Designing net zero buildings – is the NHS on the launchpad

Designing net zero buildings – is the NHS on the launchpad

Paul Warwick, Senior Project Manager
Paul Warwick, Senior Project Manager

Every Christmas, we make a charity donation on behalf of all of our GP practice customers. This time, it took the form of thousands of pounds given to the NHS Forest campaign – planting a tree for every practice in our 600+ buildings around the country. It’s fantastic to be supporting the efforts to improve the green spaces around NHS sites in any small way we can, but it was also a stark reminder of the scale of the net zero challenge that is facing the primary care estate.

It’s now a little over a year since the NHS became the world’s first national health system to commit to become ‘carbon net-zero’ for the emissions it can control, by 2040. The seeds have been planted, the NHS is watering them, and its estate must be part of the fertilizer.

With an initial target to reach an 80% reduction by 2028 to 2032, the multi-year roadmap was the first from the NHS to set out a list of milestones to decarbonise its healthcare services and infrastructure, to help the UK reach its overarching climate goals.

But the last year has brought into focus the complexity of the journey when set against the plethora of outdated properties used by the NHS from a different era, not least GP surgeries in large converted Victorian homes, former bungalows and converted offices.

Bridging the gap between the ambition and the unique, very practical challenges of reaching net zero in primary care buildings will take innovation like the primary care estate has never seen.

Design specs don’t make it easy. Many of you, I’m sure, will relate to the impact of natural light to promote wellbeing during your working day, giving you a connection to the outside and daylight. But making a building net zero often demands smaller windows to reduce energy loss. And how many of your practice buildings have front doors which are constantly opening and closing as patients walk in and out? You’ll already know how difficult these make it to minimise heat loss and reduce energy use in the colder months.

Pushing buildings closer to net zero also means thinking about the materials you use to construct them. A timber frame for a medical centre could drive down carbon considerably, but could send insurance rates skyrocketing. And at a time when the cost of raw materials is rising, the financial pressures don’t end with construction. Notoriously complex offset payments ‒ the last resort to compensate for the emission of carbon which can’t yet be designed out – remain a crucial part of the budget.

The 2019 Health Infrastructure Plan set out the broad approach to improving the NHS estate, and the recent launch of an Estates Net Zero Carbon Delivery Plan for the NHS. All work is seeking to meet the Government’s budgetary guidelines and NHS’s mandatory design requirements, so that new developments remain viable and affordable for the long-term. But in practice, many of these things are difficult to reconcile with the pace of change our climate requires.

We’re proud that many of our buildings already include sustainable technologies, such as West Gorton Medical Centre’s photovoltaic panels and heat retaining insulation, or Ardudwy Health Centre’s insulated timber frame and biomass boiler. We are driving towards 2026 from when we have pledged to deliver only buildings which are net zero for both their construction and operation.

As part of our SixbySix goals and our World Green Buildings Council Net Zero Buildings Commitment, we’re supporting this work with investment into moving every medical centre site we own to EPC B or better in the same timeframe – and work is already underway at our first cohort of GP practice sites for full LED lighting replacement.

These schemes and the research pilots we are developing with a number of GP practice customers around the country are showing us that net zero buildings should not cost the earth. Meeting this goal means thinking about natural ventilation, moving to more sustainable lighting and heating systems, improving insulation, and building performance. Simple changes such as setting windows back into their frame or reducing glazing on south-facing elevations reduces heat gain and flattens the temperature curve. Making buildings more modular and rectangular helps to match a timber frame more effectively ‒ probably the single biggest component in reducing embodied carbon.

These changes don’t demand an inordinate budget, and we already have the know-how to implement them. Applying these across all NHS schemes must become the norm, so that innovation can be focused on the more complex elements.

From little acorns, oak trees grow: your buildings can and must be part of that forest of the future.

If you’re looking for help on net zero carbon challenges at your building, contact Assura via

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