Strengthening energy resilience in the healthcare sector

Resilience is no longer just about having an emergency plan in a drawer. It’s about embedding the ability to anticipate, absorb, and recover from disruption into every aspect of estate management. It’s about being able to withstand heat waves and winter storms. It’s about reducing exposure to cybercrime. It’s about reducing the impact of volatility on day-to-day operations.  

The stakes are high: when estates fail, patient care is directly impacted. For estates teams across the healthcare sector, this means rethinking energy strategy to ensure it’s a core enabler of continuity, safety, and sustainability. 

Understanding the risks: what are healthcare providers up against? 

Resilience planning starts with a clear-eyed view of the risks facing NHS estates today: 

• Physical risks: Flooding, overheating, structural failure, and power outages are becoming more common, especially for older sites with poor drainage or those near rivers. For example, repeated summer heatwaves push cooling systems to their limits, threatening both patient safety and equipment performance.
• Operational risks: Service disruption, staff shortages, and equipment failure can cascade quickly. A single power outage can halt critical care, disrupt surgeries, and compromise IT systems.
• Strategic risks: Non-compliance with evolving regulations, reputational damage, and missed performance targets are real threats. The NHS Green Plan Guidance and Net Zero Carbon Building Standard now require Trusts to address climate risk and infrastructure resilience as part of their core strategy.
• Cybersecurity risks: As estates become more digital, the risk of data breaches and system attacks grows. Estates teams must now consider not just physical, but also digital resilience. 

Within the NHS specifically, there’s also a range of policy drivers that underpin the importance of greater resilience: 

• HTM 07-02: Focuses on sustainable development and climate adaptation.
• NHS Green Plan Guidance: Requires Trusts to address climate risk and infrastructure resilience.
• Net Zero Carbon Building Standard: Includes resilience as part of sustainable design.
• ICS Infrastructure Strategies – Increasingly include resilience as a core theme. 

A holistic approach is essential, integrating technical, financial, and human factors into risk management. Estates teams should work closely with clinical leads to ensure that resilience planning supports care delivery, not just compliance. 

Practical steps: building resilience into healthcare’s energy strategy 

Building resilience doesn’t mean starting from scratch. It’s about making smart, strategic upgrades that protect services and support sustainability. The following steps are drawn from best practice across the healthcare sector, and provide a roadmap for estates teams: 

1. Assess and map risks 

• Conduct a thorough risk assessment across all sites, identifying vulnerabilities and prioritising critical systems
• Use scenario modelling and data insights to understand the likelihood and impact of different threats, from power outages to extreme weather 

2. Upgrade infrastructure for resilience 

• Invest in thermal upgrades, like insulation, shading, and passive cooling, to manage heat risk and reduce reliance on mechanical systems
• Implement flood mitigation measures, such as improved drainage, flood barriers, and site-level planning, especially for at-risk locations
• Design in redundancy: backup power, water, and HVAC systems ensure continuity during failures. Sites with on-site generation and battery storage have demonstrated the value of this approach during recent grid disruptions 

3. Embrace digital tools and predictive maintenance 

• Deploy smart sensors and remote monitoring to track energy, water, and equipment performance in real time
• Move from reactive to predictive maintenance, using data to anticipate faults before they become failures. Estates teams using digital platforms have reported fewer unplanned outages and faster recovery times 

4. Foster a Culture of Resilience 

• Create and regularly rehearse contingency plans for fire, flood, cyberattack, and utility failure. Cross-functional drills involving estates, clinical, and IT teams ensure everyone knows their role when disruption strikes
• Embed risk awareness into daily operations through regular training, transparent reporting, and learning from incidents
• Leadership is crucial: visible commitment from the top ensures that resilience is prioritised and resources are allocated effectively 

The role of partnerships to accelerate resilience 

Resilience isn’t something estates teams can deliver alone. It requires collaboration across estates, clinical leadership, IT, finance, procurement, and external partners. Long-term partnerships bring in the skills, technology, and delivery capacity needed to make resilience real, not just theoretical. 

Governance is also critical. Estates teams must embed risk awareness into daily operations, supported by: 

• Clear governance structures
• Regular training and drills
• Cross-functional collaboration
• Transparent reporting and learning from incidents
• Leadership buy-in to prioritise resilience and allocate resources effectively. 

Resilience is no longer optional. For healthcare providers, it’s about protecting services from climate and operational risks, supporting patient care and staff wellbeing, meeting regulatory expectations, and building infrastructure that’s fit for the future.