Annual State of NHSScotland Assets and Facilities Report for 2013

Annex C: Review of Energy Performance

In support of the aspirations of the Climate Change (Scotland) Act 2009, and the associated duties incumbent upon public sector bodies, NHSScotland Boards continue to be proactive in reducing energy consumption and associated greenhouse gas (GHG) emissions.

In the reporting year 2011/12, the cost of energy from NHSScotland's National Utility Contracts was c £85.2 million - a 9.38% increase on the previous year. However, absolute energy consumption from these contracts reduced by 9.73% in the same period² , reflecting the ongoing challenge of rising energy costs.

The above costs do not include NHSScotland Boards' costs under the Carbon Reduction Commitment Energy Efficiency Scheme (CRC EES). In 2011/12, this amounted to c £5.7million. Again, CRC EES costs are expected to increase significantly in future years.

NHS Boards³ continue to report their hospitals' energy consumption and GHG emissions under the HEAT Target (Phase 2). This requires a year-on-year energy efficiency improvement of 1% on all energy sources based on an overall improvement by 2050 of 33% (or one third) on the comparative performance as at the 2009-10 baseline year. This equates to a 10% reduction in energy performance by 2020. For 2011/12, NHS Boards had to achieve a 1.99% reduction in energy consumption compared with 2009/10.

The HEAT Target also requires NHS Boards to achieve a 3% year-on-year reduction in carbon dioxide (CO2) emissions from fossil fuels only, based on a 2009/10 baseline. For 2011/12, NHS Boards had to achieve a 5.91% reduction in energy consumption compared with 2009/10.

The HEAT Target performance figures for 2011/12 showed that NHS Boards' hospital sites reduced their energy consumption by 2.14% against the baseline year - 0.16% better than target. In the same period, CO2 emissions from fossil fuel use were reduced by 2.58% against the baseline year - 3.31% worse than target. The poorer CO2 performance was in part due to the installation of a new Combined Heat and Power (CHP) plant at NHS Grampian's main hospital site. As the current HEAT target calculation method does not include GHG emissions from electricity, the positive impact of the CHP on these could not be demonstrated.

During 2011/12, the average energy performance across the NHSScotland hospital estate was 452 kWh/m2 - a 4.4% reduction since 2010/11⁴. However, it would be misleading to recommend an absolute target KPI for all hospitals based on this figure. The NHSScotland estate is diverse, having a wide range of hospital types, such as large teaching hospitals and small community hospitals, and from widely varying construction periods, i.e. from the turn of the previous century to today. The table below shows the average energy performance key performance indicators (KPIs) for hospitals for the different NHS Boards for the last 3 years and future values if the present energy consumption reduction targets were carried forward and met.

Note that NHS Boards marked with an asterisk (*) have only one hospital site. KPIs for these NHS Boards may be misleading as they are being compared to NHS Boards with a mixture of hospital sites.

The dramatic reduction in energy consumption at the State Hospital is due to the completion of new premises. These have been designed to tougher energy performance criteria and are heated by biomass.

As evidenced by the 5.8% KPI reduction from the 2009-10 base year, NHS Boards continue to produce savings against a backdrop of national resource constraints. Assuming all hospitals achieve their HEAT targets, there would be an average 10% reduction in energy consumption by 2020 (against a 2009/10 baseline). However, this is considered to be a minimum target as NHS Boards continue to exceed energy efficiency targets.

Future Plans

Over the next three financial years, a widespread programme of energy efficiency projects will be carried out across the NHSScotland estate. The 'EcoHospitals' programme will see c £27million invested in a range of projects, leading to annual energy savings of over 69,000MWh - equivalent to c £7.3million per annum (2011/12 energy prices) and c 41,400 tCO2. Projects being funded under the EcoHospitals programme include:

• Pan-NHS upgrades to lighting systems, e.g. installation of energy efficient LED lighting, improved controls;
• Pan-NHS upgrades to heating and ventilation controls, including Building Management System upgrades;
• Installation of containerised biomass boilers at selected sites across NHS Highland, NHS Borders and NHS Dumfries and Galloway;
• Installation of a large biomass plant at Raigmore Hospital, Inverness;
• Installation of a theatre ventilation optimisation system at Glasgow Royal Infirmary;
• Conversion of selected sites from heavy fuel oil to gas (including Gartnavel Royal Hospital);
• Installation of wind turbines at two NHS Shetland health centres.

However, there is widespread consensus amongst NHSScotland Energy Managers that most 'quick wins' in terms of energy and carbon reduction have now been identified and implemented. If NHS Boards are to meet national climate change targets, and realise the other added benefits of a low carbon society, the focus must shift to additional 'spend-to-save' measures requiring extensive investment in healthcare estates.

Over the next year, an NHSScotland Energy Strategy will be produced that will identify the overall potential for further savings and a prioritised action plan for implementation. The initial phase of this work involves a desktop exercise to identify the worst performing sites across the NHSScotland estate. This will be followed by a series of comprehensive energy audits to identify potential remedial actions and routes to funding and procurement.