Is Net Zero healthcare really possible?
The NHS has set itself one of the most ambitious decarbonisation targets of becoming the world’s first Net Zero national health service. Given that healthcare is one of the most energyintensive sectors globally, responsible for almost 5% of all greenhouse gas emissions, is this possible and can the path to decarbonisation sit alongside or even support increased service demand provision?
As we’re all aware, the NHS is overstretched and underfunded, does adding sustainability goals to this mix muddy the waters when really the number one priority should be patient care? Steve McGregor, Executive Chairman for the DMA Group, thinks it’s possible, but only if change is delivered in a phased and affordable way.
To get Net Zero healthcare and building operators must start with the fundamentals and do them properly, focusing on an approach which begins with quick wins that can then help fund more major upgrades. In an ideal scenario, well planned sustainability initiatives will lead to significant fuel bill reductions; savings which can be reinvested in improved healthcare services.
To help deliver this decarbonisation, the NHS introduced a new Net Zero Building Standard, applicable to all new-build projects and upgrades to existing sites, with the aim of delivering a Net Zero health service by 2045. Sitting alongside this is the New Hospital Programme (NHP), which has recently been reignited and revised to include improvements to older sites, as well as around 40 new developments. Both schemes promise much, but for success to be achieved, we must first understand the challenge.
Understanding the NHS Net Zero challenge
The NHS estate is vast and varied. It includes cutting-edge acute hospitals, ageing community facilities, mental health trusts and a huge volume of legacy buildings that were never designed with energy efficiency in mind. Many are operating with outdated plant, poorly integrated controls and rising maintenance backlogs.
The NHS Net Zero strategy distinguishes between emissions the NHS controls directly – such as energy use in buildings – and those it can influence, including supply chains and pharmaceuticals. For estates teams, the most immediate opportunity lies in reducing operational energy demand, which in turn can equate to immediate savings.
Start with the basics: energy audits first
One of the most common mistakes organisations make is jumping straight to expensive low carbon upgrades – swapping out gas boilers for heat pumps, for example – without fully understanding how energy is being used, wasted or mismanaged. There are usually major improvements to building operations that will reduce carbon and cut fuel bills, which don’t cost the earth and can be implemented immediately, paving the way for enhanced efficiency when the time is right to invest in more major improvements.
Every credible Net Zero journey, therefore, must start with a robust energy audit, to identify where energy is being used and wasted: equipment running out of hours, poorly optimised ventilation, heating and cooling fighting each other, or controls that have been overridden and forgotten.
Getting BMS right
A crucial part of an energy audit should be checking that the building management system (BMS) is set up correctly and working as it should. Too often, we see BMSs that are underused with faulty sensors or switched off completely. When working properly, a BMS enables continuous optimisation: adjusting plant operation in real-time, responding to occupancy, weather and clinical demand. BMSs also provide the data needed to demonstrate progress against Net Zero targets and to make informed investment decisions. For any building owner or facilities manager thinking of integrating artificial intelligence (AI) into operations, accurate data collection is crucial.
Improve energy security with solar PV and battery storage
Once demand has been reduced and controls optimised, on-site electricity generation becomes far more effective. Solar photovoltaics (PV) is now a mature, proven technology, particularly well suited to healthcare sites with large roof areas and predictable daytime energy use. When paired with battery storage, it allows trusts to smooth peak demand, increase resilience and reduce exposure to fluctuating energy prices.
At the time of writing, there is extreme volatility in the markets thanks to our ‘friend’ Donald Trump. Self-generation has never been more attractive, with a return on investment swift. Individually, and as a country, we need to improve our energy security, making a move to PV and battery storage a future-proof investment for savvy healthcare estates.
At Rye Community Hospital, DMA worked closely with the trust to take a whole system view, combining energy efficiency, controls optimisation, solar PV and storage. The result was the UK’s first Net Zero hospital of its type. We started this journey with an energy audit, focused on the quick wins that would deliver instant returns such as fan upgrades, and swapping to LED lighting, and now, Rye hospital stands as an exemplar for the right way to do things.
At Rye, the reduction in energy consumption and operating costs freed up resources that could be reinvested directly into patient care. Improved environmental conditions also created a more comfortable space for patients and staff alike.
This is a critical point: decarbonising the healthcare estate is not just an environmental imperative; it is a clinical and operational opportunity.
New hospitals, new standards
The NHP is a once in a generation opportunity to embed Net Zero principles from the outset. New hospitals should not simply meet today’s standards; they must be designed for the next 40 or 50 years. That means prioritising fabric efficiency, flexibility of use, digital integration and wholelife carbon performance.
However, we must also be realistic. New-builds alone will not deliver Net Zero for the NHS. The vast majority of the 2040 estate already exists today. Retrofitting, upgrading and optimising existing buildings will determine success or failure.
What we need now is consistency: clear standards, realistic funding models and partners who understand both healthcare and energy systems. Rye Community Hospital shows what is possible. The challenge now is to replicate that success across the NHS estate: not as an exception, but as the norm. It is a clinical and operational opportunity.
