Shine a light

The NHS’s current building programme offers a once-in-a-lifetime opportunity to influence the performance of its built estate.
25 per cent of hospitals are being replaced or upgraded; 100 new hospitals are to be provided by 2010; and up to 3,000 GP premises are being built, replaced or refurbished. Through these buildings, the NHS has significant environmental impacts every year, including consuming 45 million GJ of energy; generating 3.4 million tonnes of CO2 emissions; and using 40 million m3 of water.
SHINE – the learning network for sustainable healthcare buildings – has been developed to help NHS Trusts improve the sustainability performance of their new build projects by providing them with guidance, case studies, events and training, covering all aspects of sustainability and how it can be delivered through NHS procurement processes. SHINE is a partnership between leading healthcare, sustainability and built environment organisations, including the DH, Partnerships for Health and other key charities and organisations.

What are sustainable healthcare buildings?
On a human level, defining sustainable buildings is fairly simple - it means balancing the economic, social and environmental factors of a building project to maximise the benefits the building can bring to the local community and economy whilst minimising the impact of the building’s construction and operation on the environment.
In other words, sustainable buildings are: “Buildings that are safe, healthy and productive for their users and owners, make a positive contribution to their local surroundings, and have a minimal impact on the local and global environment both today and for generations to come”.
For healthcare buildings, we can break this down into a series of ten key principles covering both the performance of the buildings themselves and how they interact with their local surroundings:

  • Integrating with the local neighbourhood and promoting regeneration
  • Meeting the needs of and providing extra facilities for local communities
  • Providing accessible transport options for all members of the community
  • Delivering cleaner, greener and safer public spaces that are rich in biodiversity
  • Using resources (e.g. energy & water) efficiently
  • Providing flexibility and adaptability to meet changing service needs
  • Considering whole life performance, including long-term asset value
  • Providing a quality internal environment to support health and well-being for users
  • Using materials that reduce environmental and health impacts
  • Reducing pollution and waste to avoid health and other impacts.

Obviously, sustainable buildings should also be delivered through sustainable processes, including effective stakeholder engagement and on-site construction activities, such as managing health and safety requirements on site; avoiding nuisance and disruption for staff, users and neighbours; and minimising waste, pollution and environmental damage.

Why is this important?
There are many reasons why it is important to improve the sustainability of healthcare buildings:

  • To improve the efficiency of service delivery. Sustainable buildings can improve the quality of the patient environment, reduce patient recovery times and increase the productivity of a Trust’s workforce.
  • To increase the long-term usability and value of the building. Taking a long-term view will increase the flexibility and adaptability of a building to meet changing service requirements.
  • To reduce costs and access additional funding. Additional funding can be obtained from non-health sources to help improve the quality of a project – some projects have even been funded from 100 per cent non-health sources.
  • To provide additional facilities for staff, users and local communities. Developing partnerships with local communities and organisations can improve the hospital environment, increase staff and user satisfaction, and improve local ownership and involvement with the Trust.
  • To improve public health among local populations. Providing public green space, encouraging walking and cycling, and reducing pollution from engineering and waste systems can all significantly improve public health.

A few statistics about the environmental impacts of the NHS should help to highlight why, in environmental terms, it is important to take a sustainable approach. Each year, the NHS generates 3.4 million tonnes of CO2 emissions, creates over 350,000 tonnes of waste and uses about 40 billion litres of water. Although these figures look daunting, improving the performance of NHS buildings can help to make a difference in reducing all these impacts.

What should Trusts and PCTs do?
There are many policy and approval reasons why Trusts need to focus on the sustainability performance of their buildings, such as local planning and building control requirements; NHS policies and funding approval requirements; and national and local Government policies.
Some of these policies are simply good practice guidelines, others can prevent or delay the approval and delivery of a project. For example:

  • NEAT – all new NHS buildings are required to achieve a NEAT “Excellent” environmental performance ratings; refurbishment projects must achieve “Very good”.
  • Energy Targets – all new buildings are required to meet the NHS energy performance target of 35- 55 GJ/100m3.
  • Planning policies – many local authorities now require 10 per cent of energy requirements to be provided from renewable sources.

Sustainability aspirations should be considered from the very start of the procurement process, ideally even before firm details of the service requirements are in place. This will allow maximum flexibility to consider the need for and location of any buildings required, long before these are tied down by restrictions on the layout and form of the building design. However, for Trusts that have already embarked on the process, there are lots of steps that can still be taken to help deliver a more sustainable solution.

How SHINE can help
SHINE provides guidance modules, detailed guidance and case studies to show what can be done at each stage of the procurement process and to demonstrate particular improvements that have been made on real projects by other NHS Trusts. We also run outreach and training courses to explore how to include sustainability requirements into the procurement process.
If you have embarked on a new building project, or are about to do so, please make contact with the SHINE project team or come along to one of our events to find out more about the services we offer and how we might be able to help you improve the sustainability performance of your project.

The SHINE network was launched in 2006 and is supported by the Department for Health Estates & Facilities, the London NHS, Partnerships for Health and Procure 21, as well as several charities and other organisations. Its programme is delivered by CIRIA, Forum for the Future and the Sustainable Development Foundation.

For more information
Phone: 020 7549 3300

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