Copyright: Eye Level)

 

3. Decarbonising Existing Facilities

Finally the most light touch form of intervention which is still likely to deliver real-world improvements in the environmental performance of healthcare estates, is the decarbonisation of existing buildings. In this regard, the Government’s ‘Public Sector Decarbonisation Scheme’ can provide grants for public sector bodies to fund decarbonisation and energy efficiency measures on large public buildings such as schools and hospitals. Phase 1 of the Scheme provided £1 billion in grants as part of the Chancellor’s ‘Plan for Jobs 2020’ commitment to support the UK’s economic recovery from COVID-19, supporting up to 30,000 jobs in the low carbon and energy efficiency sectors.
Funding through Phase 1 was awarded for the decarbonisation of North Tyneside General Hospital, equating to some £22 million. Working with Breathe Energy Ltd, Lichfields utilised a variety of development management processes, including planning applications, prior approvals and permitted development rights, to transform the performance of one of North Tyneside’s largest buildings through the introduction of a range of decarbonising measures; aiming to save 3,470 tons of CO2 per annum. This included obtaining prior approval for the installation of photovoltaic panels totalling an output of circa 975 kW, as well as planning permission for new air source heat pumps and boiler upgrades.
Each of these approaches in itself can make a meaningful contribution to the NHS’ net zero target. However they also serve to illustrate both the variety of interventions available (in terms of cost and complexity) and the need for a bespoke site solution, cognisant of the local planning context, in order to achieve best value from both an environmental and financial perspective.
Please get in touch with Lichfields’ Health and Education team if there are any ideas you would like to discuss for your own estates. You can see the full range of our expertise and experience on healthcare projects within our Sector Guide.

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Moving on up? Levelling-up town centres across Northern England
It has, without question, been a challenging year for our town and city centres. As the global pandemic continues and lockdowns come and go, a raft of the nation’s most famous retailers have disappeared from high streets across the country. As in the rest of the developed world, the Covid-19 pandemic has been a ‘game changer’ for the sector. With the growth in online shopping over the last decade or so, most centres had already devised strategies based on re-focusing their offer away from retailing and toward a leisure and food and beverage-based offer.
However, successive lockdowns have acted as a catalyst in speeding up changes in shopping behaviour, and impacted directly on the leisure and hospitality sector to the extent that it is now quite unclear how centres will function as restrictions ease.
In the North of England, our town and city centres have suffered more than most in recent years. While Covid-19 has sped up the process of change, even prior to the pandemic many centres were already experiencing major challenges due to both changes in shopping behaviour and weak underlying economic conditions.
The Government’s Levelling Up Fund Prospectus, published in March 2021, identifies a total of £4.8 billion to be invested over the coming years to support town centre and high street regeneration, local transport projects, and cultural and heritage assets across the country.
In addition to the Levelling Up Fund, as part of the Government’s wider package of interventions, there are three key funding streams, which have already seen a great deal of uptake across the North:
  • Future High Streets Fund – This fund seeks to allocate £830 million to help deliver transformative changes to struggling high streets;

  • Towns Fund – 100 cities, towns and areas have been invited to bid for part of this £3.6 billion fund designed for proposals which drive economic growth. In many places, town centres are integral to these schemes; and

  • High Street Heritage Action Zones – Seeking to transform High Street buildings which can help to fuel economic, social and cultural recovery.
Town centre stakeholders are responding with a range of radical and ambitious projects. These include strategic interventions by local authorities, including through the acquisition of shopping centres and use of Compulsory Purchase Order powers.
With innovative and ambitious strategies now in place in many towns – and Government funding available to support delivery - there are grounds for optimism over the future of our town centres.
Lichfields’ Insight, ‘Moving on up? Levelling up Town Centres across Northern England’, reviews the various different funding bids currently under consideration. Using this research, we have identified six key themes which underpin the different plans and strategies currently under consideration. These are:
  • Health and Wellbeing - With the demise of retail, we need to find a reason to draw visitors into town centres. As well as more pleasant and healthy outdoor spaces and experiences, this could also involve locating other essential services close to transport hubs where they can help to maintain footfall.

  • Education - Universities and colleges have long been key parts of daily life in our city centres. Opportunities exist to locate student populations in the heart of these centres, where they can contribute to vitality and viability.

  • Tourism - Many of the North’s town and cities have fascinating visitor attractions and dramatic physical and geographical environs. An ambitious and coherent tourism strategy should seek to make the most of these unique assets to drive trips to their town centres.

  • Heritage - The North has a rich and varied history, the remnants of which live on in many of our town and city centres. They can make a real contribution to the environment and attractiveness of these towns as visitor destinations.

  • Digital and creative - Whilst retail may never return to its previous levels, flexibility is required to re-purpose the floorspace left behind by these vacancies. Utilising new funding streams and planning reforms, space should be made to accommodate innovative small businesses which will contribute to the vibrancy and culture of town centres.

  • Town centre living - As retail space recedes, we need to ensure our town centres remain attractive places to live. As well as making an invaluable contribution to housing supply in our urban areas, maintaining a meaningful 24-hour population in town centres will in turn drive demand for services and facilities which contribute to the vitality and viability of the centres.
With these themes in mind, our Insight provides evidence across the North of innovation, optimism and ambition in the town centre sector, which means the future may not be as bleak as many sceptics would have you believe.

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