This research project aimed to find out more about improving the sustainability performance of existing healthcare buildings. It acknowledged that the vast majority of healthcare buildings have already been built, and that the context for public spending means that few new healthcare facilities will be built over the coming years. Instead, the focus of attention will switch to how we can improve the existing estate.

The research covered all aspects of sustainability, but energy use and CO2 emissions were the principal focus points. We were encouraged by the Estates and Facilities Division of the Department of Health to include climate change adaptation in the research, which we did. Other aspects of sustainability that we included in the work were:

  • Water use
  • Travel and transport
  • Green space and landscaping
  • Waste and recycling
  • Providing a high quality internal environment
  • Whole life costs and investment appraisal
  • Low impact materials • Improving historic/listed buildings, and
  • Providing facilities for local people.

There were three basic objectives of the work. First, to understand how to improve existing buildings on sustainability issues. Second, to make recommendations to the Trusts we studied – and to a wider audience – about how to improve. And third, to write guidance on meeting climate change targets, adaptation and other climate change issues.

CIRIA, The Sustainable Development Foundation and Forum for the Future worked in partnership to carry out the work, with CIRIA coordinating. We were supported by the Department of Health and funded by the National Institute for Healthcare Research.

This report is divided into four sections:

Section 1 – Methodology

Describes how we carried out the research.

Section 2 – Overview

Summarises our findings, including a short description of each Trust or building in the study, and the main findings from each of them.

Section 3 – The case studies

Provides detailed descriptions of all six case studies, including energy and climate change emissions for all of them, and focusing on the other aspects of sustainability for Trusts that felt they were important.

Section 4 – Recommendations

Draws out the key recommendations from all of the case studies, and includes two tools for other Trusts. The first tool helps Trusts to assess themselves and work out their own priorities in terms of sustainability, while the second allows them to see where they are in the sequence of upgrades aimed at improving carbon dioxide emissions from their buildings, and plan what to do next.