Decarbonising the healthcare sector

Why is decarbonisation so hard for the healthcare sector? 

The decarbonisation challenge is significant: 

• Competing priorities: Clinical demands always come first. It’s hard to justify a boiler upgrade when new diagnostic equipment is needed.
• Fragmented estates: From Victorian hospitals to modern clinics, every site is different, making a unified strategy almost impossible.
• Budget constraints: Every pound is scrutinised. Long-term savings are clear, but upfront investment is tough to secure.
• Disruption aversion: Even minor works can disrupt patient care, so projects must be carefully timed and coordinated. 

But estates teams are at the heart of the decarbonisation journey. Their work creates safer, healthier, and more resilient environments for patients and staff. The link between estates and clinical outcomes is real and urgent: 

• Cleaner air means fewer respiratory admissions.
• Comfortable, well-lit spaces aid recovery and staff wellbeing.
• Resilient infrastructure keeps services running during heatwaves, floods, and power outages. 

If we get this right, sustainability becomes a clinical enabler. Every energy project should enhance care delivery, infection control, and operational resilience.  

Turning net zero targets into ambition in healthcare 

In the UK, the NHS has made bold, legally binding commitments: net zero for direct emissions by 2040, and for its wider supply chain by 2045. In Ireland, the HSE has mandated they will deliver a 51% reduction in emissions by 2030, and get to net zero emissions by 2050. 

But for those on the ground, the question isn’t “why”, it’s “how”. This simple four-step approach can help estates teams plan and deliver decarbonisation: 

1. Energy efficiency: Start with the basics, like LED lighting, insulation, and building management system (BMS) upgrades.
2. Electrification readiness: Upgrade electrical infrastructure to support heat pumps and EV charging.
3. Low-carbon heat: Replace fossil fuel systems with Heat Pumps or district heating.
4. On-site renewables: Install Solar PV, Battery Storage, and smart energy management. 

Each step builds on the last. It’s not about doing everything at once, but about creating a scalable, cost-effective roadmap that fits each estate’s unique needs.  

Not sure where to start?  

Choosing the right solutions is the first step. Getting stakeholder approval proceed is the second. When building your business case, consider: 

• Leverage data: Use energy audits, digital monitoring, and smart systems to prioritise and justify investment.
• Engage stakeholders: Early involvement of clinical, operational, and finance teams ensures alignment and buy-in.
• Ensure regulatory compliance: Align with all regulatory considerations, including NHS Net Zero Building Standard, BREEAM, and local planning requirements.
• Build partnerships: Work with suppliers and experts who understand healthcare pressures and can deliver real change.
• Funding and procurement: Explore innovative funding models and procurement frameworks that prioritise sustainability outcomes.
• Identify ‘no regret’ opportunities: Think about LED upgrades, building controls optimisation, and small-scale solar.
• Embrace digital: IoT sensors, digital twins, and AI-driven optimisation can transform estates from reactive to proactive. 

Decarbonisation isn’t optional, it’s essential. For estates teams, it’s a chance to cut emissions, improve patient and staff environments, unlock funding, and build resilience for future challenges. The journey is daunting, but the rewards are immense.