Sustainability in the Health Sector

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An Architects for Health event held on Thursday 14 October 2004 at The RIBA, London

This event was chaired by Richard Burton, speakers where:

  • Alex Abbey – Architect, Edward Cullinan Architects
  • Lorraine Brayford – Sustainable Development Policy Manager, NHS Estates
  • Bill Dunster – Director, Bill Dunster Architects / ZEDfactory
  • Professor Max Fordham – Founding Partner, Max Fordham LLP
  • Brendan Geraghty – Associate Director, TPS Consult – Carillion Group
  • Mark Hewitt – Director, Icax Ltd

Over the last five years, the profile of sustainable development within the health sector has been raised considerably. Several documents have been published by the NHS advocating sustainability in the design of health facilities and services, including Material Health – a mass balance and ecological footprint analysis of the NHS in England and Wales (2004), NHS Environment Assessment Tool (NEAT), Sustainable Development in the NHS (2001) and the New Environment Strategy for the NHS (2002).

To what extent are these initiatives influencing the procurement and design of health facilities and services? Is there a serious and co-ordinated sustainable development agenda being actively pursued by the NHS? What approaches and technologies are being applied to the health sector, and what further initiatives could be considered? What part does sustainability play in PFI developments? What lessons can be learned from the activities of other sectors, such as housing, commercial developments and education?

This event seeked to shed light on these questions and others through the examination of policy, technology, and recent building projects, in health and other sectors, incorporating a sustainability agenda.


The following article about this Architects for Health event which was written by Rosemary Glanville and appeared in Hospital Development magazine is reprinted with permission below:

Getting Sustainability firmly on the agenda

The recent Architects for Health meeting put sustainability firmly at the top of the health building agenda, with a wide range of speakers giving informed views on the possibilities open to us. The varying inputs took us from philosophy and policy to technical innovation and practical implementation through construction partnerships and design.

Richard Burton chaired and reminded us of the early initiative by Howard Goodman in commissioning the first low energy R&D project for St Mary’s, the new Isle of Wight hospital; a long term project supported by EU monies and producing 3 reports on the low energy developments in use.

Max Fordham with his usual clarity, demonstrated that the 1bn people with a high standard of energy use now, will inevitably extend to the total world population of 10bn thus reducing the current fossil fuels reserves from 400 years to 40 years. His suggested response was the need to reduce demand for energy by a factor of 10.

We moved from concern for the more distant future to the policy drivers of today for delivering the best environment for health. Loraine Brayford from NHS Estates Policy Division led us to the broader sustainability agenda with issues such as special waste regulations and the sustainable communities requirement. Her key message was the potential, with a building programme of 100 hospitals, to make an impact by demanding an “excellent” rating from the health buildings sustainability assessment tool, NEAT, for all new buildings.

Brendan Geraughty from TPS consultants, a wholly owned subsidiary of Carillion, took the Swindon hospital scheme as an example of best practice to date for 550m2 of hospital space. Carillon formed a partnership with Natural Step, but unfortunately not until after the ITN stage. Through workshops they formed objectives around flexibility, maximising repetition etc, and developed SAPs (sustainability action plans), reminding us that an integrated strategy is essential across the whole supply chain. A wide range of actions emerged such as: saving 20,000 lorry movements, recycling shuttering, reducing use of synthetic materials, increased insulation saving £50k on heating during the concession period, contractors sharing lorries for site deliveries and many more.

Mark Hewitt introduced us to the concept of seasonal heat transfer technology whereby seasonal solar energy can be collected and stored underground for use at another season. Any flat surface can act as a collector so that, for example, a road can store heat absorbed during the summer for use in warming roads in winter. Cooling can work in the same way. He described a demonstration project for the Carbon trust of using a school playground as a collector surface and parking the heat under the school building.

Other examples of implementation were the sustainable design strategies for the Edward Cullinen Millenium school and health centre buildings at Greenwich. Alex Abbey described the buildings on a brownfield site designed for passive solar energy within a masterplan framework set by Ralph Eskine with goals for the specification of natural materials, reductions in plastics. The solution is a south facing building with solar shielding and north facing rooflights delivering a 45% daylighting figure and using a ventilated building structure of precast slabs with ventilation channels.

Finally Bill Dunster brought us to the reality that by 2080 the temperatures in London would be as Marseille today and that by 2006 the demand for oil would overtake supply. He concurred with Max that we needed to reduce our energy demands to about 10% of current levels, pointing out that 1/3 was currently used in housing, 1/3 for “food miles” and 1/3 for transport. In describing his famous Bedzed housing development, with its density of 160 homes per hectare all with an outside space and its harnessing of ambient energy such as the 25% solar gain, he could see no reason why his principles could not be used for health care buildings. Lets hope he has an opportunity soon to develop these ideas.

AfH provided an inspirational evening as a timely reminder that the sustainability agenda is the most important issue we need to contend with in health building design today.

Rosemary Glanville, Hospital Development magazine

An Architects for Health Event – 14 October 2004

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