Climate Change Challenge A Sustainable NHS: “Build for Health & Reduce your Waste-line”

1. Climate Change ChallengeA Sustainable NHS: “Build for Health & Reduce your Waste-line” Sustainability & Energy Event – 30th April 2009

2. BUILD 4 HEALTH (B4H) LEGISLATIVE/GOVERNMENT IMPACT • Environmental Assessments Plans & Programmes Regulations 2004 • Sustainable & Secure Buildings Act 2004 • Environmental Liability Directive - April 2007 • EU Emissions Trading System - £££££ • Buildings Regulations 2006 – 2010; 2013; 2016; 2020 • Code for Sustainable Homes • Energy Performance of Buildings Regulations • Strategy for Sustainable Construction • Sustainable Development in Non Domestic Buildings • Energy End Use Efficiency Energy Services Directive - procurement • Climate Change Act 2008 - £££££ • Carbon Reduction Commitment (consultation) - £££££ Chancellor’s 2008 Budget Statement for “public sector buildings to be zero carbon by 2018” - £££££

3. B4H Why does the NHS need to use BREEAM? BREEAM is a Government requirement under: • Constructing the Best Government Client - Achieving Sustainability in construction procurement - Sustainability Action Plan • Sustainable Procurement National Action Plan • Sustainable Operations in the Government Estate • BERRs Strategy for Sustainable Construction • OGCs Achieving Excellence in Construction - Procurement guide 11 - Sustainability • OGCs Common Minimum Standards - For the procurement of built environments in the public sector - mandated with immediate effect "Ministers have now agreed the key minimum procurement standards, which are mandatory across Government, including departments, executive agencies and the non-departmental public bodies for which they are responsible. They will apply to any procurement of a built environment carried out in England for a public sector client, whether through capital procurement, a private developer scheme or a Public Private Partnership/Private Finance Initiative." • CLG have further guidance on sustainable construction & buildings plus consultation document 'Definition of zero carbon homes and non domestic buildings' • The Department of Health supports the Governments’ commitment to the sustainable development agenda and recognises the importance of delivering on this agenda through the design and build process. BREEAM Healthcare as the successor to NEAT is the continuation of that process to ensure standards continue to improve. This will be further reinforced through HTM 07-07 Sustainable health and social care buildings: Planning, design, construction and refurbishment • Saving Lives: Improving Health – NHS Carbon Reduction Strategy

4. BUILD FOR HEALTHB4H Why? • Sustainability is particularly relevant to construction • Scale - NHS - 130 hospitals built or under construction at a cost of £12bn • Built environment is responsible for: • 47% carbon emissions • 50% water consumption • 1/3rd landfill waste • ¼ raw material used in the economy • 60% of timber used • 20% of all noise complaints • 20% water pollution incidents Early Decision Points: • What do we want to achieve – strategic overview – long & short term • Identify who takes lead – someone who can take decisions • How to involve supply chain – gain share/pain share • How to monitor achievement against brief/specification i.e. performance indicators (BREEAM Healthcare) • Whole life costs for operational running and maintenance resource management • Use contractual provisions to empower and achieve progress

5. BUILD FOR HEALTH Some thoughts: • WRAP “Halving Waste to Landfill” • Significant savings can be made by targeting good practice • Contract specifications • Procurement – supply chain routes • 5 skip principal • Pain share – gain share £££££ • Invest to save : SWMP; site logistics strategy; training; materials storage; management time; segregation

6. Build for Health Some further thoughts: • Anaerobic digestion – biogas renewable energy technology from food waste by 2020 • Biomass fuel – from waste wood [2m tonnes wood = 2600 GWh electricity = saves 1.15m tonnes C02 ] • Defra ‘Recycle on the Go’ – bins in public places • Partnership with Local Authorities – sharing resources • Defra to develop a voluntary agreement with manufacturers to reduce plasterboard waste to landfill • NHS Forest – green spaces initiative – a tree per employee 1.3m • Others etc – what can you do? What the Department did ……….

7. B4H From NEAT to BREEAM: • Update to • Current best practice standards • Building Regulations 2006 • New Health Technical Memoranda (HTMs) etc • Credit filtering system to meet the scale of primary, intermediate and acute developments • Provide guidance early on in the procurement process • Training and technical support • Certification • New self assessment tool for Existing Buildings in Operation • B4H XB

8. B4H The Assessment Process: BRE Capital development scheme Independent Licensed Assessors Pre BREEAM advice Quality control Formal assessment IssueCertificate

9. B4H When to use B4H? http://www.breeam.org/page.jsp?id=105 • Not for schemes under £1m • Schemes under £2m use Pre Assessment Estimator • Yes for Schemes over £2m or that require Business Case approval; and • Refurbishment schemes where the area affected by works is 10% of the total building’s area

10. B4H - GUIDANCE • Health Technical Memorandum 07-07 “Sustainable Health and Social Care Buildings – planning, design, construction and refurbishment” • In support of BREEAM Healthcare • In association with the Government agenda • To pull together legislative strands • To advise on what makes a building sustainable and how to get there • For all involved in healthcare buildings

11. Techniques for achieving B4H in new builds/refurbishments • “A genuinely sustainable building is one that is sufficiently adaptable that it remains operationally useful throughout its structural life” • Includes guidance for all scales of project • Can be used as a checklist for new buildings, refurbishment and maintenance

12. DH HTM 07-07: Key Principles Sustainable Health and Social Care Buildings Justif-ication Scoping Procure-ment Commit-ment Cons-truction Post-Completion Operation End of Life PFI LIFT Broader Sustainability Principles BREEAM Topics BREEAM issues - Energy, Water, etc.

13. 1. Develop a vision Establish a clear vision for the project that: • Includes results from stakeholder engagement • Is bold and aspirational • Reflects your core values • Is broad enough to include community-scale requirements • Captures your sustainability objectives

14. 2. Set an appropriate brief Include sustainability within the brief: • Set minimum standards, ideally with benchmarks and targets • Indicate the relative importance of sustainability (e.g. % weighting on bid evaluation) • Express a clear need for whole life evaluation • Set requirements against the objectives in your vision

15. 3. Get the budget right Make sure the budget: • Reflects your vision and key sustainability objectives • Addresses the whole life costs, including energy bills. • Highlights the early-stage design decisions that deliver big wins for little cost

16. 4. Managing collaborative projects & ensuring contractors deliver your sustainability requirements Manage design & construction to deliver your objectives: • Named sustainability champions in design & building teams • Have regular reports and team meetings about sustainability objectives • Look at incentives and penalties for sustainability • Assess sustainability impacts of any changes

17. Managing collaborative projects ensuring contractors deliver your sustainability requirements A collaborative vision Lewisham Hospital identified the development control plan as a priority and requested additional information from bidding teams about the implications of their design on the plan. Lewisham also attracted extra funding to improve a park for local communities.

18. 5. Embedding SustainabilityKnowledge Base

19. BUILD FOR HEALTH • BREEAM Helpdesk = breeam@bre.co.uk • Tel = 01923 664462 • Visit = www.breeam.org • DH/Sustainable Development Commission • Good Corporate Citizen Model • www.sd-commission.org.uk/pages/work_streams/health.html • Waste & Resources Action Programme • Recycled materials/sustainability tools • www.aggregain.org.uk • Carbon Trust – Design Advice Service • www.thecarbontrust.co.uk • SHINE – Alliance for Sustainable Buildings • www.shine-network.org.uk

20. NEATBREEAM HEALTHCARE LORRAINE HOLME Sustainable Development Programme Manager DH Estates & Facilities Division Lorraine.holme@dh.gsi.gov.uk Tel: 0113 254 6328