Sustainable Healthcare

Buildings

Sustainability options:
Costs and benefits

Growth Area RPHG Seminar

8th March 2005
complexity
Increasing Sustainability Agendas

Sustainable
Development
Sustainable
Communities

Sustainable built
environment

Sustainable
Construction

Increasing
Source: Sustainable Construction – number of actors
Future R&I Requirements, CRISP 1999
 Sustainable Communities
Key issues Responsibility

Regeneration

Development Cos

Urban integration

Clients/ designers

Engagement with the local
community

Sharing facilities
Key stakeholders

Training opportunities

Public transport
Planning (UDPs)

Etc……….
Local communities
 Sustainable Building
Key issues: Responsibility

Fitness for purpose

Clients & funders

Flexibility

Designers/advisors

Safety and security

User health and well-being

Energy efficiency Key stakeholders

Landscaping & biodiversity

Whole life value
Service providers

Etc……….
Users/staff

Building control

Constructors
 Sustainable Construction
Key issues: Responsibility

Contaminated land & waste

Constructors

Local employment

Clients/ advisors

Noise and disturbance

On-site health and safety

Pollution prevention Key stakeholders

Decanting and temporary
accommodation
Service providers

Etc……….
Users/staff

Neighbours
 Sustainable construction
Treatment of contaminated land (Photo: CIRIA)

On-site waste
recycling
(Photo: CIRIA)
 National Guidance & Targets Targets, guidance
Key Intervention Points
Trust identifies need

Making the case

Major Sustainability Intervention Points:

Strategic Outline Case Client
(SOC)
Advice, need
Outline Business Case
(OBC)

Public Sector Comparator

Benchmark (PSC) Benchmark

OJEC
Bidding & Selection

Pre-qual
Bid-team
PITN
Focus
Process

FITN

BAFO
Detailed
Preferred
Bidder negotiations &
contract
Financial Close (FC)
Final Business Case (FBC)

Construction

Compliance &
Operation & variations Variations.
Slide courtesy of Faber Maunsell
Operator engagement
BBC White City/ media village
Approach:

Public access to facilities

Site designed around a “high
street”

Significant landscaping
Benefits:

More community involvement

Better setting for staff

More facilities for staff
Design detail

Security between
ground & floor 1

Landscaping for
SUDS & ecology
Specific benefits

98% staff retention
(cf 85% prediction)

Local input to focus
groups and trainees
 Glasgow Homeopathic
Hospital
Approach: “I feel a calmness
here… so have a

A therapeutic garden space productive working

A courtyard form environment”

Maximum daylight and natural
“I wonder if you
ventilation realise how important
Benefits: it is for us… for its
environment to calm

Within standard cost yardsticks us, strengthen us and

Positive feedback from staff then send us out into
and patients – see quotes! the world to cope for
* Source: People & profit, CIEF/CIRIA 2004
another while”
 Fairfield Housing Co-operative
Approach: Original stats

Improve external environment (e.g.
landscaping)
80% unemployment

Improve site layout
75% wanted to leave

Design of low-allergenic houses
<33% occupancy
Benefits:

Increased occupancy (& hence rental
income)
Post-regeneration

Reduced crime (and hence costs of
anti-vandalism/ maintenance)
19% unemployment

Possible 30% reduction in the need
1% want to leave
for anti-asthma drugs (£500 pppa)
0 empty properties
* Source: People & profit, CIEF/CIRIA 2004
 Princess Margaret Hospital
Approach Investments

Waste minimisation

£47k energy

Use of recycled materials efficiency

Investment in energy efficiency
£147k social

Health & Safety on site measures

Liaison with local communities
Benefits Cost savings

£1,786,388 net
£384k energy use
environmental savings for
£434k waste
Carillion*

£1.15m materials
* Source: Sustainability Accounting in the construction industry, CIRIA 2002
 Specific examples

Daylighting - energy efficiency & IEQ

Landscaping and biodiversity

Energy - consumption and renewables
 Daylighting, energy efficiency
and internal environment
Costs

May be additional capital costs

May be additional design costs

Will require more thought

Benefits

Gains in staff productivity,
recruitment and retention

Improvements in patient recovery
rates

Reductions in energy costs

Other benefits e.g. wayfinding St Bartholomew’s Hospital
(photo: Greenhill Jenner Architects)
 Landscaping and biodiversity
Costs

May be additional capital costs

May be additional design costs

Will require more thought
Benefits

Evidence of impacts of natural
environment on health and well-
being of the building users
(patients and staff)

Links between external views and
daylighting/energy use
Royal London Hospital
(photo: Ecology Consultancy)
 Energy consumption and
renewables generation
Costs

May be additional design costs

May be additional capital costs

Will need more thought
Benefits

Reductions in operating costs

Managing the risk of future
energy cost rises

Watch out for who pays –
incentivise the contractor e.g.
volume risk shares in the
payment mechanism University of Gloucester - PV
(photo: Fielden Clegg Bradley & ESD)
Internal environment - benefits
Staff productivity,
recruitment & retention

Office Productivity Network

BA Waterside, RBoS HQ
(photo: Buro Happold)

Patient recovery

Bryan Lawson research

Roger Ullrich studies
 Further information

Good practice
BRE, NHS Estates, CABE etc.

Socially responsible construction:
Engage-construct – www.engageweb.org

Staff productivity and retention:
Office Productivity network –
www.officeproductivity.co.uk

Detailed sustainability costings:
- Sean Lockie, Faithful & Gould – www.fgould.com
- Isabel McAllister, Cyril Sweett – www.cyrilsweett.com
- Brendan Patchell, Bucknall Austen – www.bucknall.com