2010 ctv024 hospitals
TRANSCRIPT
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Sector overview
HospitalsHealthy budgets through energy efciency
enter
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Preface
Reducing energy use makes perfect business sense; it saves money,enhances reputation and helps everyone in the ght againstclimate change.
The Carbon Trust provides simple, effective advice to help organisationstake action to reduce carbon emissions. One of the simplest ways to dothis is to use energy more efciently.
This overview for hospitals introduces the main energy savingopportunities for the sector and demonstrates how simple actions
save energy, cut costs and increase comfort for patients and staff.
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Energy management within hospitals
Achieving energy and carbon savings in hospitalsrequires strong leadership from the front – ideally by thechief executive and an ‘energy champion’ at board level.Demonstrate commitment through:
Publicly endorsing the organisation’s energy policy•
Empowering staff to take action•
Encouraging a willingness to explore energy•
saving opportunities.
Strong commitment from the top underpins all energysaving initiatives undertaken throughout the hospital.
Who is this publication for?
Focusing on low and no-cost measures with quickpaybacks, this overview will help facilities and energymanagers to:
Assess the potential for energy savings and indicate•
key areas for improvement
Raise awareness and motivate action across the•
whole site
Prioritise activities to maximise savings.•
The UK’s healthcare sector spends more than £400million per year on energy. Unfortunately, a signicantproportion of this is wasted, meaning that moneyis being wasted too. Implementing a few simpletechniques can help to reduce the amount of energy
consumed in a hospital, which releases important fundsfor use elsewhere. Furthermore:
Energy efcient buildings provide better indoor•
conditions for patients and staff
Taking control of energy usage will enable a hospital•
to achieve mandatory Government targets
Energy efciency campaigns can go beyond•
departmental boundaries, improving general morale
Hospitals can publicise their energy efciency•
achievements, generating a positive image tostakeholders and the local community
The environment will benet from reductions in•
carbon emissions and energy use, which helps topreserve fossil fuels and minimise climate change.
A signicant number of healthcare units are alreadyfeeling the value of these benets.
IntroductionImproving energy efciency in healthcare is about making the most of the energythat is used – without compromising the comfort of patients and staff.
Carbon Reduction Commitment
The Carbon Reduction Commitment (CRC)Energy Efciency Scheme is an emissionstrading scheme aimed at reducing carbonemissions in large non-energy intensiveorganisations by 1.2 million tonnes of carbonper year by 2020.
It is a mandatory scheme, targeting emissionscurrently not included in the EU EmissionsTrading Scheme or Climate Change Agreements,and will apply to organisations that used morethan 6,000MWh of electricity through half-hourlymeters during 2008.
See our website for more about CRC
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Energy consumptionEnergy consumption in hospitals is growing steadily. Electricity already accounts forover 50% of a hospital’s energy costs and with the increased use of specialist medicalequipment that generally relies on electricity, consumption is set to increase.
There are still many opportunities to achieve energyand cost savings just by implementing a few basicmeasures. The chart on page 5 details where thebiggest savings can be made: in heating, hot water,lighting, ventilation and the effective use of electrical
equipment.
In each of the key consumption areas identied inthe chart above, there are three main oppor tunitiesto save energy.
Switching off – all energy-consuming equipment shouldbe switched off when not required. This can be donemanually by staff or automatically with special devices.
Maintenance – a number of energy efciencymeasures can be carried out as part of routine
maintenance procedures at no extra cost.
Refurbishment – energy saving measures takenwhen planning major refurbishment can be extremelycost-effective.
Specialist help
Enco 2de 2006 and its accompanying CD-ROMis the primary guidance on energy efciencyin NHS healthcare facilities. It provides a one-s topshop for all issues relating to the procurementand management of energy in the NHS. Enco 2deis not prescriptive and draws together bestpractice guidance so that healthcare organisationscan determine a way forward that best suitstheir situation.
Enco 2de is funded by the Carbon Trust and writtenby the Building Research Establishment (BRE) as acollaborative project between the Department of
Health, NHS Scotland Property and EnvironmentForum, Welsh Health Estates and Northern IrelandHealth Estates.
This publication and its accompanying CD-ROMis available from TSO (The Stationery Ofce).Visit www.tsoshop.co.uk for ordering information.
NHS trusts in England and all UK Governmentdepartments can download core guidance (HBNs,HTMs etc) from the Estates Knowledge andInformation Portal (KIP).
A free synopsis is available to download fromthe Carbon Trust website: Health TechnicalMemorandum: Enco 2de (CTC605) .
There are various other Government-funded
schemes that offer specialist support to healthcareorganisations seeking energy saving opportunitiesand guidance on appropriate actions. Contact theCarbon Trust for more information.
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The European Energy Performanceof Buildings Directive (EPBD)
This Directive promotes improvement in the energyperformance of buildings, taking into account outdoorclimatic and local conditions as well as the internalenvironment and cost-effectiveness. The Directiverequires hospitals with oor areas over 1000m 2 toproduce and display energy performance certicates ina prominent and public location.
Figure 1 Energy consumption in a typical hospital,by end use
Air heating
Space heatingFans
Hot water
Catering
Lighting
Sterilization
Humidification
Small power
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Opportunities for energy savingThere are many energy saving measures thathospitals can implement without affectingpatient comfort or well being.
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Heating
Obtain feedback
Encourage staff to report any areas that are too hot,cold or draughty. Investigating problem areas can help
to identify maintenance issues. If these issues areaddressed, staff and patients are less likely to adjustthe temperatures by opening windows whilst heatingor cooling is on, or bringing in por table electric heatersor fans.
Maintain appropriate internal temperatures
Temperature settings should reect the activity takingplace in the area. A good starting point is to know the
recommended temperatures for specic areas inhospitals and these are outlined in the table below.
Heating and hot waterEliminating energy waste does not have to compromise patients’ comfort.
Most managers recognise the importance of having aneffective heating system to keep patients and staffcomfortable. A good heating system is an efcient oneand it is often possible to reduce energy wastage whilstimproving internal comfort conditions at the same time.
Costs can be reduced by setting appropriatetemperatures and ensuring that heating equipment andcontrols are operated and managed correctly. In fact, it ispossible to save up to 30% on heating costs through theimplementation of some simple energy saving measures.
Room type Temperature ºC
Bedheads/wards 22–24
Circulation spaces/wards 19 –24
Consulting/ treatment rooms 22–24
Nurses’ stations 19–22
Operating theatres 17–19
Source: CIBSE, Heating Guide B1.
RememberPatient welfare comes rst, so seek furtherguidance before turning the heating down.
Biomass heating
The guidance on the Carbon Trust website
can help you evaluate the effectivenessof implementing biomass at your site.
Tell me more about biomass.
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Keep the heat in
Easy access to hospitals is imperative at any timeof day or night. However, open doors allow warmedair to escape and cold air to enter. The thermostat thensenses a temperature decrease and automaticallyswitches on heating which may be unnecessary.The same happens with cooled air in warmer months.Try to keep external doors open only when absolutelynecessary. Alternatively, install automatic doors or adraught lobby, particularly in frequently used buildingentrances. Lobbies should be large enough to provideunrestricted access and enable one set of doors to beclosed before the other is opened. Where possible,the two sets of doors should have automatic control toincrease ease of access and help keep heat in.
It is important to ensure time settings are reviewedevery month or so to check that they are correct. Manysystems function inefciently because someone made ashort-term adjustment and then forgot about it –
for example, in waiting areas of specialist wards withoccasional extended hours. Although heating or coolingmay be required during these extra hours, buildingservices (such as heating, ventilation and lighting) shouldbe set so they revert back to normal operating timesoutside these periods to minimise energy wastage.
Zoning
Hospital buildings frequently have areas with different
time and temperature requirements such as in waitingareas or individual private rooms. This can beproblematic where only one overall heating or coolingcontrol system exists. In this instance, consider dividingthe area into zones with separate controls for heating(other systems such as lighting can also be zoned in asimilar way). As well as saving money, the extra controloften results in increased comfort for patients and staff.See the Carbon Trust’s Heating control guide (CTG002) for more information.
Check controls
Some signs of poor control in hospitals include:
Heating being on in unoccupied areas, because timers•
are not set correctly
Heating being on too high or not high enough,•
because the thermostat is located where sunlight,draughts, radiators or equipment affect the reading
Thermostats being set to maximum, because staff•
believe this will make the space heat up faster. It doesnot; it simply results in overheated space.
Check controls thoroughly and regularly. Ensure systemoperating hours match the times when heating,ventilation and cooling are required, as needs varythroughout the day. Fit simple time switches in smallerspaces, such as treatment and consulting rooms,to automate this process. Investigate CHP
The Carbon Trust can help you nd out ifcombined heat and power is suitable for your sitewith our range of tools, guides and advice.
Is CHP right for me?
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Consider combined heat and power (CHP)
In an appropriate application, CHP can reduce ahospital’s energy bill by around 20–30%. Hospitals aregood candidates for CHP due to their year-rounddemand for heat. Further information is provided in theCHP section on page 27 .
Localise control
A thermostatic radiator valve (TRV) is a simple controlvalve with an air temperature sensor, used to control theheat output from a radiator by adjusting water ow.Correctly tted and operated, TRVs can provide efcienttemperature control in areas which have different usagepatterns, such as treatment and consulting rooms.
Upgrade controls
Many existing systems have old, inefcient time controls.Upgrading them is worthwhile as they can pay forthemselves very quickly through savings on energy bills.
Sophisticated heating systems can adjust themselves inline with the changeable UK weather. A compensator isa form of control for heating systems that automaticallyregulates the heating temperature based on theweather. An optimum start controller learns how quicklythe building reaches the desired temperature and bringsthe heating on at the optimum time prior to buildingoccupancy, again depending on the weather.
These types of controls can save thousands of poundsand will pay back their investment in just a couple of
years. Consult a qualied heating technician to discussthe range of options available.
Keep systems clear and unobstructed
Make sure any radiators and vents are not obstructedby furniture or equipment and keep any lters clean.This ensures better circulation of heat into the space andreduces the energy required to meet the heating demand.
Maintain boilers and pipework
Have boilers serviced regularly by a reputable rm ormaintenance contractor. Gas-red boilers should beserviced once a year; oil boilers twice a year. A regularlyserviced boiler can save as much as 10% on annualheating costs.
Boilers, hot water tanks, pipes and valves should beinsulated to prevent heat escaping. Payback can usuallybe expected within a few months of installation, withadditional savings in subsequent years.
More information is available in the Carbon Trust’stechnology overview of Low temperature hot waterboilers (CTV008) .
An example of a draught lobby
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Hot water
Water costs within a hospital can be considerable andthis is made worse when hot water is wasted, as theenergy used to heat it has been wasted too. However,water is a metered and controllable resource and it ispossible to save a signicant amount of water simplyby implementing some inexpensive efciencymeasures. Conservation of water also reduces thepumping requirement, which saves energy and reducescarbon emissions.
For further tips on saving energy in hospital laundries,see page 24 .
Consider water-saving devices
The largest area for potential savings is through theinstallation of water-conserving devices such as:
Tap restrictors – these provide equal ow at a number oftaps in a washroom and can reduce water ow by 15%.
Push taps – these only operate when pressed, turn offafter a brief time period and are ideal for areas wheretaps may be left running.
Shower regulators and water-efcient showerheads – these decrease the volume of water coming outof a tap or shower and can reduce water ow by 20%.
Infrared controllers – these provide water only whenrequired, switch off automatically and can save between5 and 15% of water per tap per year.
Supply efciently
It is inefcient to supply isolated and infrequently usedhot water taps from a central hot water storage tankbecause of heat loss from long pipe runs. Considerinstalling a point-of-use instantaneous water heater insuch cases. These can be extremely economical wherehot water demand is intermittent, yet essential such asfor hand washing in administrative areas.
Regular maintenance for optimumperformance
Maintain water services including taps, storage facilitiesand pipework on a regular basis and ensure all dripsare xed immediately. Check for water vapour, oodedducts and corrosion around joints or ttings on pipework.
Run an awareness campaign
Encourage staff to report any issues such as drippingtaps, overowing cisterns and inefcient water-saving/ ushing devices in toilets so they can be repaired beforethe problem escalates.
Point-of-use water heater
Top tip
Taps and toilet ush mechanisms tted withinfrared controllers are a particularly good ideabecause they also reduce the opportunity for thespread of infection.
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1 The true denition of an ‘air conditioning system’ is one which has the ability to control temperature, humidity and air quality within precise limits,yet the term is often applied to systems which simply cool the space. These cool air systems are more correctly referred to as ‘comfort cooling’.
Take advantage of natural ventilation
As simple as it sounds, natural ventilation and coolingrelies on natural airow between openings on oppositesides of a room or building – or rising warm air beingreplaced with cooler air sucked in through windows orvents. It may be possible to use windows and doors toprovide good levels of natural ventilation in some areaswithin a hospital, allowing mechanical ventilation to beswitched off or turned down to save money. Whenopening vents, doors and windows, always considersecurity implications.
Ventilation and air conditioningIn modern hospitals, ventilation can account for more than 30% of total site energy consumption.Although an integral part of hospital design, it is possible to reduce the amount of energy that ventilationsystems consume by focusing on some key energy saving opportunities.
Ventilation is especially important in hospitals – it isrequired not just to combat heat gains from lighting, staff,patients and specialist equipment but, more importantly,to provide high air change rates in operating theatresand on the wards to help eliminate airborne bacteria.
Some of the actions below will assist in simply coolingthe premises while others will provide air changes. 1 It isimportant to remember that a certain level of ventilationfor infection control is vital in healthcare buildings.Always seek advice from an expert technician ormicrobiology department before implementing anymajor changes.
Safety rst – ventilation systems
The use of ventilation for infection control isparamount so always seek professional advicebefore making alterations to systems.
Ventilation systems for clinical areas in hospitalsdiffer from those in most commercial buildingsin one critical respect: they must use full fresh airwith no recirculation. This can create very highenergy demands and is expensive to operate.
It is therefore important to distinguish betweenseparate non-clinical areas such as administrativerooms which do not have this constraint, as somefurther energy efciency measures may apply
to these. In general, air should ow from clean toneutral to dirty areas within a hospital, and outletgrilles should be sited at locations that do notpresent a health and safety risk.
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For more detailed technical advice, refer to Enco 2de2006 (see page 4 for more details).
Mixed mode systems
Some hospitals use what is known as a ‘mixed mode’system, which uses a combination of both naturaland mechanical systems. The building uses naturalventilation, heating and cooling where possible, withmechanical systems being used only when needed.There are various advantages to such a system:
The building becomes more adaptable to a wide•
range of requirements
The occupants have more control over their•
environment
Hospitals can cut down on energy spend•
and carbon emissions.
Set a ‘dead band’
Do not let heating and cooling operate at the same time.This can be avoided by setting a temperature ‘deadband’ – a wide gap between the temperatures at whichheating and cooling cut in. For example, in a hospitalward, the heating may be set to switch off when atemperature of 19ºC has been reached and coolingwould not come on until the temperature exceeds 24ºC.See Figure 2 below.
Maintain system components
Energy consumption can increase by up to 60% if regularmaintenance is not undertaken. Dirty or faulty fans, air
ducts and components directly affect system efciencyand will increase running costs and risk of breakdown.The performance of the whole system should bereviewed annually and replacement parts ordered asnecessary. Always consult a maintenance technician.
Cooling is on whentemperature exceeds 24ºC
Heating and cooling both off between 19ºC and 24ºC — a ‘dead band’ of 5 degrees
Heating is on untiltemperature reaches 19ºC
35ºC 40ºC15ºC 20ºC0ºC 10ºC 25ºC5ºC 30ºC
Figure 2 Diagram of ‘dead band’ control providing recommended temperatures
Case StudyWhat are other hospitals doing?Freeman Hospital in Newcastle
Ventilation systems serving 11 operating theatreswere being run at either full or standby rates for24 hours a day. Proposals to reduce the plant runtime were put forward. Unlike other, olderhospitals in the district, the Freeman has modern,purpose-built theatre suites and this encouragedventilation to be switched off when not required,rather than to a ‘standby’ level.
The ventilation plant was linked to the BMS andtted with passive infrared (PIR) detectors. Atnight, the plant is now switched off and the BMSswitches it back on if required (i.e. if people arepresent). The cost of the project was around£20,000 and benets have included a reduction inelectricity consumption and boiler fuel, leading tonancial savings of over £17,000 per year.
Further information
Find more information in the Air conditioningtechnology guide (CTG005) , available from theCarbon Trust.
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Variable speed drives (VSDs)
Fans do not need to operate at full speed all of the timeand variable speed drives (VSDs) can help to reducecosts by enabling the output speed of the fans to matchrequirements at different times of the day. This reductionin speed saves energy and there are correspondingheating and cooling cost savings too. For moreinformation, see the Carbon Trust’s technology guideon Variable speed drives (CTG006) .
Building Energy Management Systems
A Building Energy Management System (BMS orBEMS) is based on a network of controllers and offers
closer control and monitoring of building servicesperformance, including heating, ventilation and airconditioning. This is shown on a computer screen in realtime and allows settings to be changed quickly andeasily. BEMS can reduce total energy costs by 10%or more so they are well worth considering.
MythTurning air conditioningthermostats as low as they can gocools the building more quickly.
RealityThe temperature drops at the same rate but thenovershoots, using more energy than necessary andcreating discomfort for staff and patients. If controlsare not coordinated, the temperature could even go
low enough for the heating system to be switchedon. Both systems then operate at the same time.
RemedySet thermostats correctly and educate staff to dispelthis myth. As a last resort, protect thermostatsto prevent tampering, where possible.
Did you know?
Fan power requirements are high in buildingsthat are poorly insulated and draughty becauseof the need to distribute larger volumes of air.Improving insulation can help to reduce thisneed. See the Building fabric section onpage 25 to nd out more.
Top tip
To save money and increase comfort, it isbetter to reduce the amount of heat producedin an area than to raise ventilation rates. If youare concerned that your system is not operatingcorrectly, or if staff or patients complain aboutdraughts from ventilation fans, talk to yourmaintenance technician.MENU
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Case StudyWhat are other hospitals doing?Hammersmith Hospitals NHS Trust
With a current annual energy bill of over£6 million and annual emissions of morethan 43,000 tonnes of carbon dioxide, theHammersmith Hospital’s NHS Trust is continuingto work with the Carbon Trust to cut its carbonemissions by 15% by 2010. Current initiatives aimto reduce energy costs by over £0.5 million and3,540 tonnes of carbon dioxide within two years.
The energy saving initiatives being implementedinclude a programme of continuous commissioning,installing variable speed drives and high efciencyelectric motors, along with automatic lightingcontrols. These schemes follow on from two yearsof successful work aided by the Carbon Trustwhich have seen the hospital’s annual emissionsof carbon dioxide reduced from 49,600 tonnesin 2003/04.
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Install low-energy lighting
Upgrade lights to the most efcient suitable options.For example, any ‘standard’ tungsten light bulbs can beupgraded directly to energy saving compact uorescentlamps (CFLs) which use 75% less energy, produce lessunwanted heat and last 8–10 times longer.
Replace blackened, ickering, dim or failed uorescenttubes with triphosphor coated ones. This is stated onthe packaging. Triphosphor coating provides a morenatural, brighter light for the whole life of the tube. If thetubes are 38mm (1.5 inch), replace them with slimmer26mm (1 inch) tubes.
Specify high frequency uorescent lighting systems andmirror reectors whenever uorescent lighting is to bereplaced. This should be included in the hospital’spurchasing policy. High frequency tubes reduce energyuse and heat output, eliminate icker and hum, extendlamp life (by up to 50%) and can allow dimming – all ofwhich can make a ward more comfortable.
Always consult a qualied lighting technician beforeupgrading lighting systems and specify lighting thatappears on the ‘Energy Technology List’ to ensureit is efcient. Visit www.eca.gov.uk/energy to ndout more.
Sensors can achieve savingsof up to 30% on lighting costs
Label light switches
Help staff to select only those lights they need bylabelling light switches. As part of general policy, lightsin unoccupied areas should be switched off butremember to consider health and safety implications,particularly in corridors and stairwells. Key areas forsecurity lighting include pharmacy drug stores,laboratories and residential accommodation.
Maintenance
Without regular maintenance, light levels can fall by 30%in 2–3 years. Keep windows, skylights and light ttingsclean. Replace old, dim or ickering lamps and keep
controls in good working order by ensuring timers areset correctly and that any occupancy sensors are clean.
Encourage staff to report maintenance issues. This willhelp maintain the desired light output and, in turn,provide a safer, more attractive environment for bothstaff and patients.
Did you know?
Good housekeeping can typically save 10%on energy bills.
Examples of modern, attractive low-energy bulbs– trial a few different types to see which best suityour premises
Top tip
Lighting design is complex and many of theexamples given here are general guidelines,appropriate for reception areas and othercommon rooms in healthcare units. Some tipswill not be appropriate for specialist areas, soalways seek advice before making any changesto the lighting in your hospital.
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Occupancy sensors
Occupancy sensors ensure lights only operate whenthere is somebody there to require them. These areespecially useful in, for example, the following spaces:
Intermittently used ofce areas•
Toilets and washroom facilities•
Storerooms•
Areas where lighting is zoned.•
Occupancy sensors can also be used to lower light levelsin corridors at night time, which can be an effectivecost-saving measure. However, it is imperative to
maintain minimum light levels so as not to compromisehealth and safety standards.
Occupancy sensors may not be appropriate for wardsand in patient rooms where people may not be movingfrequently enough to be detected.
More information on lamps, lighting gear and controlscan be found in the Lighting technology overview(CTV021) , available from the Carbon Trust.
Switching in parallel
Hospitals tend to have a lot of windows, par ticularlyon wards and in consulting areas. This provides a goodopportunity to maximise daylight. Wire lights so thatthose closer to the windows can be switched off, whilethe rest remain on with separate controls. This is called‘switching in parallel’ and enables staff and patientsto make the most of natural daylight, which is usuallypreferred. As a result, less lighting is used, reducingenergy consumption and additional heat generated by thelights which, in turn, means that less cooling is required.
Case studyWhat are other hospitals doing?
Maintenance staff at Blackburn, Hyndburn andRibble Valley Health Care NHS Trust noticed thatthe lights in sluice rooms tended to be left onwhen nobody was around. To combat this, theyreplaced traditional switches with intelligentlighting that incorporates passive infrared andmotion detection. Lights now come on whensomeone enters the room, but go off if no motionis detected after a preset period. This measurenot only saves energy, but helps to prevent the
spread of disease because staff no longer need totouch switches. Similar systems have beeninstalled in some corridors too.
St Charles’ Hospital in London , managed by theParkside NHS Trust, knocked £1,200 a year offelectricity bills by installing a microprocessorcontrolled lighting system in the main corridors.Each controller sets the light level dependingon the amount of natural daylight available.At night, light switching is controlled by presence
detectors. The system is also linked to the re-alarm system so that lights respond to emergencysituations. This measure was introduced duringrefurbishment and cost no more than a traditionallighting scheme.
MythIt is better to leave uorescentlighting on as starting it up wastesmore energy than if it remainspermanently switched on.
RealityFluorescent tubes use only a few seconds worthof power in start-up – therefore, energy is alwayssaved by switching it off when leaving a room.
Top tip
Always make the most of natural daylight.Research indicates that increased daylightingin patient rooms may ease post-surgical pain,decrease the use of pain medication and reducethe length of stay.
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Seven-day timers
These only cost a few pounds from most DIY stores butreduce the likelihood of machines being left on out ofhours. They can be tted to photocopiers, printers,drinks and vending machines. Check with yourequipment supplier rst about any service agreementsparticularly in vending machines (see the top tip below).
Maintain equipment
Check and clean all heat-emitting equipment regularly,including keeping lters free of dust. This is not just toimprove cleanliness and appearance; dirt can reduce theeffectiveness of apparatus and affect its cooling downprocess. Seek advice from the manufacturer on servicingschedules in order to maintain optimum efciency.
Ofce and small power equipmentOfce and small power electrical equipment can account for morethan 10% of total electricity use within healthcare organisations.
Ofce and IT equipment is widely used in hospitals,particularly in reception areas. Other common smallpower appliances include equipment in on-site staffresidences such as kettles, electric cookers, toasters,microwaves and other electrical appliances including
vending machines, televisions, stereos, vacuumcleaners and washing machines.
Turn off and power down
Where equipment is left on unnecessarily there areopportunities to make signicant savings. Switch offall equipment when not in use and enable power-downmodes. This reduces the energy consumption andheat produced by equipment, lowering cooling costsand improving staff and patient comfort. The lifespan
of this equipment will also be extended, the risk ofbreakdown reduced.
Top tip
Switch off vending machines at night in areasof the hospital that are unoccupied. Leavingthem on 24 hours a day costs around £120 a yearper machine. Fit a simple time switch and savearound 30% of this cost. NOTE: do not switchoff vending machines containing perishableitems and check service agreements beforetaking action.
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Reduce the risk of an area overheating
Place heat-emitting equipment such as printers andphotocopiers in a separate, naturally-ventilated areawith good airow. This helps prevent overheating,removes potential emissions from the equipmentand reduces noise.
Purchase for your requirements
With healthcare units under increasing pressure tospend budgets wisely, it makes sense to work out thewhole life cycle cost of the item, that is the capital costplus the running costs in energy over the lifetime of theequipment. Slightly higher costs of some energy
efcient equipment can often pay back very quickly.This could be an important policy point for the hospital’sprocurement department, which may only consider thecapital outlay in its decisions.
More information about simple actions and purchasingcan be found in the Ofce equipment technologyoverview (CTV005) , available from the Carbon Trust.
Case studyWhat are other hospitals doing?
The typical annual running cost of a PC with atraditional screen is around £30, as opposed to
just £9 for a PC with an LCD at screen. One NHStrust energy manager persuaded its Board toadopt a new policy which states that whenequipment is being replaced, it must incorporatea at screen. This saves on electricity and cutsheat emissions, reducing the need for comfortcooling. The at screens are also more popularwith users because they allow icker-free viewing.
Remember
Ensure all staff are aware of switch-off policiesand inform them of the cost and environmentalbenets of doing so. It is important to get policiesendorsed by senior management so that they arenot purely seen as an ‘Estates issue’.
Further information
The Carbon Trust has a broad range ofpublications on saving energy aimed at alllevels of experience. Contact the Carbon Truston 0800 085 2005 for further details or visitwww.carbontrust.co.uk/ publications.
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Purchase equipment with runningcosts in mind
Although gas-red equipment is often more expensiveto buy than electrical or steam equivalents, savingsmade on running costs make it an attractive option.
Equipment that automatically switches off, such as pansensors on hobs, can save 25% on energy costs. Selectovens with large, double glazed viewing windows toreduce the need to open doors to inspect contents.
When purchasing any domestic-sized cateringequipment such as fridges, freezers or dishwashers,always look for the most efcient ‘A’ rated models usingthe European A-G efciency label.
Raise awareness amongst kitchen staff
Do not switch on too soon — most modern catering•
equipment reaches optimum temperature quickly.Label equipment with its preheat time and educatestaff to switch on only when required
Avoid using catering equipment to warm the kitchen•
space on staff arrival — the hospital’s heating systemshould do this effectively. If it does not, nd out why
Switch off grills, fryers and hobs immediately•
after use
Avoid overlling saucepans and kettles, and use lids•
where possible
Keep fridge and freezer doors closed and defrost•
at manufacturers’ recommended intervals to saveenergy and prolong equipment lifetime
Switch off equipment, lights and extraction fans when•
they are not being used.
CateringWater and energy usage in hospital catering departments are areas thatcan offer major cost savings without compromising hygiene or resources.
Efcient catering facilities can reduce the energyrequirement per meal by as much as 40%. Managingconsumption can have additional benets of improvingthe quality of the food produced as well as the workingenvironment for kitchen staff.
Did you know?
Simple actions arising from raising awarenesscould reduce energy use by 25%.
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Monitor with submeters
Submetering kitchen areas can provide an extraincentive for staff to be efcient, by showing howenergy is used in this facility and how subsequentefforts have paid off. Catering in hospitals is oftenoutsourced so there is the additional benet of allowingfor budget allocation and charging to take place.Submeters are discussed further on page 31 .
Consider heat recovery
Large volumes of warm air are expelled from kitchens.Many kitchen managers do not realise that over 50% ofthis heat can be recovered using heat recovery deviceswhich can signicantly reduce energy costs. An air-to-water recovery device is often the most effective methodof recovering heat because it can then preheat hot water,providing a year-round use for the recovered heat.
Maintain kitchen extract ventilation
Ventilation units and extractor hood grease lters shouldbe kept free from dust and grease and cleaned at regularintervals, as recommended by the manufacturer. Regular
cleaning of ventilation systems can increase efciencyby as much as 50% compared with unmaintainedsystems. There is also a reduced risk of breakdown.
Case studyWhat are other hospitals doing?
One Trust in central England tested out insulated‘hot boxes’ as replacements for traditional,electrically-heated food trolleys. After makinga few minor adjustments to working routines,it was possible for food to reach patients at thecorrect temperature without the need for trolleys.The trust withdrew 33 traditional trolleys ata saving of almost 145,000 kW per year, and at7p/kWh, that is over £10,000 per year.
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Refrigeration equipment
The energy consumption of refrigeration equipmentcan be reduced by:
Defrosting
Follow the manufacturer’s recommendations to saveenergy and prolong the lifetime of equipment.
MaintenanceCheck door seals on cold rooms, fridges and frozenstores and replace if damaged. Keep condensers andevaporator coils clean and free of dust and checksystems have the correct amount of refrigerant.
Temperature control
Maintain correct temperatures on cooling equipmentand avoid over-cooling. Keeping refrigerated equipmentat the correct temperature is better for the storedcontents and for cost savings. Energy consumption byrefrigeration equipment can be reduced by 2–4% if theset cooling temperature can be increased by 1ºC. Setthe temperature based on manufacturer’srecommendations.
Portable medical equipment
While being both convenient and cost-effective,portable medical equipment can cost hospitals in termsof energy use. Fortunately, energy performance can betackled in several ways:
Establish a purchasing policyChoosing the most efcient equipment will reduceenergy use and heat gains.
Raise awareness of energy management techniquesEncourage staff to switch off devices when they are notbeing used, or to make use of built-in standby orpower-down modes.
Building designDeal with heat gains generated by medical equipmentin the context of the building’s overall design strategy.For example, instead of installing air conditioning for anentire department, consider local comfort cooling thatcan be used as required.
Specialist equipmentThe specialist nature of a hospital environment means that there is a signicantamount of energy-intensive equipment, such as medical fridges, mortuary andpharmacy cold stores, laboratory equipment, and X-ray machines.
Each speciality area will have a wide range of apparatus.Because each item requires careful evaluation, andbecause of the potential risks to the welfare of thepatients, this publication does not provide in-depthguidance on this topic. However, careful purchasing,
along with maintaining good housekeeping practicescan generally keep consumption to a minimum, asdetailed in the action points below.
Top tip
Ensure X-ray machines, lm processors andother signicant, individual pieces of equipmentare switched off when not required.
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Sterilisation and disinfectiondepartments
To operate effectively, sterilisation and disinfectiondepartments require equipment that is particularlyenergy-intensive. As packing areas need to be keptparticularly clean, the ventilation to this department isltered by high-efciency particulate air (HEPA) ltersand usually air-conditioned. In order to minimise energyconsumption, consider:
Using cascade systems where conditioned air from•
the cleanest space (packing) ows to neutral thento dirty areas
Using heat recovery in these areas as heat is often•
emitted 24 hours per day
Choosing sterilising and disinfecting equipment on•
the basis of energy usage as well as performance –energy usage and whole-life cycle costs can differwidely between manufacturers
Insulating sterilizer bodies and pipework connections,•
valves, anges and so forth, to minimise standby losses
Metering the department for each utility and specifying•
individual energy metering for each major washerand steriliser.
Medical gases
Where medical gases are supplied in bottles or otherstorage vessels and connected to manifold systems,they have a negligible impact on energy use. However,medical compressed air, medical vacuums andanaesthetic gas scavenging, all use pumps andcompressors which consume a signicant amountof energy. Consider the following actions:
Selecting plant and equipment using whole-life•
costing techniques
Monitoring (but not controlling) plant operation via•
a Building Management System to identifyunexpected usage and highlight possible problems
Providing localised systems for applications such as•
dentistry, medical physics, laundry and sterilisers tominimise distribution energy and potential leakage.
Case studyWhat are other hospitals doing?East Cheshire NHS Trust
Compressors that served the medical gas system(to operate ventilators and air tools) dated back to1984 and needed to be overhauled. This wouldhave cost around £2,000–£3,000. The energymanager ran a test on the system to nd out thetypical usage and discovered that although themaximum requirement for compressed air was8 L/s, the compressors were sized to deliver 45 L/s.Therefore, the compressors were constantly
switching on and off and wasting energy.Instead of overhauling them, the Trust decidedto downsize to rotary screw compressors. Theyonly cost £713 to run annually against £1,925 forthe previous versions, providing an immediatesaving of £1,212 per year. Installation of the newequipment gave a three-year payback.
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Motors and drives
Motors are generally running out of sight, sometimesconstantly, every day of the year. The value of theelectricity consumed by an electric motor over its lifeis typically 100 times the purchase price of themotor itself. It is therefore important to ensure thatmotors (and their associated drives) are as efcient aspossible. Motors typically account for 19% of primaryenergy consumption in acute hospitals.
Considerable energy savings can be achieved by goodsystem design to minimise the motor load. A smallincrease in duct or pipe size can signicantly reducesystem losses and thus greatly reduce the fan or pump
power required. Low-loss motors, variable-speedcontrols and effective control can realise savings ofmore than 50%.
Laundries
Laundry facilities are extremely energy-intensive. Waterusage is also an important issue. Make sure thatlaundries are targeted in the site-wide energy strategy.Some actions to consider are listed below:
Most steam-heated laundries will generate excess•
low-grade heat that can be conveniently re-usedelsewhere across the site
Water recovery by recycling the rinse water from•
washer extractors is a proven means of reducingwater usage
Total water recovery (grey water recycling) is becoming•
more acceptable and should be investigatedHeat recovery via heat exchangers from hot efuent•
is standard practice and can be used on all typesof machine
Consider combined heat and power (CHP) which•
might be viable for many sites that incorporate alaundry. See page 27 for more information on CHP
Sub-meter the laundry to see how energy is used.•
This is discussed further on page 31 .
For more information on these technologies, contactthe Carbon Trust .
Case studyWhat are other hospitals doing?
North Staffordshire Hospitals Trust invested£10,000 in a project to t six variable speeddrives in the main plant room. The energyservices engineer monitored electricityconsumption before and after the installationand found that running costs were reduced byaround 40%, giving a payback of just 1.8 yearson the installation. Running costs were reducedto £27 per day from £50 per day.
Fife Acute Hospitals NHS Trust’s laundry washes
8 million items per year (some under contract toother trusts). The laundry system was very oldand inefcient and had to be replaced.
Steam from the gas-red boiler powers thesystem, which now includes a two-line, ten-batchwashing machine. The Trust spent approximately£100,000 on electronic controls for the systemwhich help maximise water re-use, cutting downon both water and heating costs.
The enhanced efciency of the machines meansthat the amount of moisture in cleaned laundryis cut, reducing the energy needed for drying.At the same time, old steam traps were replacedwith new ones that reduce leakage and cut downon maintenance. A steam meter was also installedso that performance of the steam heating systemcan be monitored.
Remember
Always check with an expert before switchingoff or altering controls on specialist equipment.
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Undertake regular maintenance
Identify potential building fabric problems as part ofroutine maintenance and deal with them promptly. Inparticular, repair gaps or holes in walls, windows, doorsand skylights immediately. Preventing the loss of heated
or cooled air provides instant savings and also improvesthe appearance of a hospital. It is more comfortable forstaff and patients too.
Establish a housekeeping schedule
Compile a regular checklist to address areas whereenergy is lost via the building structure. If the hospitalis large, it would be wor th delegating this to severalmembers of staff, all of whom can work from thesame checklist. A comprehensive schedule includeschecking walls, oors, roofs and skylights, doors andwindows, including frames and panes.
Keep windows and external doors closed as much aspossible when heating is on and consider sealingunused doors or windows to further reduce draughts.
Improving building fabric in a hospital makes goodsense for many reasons:
Better temperature control – it can lower ventilation•
costs and prevent overheating
Enhanced patient comfort – a more comfortable ward•
gives patients the best conditions for a faster recovery
Improved productivity – staff morale and output can•
be enhanced by providing a more comfortableworking environment through reducing draughts, solarglare, overheating and noise
Lower capital expenditure – a more efcient,•
well-insulated hospital needs smaller heating andcooling plant
A brighter, cleaner environment – this may help•
increase patients’ condence in the care the unitis providing.
Building fabricConsidering the age and outdated design of many hospital buildings, it is not surprising that someare inefcient. Newly–built structures are prone to insulation and draught problems too.
Typically, two thirds of heat from a hospital is lostthrough the building fabric, with the remaining thirdbeing lost through air inltration and ventilation. The rateat which heat is lost depends on:
The temperature difference between inside•
and outside
The insulation properties of the building fabric•
The amount of fresh air entering the building either•
by controlled ventilation or through poorly ttingwindows, doors or joins in walls.
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Install more insulation duringrefurbishment
Around a quarter of a building’s heat can escape via anuninsulated roof which adds hundreds of pounds per yearto heating bills. Insulating any roof spaces and unlledexternal cavity walls is an effective and inexpensive wayof reducing heat losses.
Many hospital buildings have at roofs and singleexternal walls making insulation measures more difcult,disruptive and costly. Improvements to these are mostcost effective during refurbishment projects and shouldalways be considered when the opportunity arises.
Make the most of curtains and blinds
As well as providing privacy for patients, curtains andblinds play an important role in protecting the building.If correctly chosen, they can reduce draughts and helprooms retain more of their residual heat overnight duringwinter months. Close curtains and blinds at the end ofthe day to keep the heat in. The same process can helpin summer to reduce heat in rooms that receive directsunlight. Blinds can also be an effective way ofcontrolling direct daylight and glare.
Improve glazing
Double glazing is now a minimum requirement when
replacing windows. Further protection is available fromtriple glazing and should be considered, particularly onnorth-facing or exposed sides of a building. Somewindow units even have integrated blinds and/or allowfor secure night opening, which can provide additionalventilation and cooling benets.
High performance glass has a coating that improves itsinsulation properties. Coatings that allow daylight throughbut block or reduce heat (infrared) can be particularlyeffective at reducing overheating from direct sunlight,
therefore lowering mechanical cooling requirements.
In highly glazed spaces such as waiting rooms and atria,it may be more effective to replace some of the glazingwith insulated blank panels. This will reduce the amountof light entering the space but provide better insulationand reduce heat and glare problems associated witha large area of windows.
Regularly check the building for damp
Damp causes signicant damage to the buildingstructure and reduces its insulating properties. It is alsounsightly and even though it may not reect the qualityof the healthcare offered, patients could be concernedby what appears to be dirty and unkempt premises.
Repair split down-pipes, faulty gutters and leaky rooftiles as soon as an issue becomes apparent. Do not justopt for a quick x – repair the cause and save time onexpensive work later on. Regularly check for signs ofdamp and condensation at least once a year, preferablyprior to winter months.
Check and maintain insulationEnsure that hot water and heating pipes are insulated.Similarly, check accessible loft spaces to make sure thatinsulation is in good condition and replace if required. Aswell as saving energy by reducing heat loss from thepipe, insulation can also improve internal comfort byreducing the risk of overheating.
Identifying and repairing problems
quickly can help avoid expensiveproblems later on
Improve your building fabric
The Carbon Trust offers help and advice onhow to make the most of the energy savingopportunities available from improving yourbuilding fabric.
Show me how.
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Information for sites withoutCHP installed
When to consider CHP installation
The best time to consider CHP in existing buildings iswhen the heating plant is being replaced, so that the CHPunit can be integrated with the heating system. Thecommercial value of the electricity and heat produced bya CHP unit is greater than the combined cost of the fueland maintenance required for the system to operate.
Understand existing heat and electricity loads
When considering CHP, it is important to carefullyassess its application and feasibility. Spacerequirements should be considered, along with adetailed evaluation of the system’s engineering,economics, reliability, operation and maintenance.To justify the cost of investment, the aim should be tomaximise the use of all the heat and hot water that thesystem can produce. Every hospital is different andtherefore a detailed cost calculation is essential. Thisassessment should be made only after other, simplerenergy efciency measures have been implemented.
Combined heat and power (CHP)CHP can offer an economical method of providing heat and powerwhich is less environmentally harmful than conventional methods.
CHP is the simultaneous generation of heat and powerin a single process. CHP equipment usually burns fossilfuel such as natural gas or diesel oil to generateelectricity on-site.
At a power station, the heat generated when electricity
is produced has to be dissipated via cooling towers.With CHP, the heat is recovered on-site, and used forspace heating and hot water. This means that overall,the process is more efcient, so less fuel is used.
To gain maximum benet from CHP, the system needs tobe in operation for as many hours of the year as possible.
With year-round requirements for electricity andsignicant amounts of hot water, hospitals are ideallysuited to using CHP.
However, not all sites are suitable for CHP, nor willthey have good payback. Make sure that the site isinvestigated properly, including a complete nancialand technical appraisal from an expert.
CHP support
In an appropriate application, CHP can reduceenergy bills by around 20–30%, provided theunit is designed to meet the building’s seasonal
demands for electricity and heating. Even better,Good Quality CHP qualies for Enhanced CapitalAllowances and the fuel input is exempt fromthe Climate Change Levy (CCL). Contact theCarbon Trust for more information.
Consultancy support is also available from theCarbon Trust to help evaluate the feasibility ofCHP for hospitals and large healthcare facilities.
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Monitor performance
A CHP system should be monitored to ensure it isoperating correctly. Look out for factors that affectperformance such as changes in output and fuelconsumption, air temperature and pressure in gasturbine installations. It is also important to monitor therate that system performance changes as this providesa basis for planning maintenance tasks and plantoverhauls. Always explore why performance is failing tomeet the specication as this could indicatemaintenance requirements. It will also be reducing thecost effectiveness of the system.
Meet CHPQA requirements and avoid payingthe Climate Change Levy (CCL)
Monitoring data collected can be used to demonstratecompliance with the necessary quality standards forexemption from the Climate Change Levy (CCL).Metering installed for CCL registration must be able todifferentiate between heat used by the site and heatrejected to the atmosphere via a cooling system, soensure meters are positioned correctly to achieve this.
Exemption from the CCL for Good Quality CHP is basedon certicates issued by the Government CHPQAprogramme. Details of monitoring requirements for theCHPQA programme are available at www.chpqa.com .
Consider exporting heat via a communityheating system
Where there is insufcient heat demand in an area,CHP may still be feasible if there is a close off-site heatdemand. For example, a nearby industrial companywith a demand for heat could allow any excess heatto be sold on.
Investigate funding opportunities
If budgets cannot stretch to investing in CHP, exploreoptions for third-party funding. Energy services andcontract energy management options absorb the initialcost and risks associated with installation, maintenance
and operation of a CHP unit. Charging arrangementsvary but under certain contracts, a hospital may onlypay for fuel used by the CHP unit and receive the heatfor free, as well as paying a reduced price for electricity.
Information for sites with CHP installed
Maintenance issues
CHP systems require regular maintenance to ensureefcient operation and reduce risk of breakdown. Major
maintenance should be carried out as part of a plannedshutdown. When deciding on the timing and durationof a shutdown, always consider cost implications such asfor labour and materials required to carry out the plannedwork as well as additional costs of meeting the site’s heatand power requirements from other sources. For smallerinstallations, shutdowns are normally undertaken by theCHP supplier who also maintains the unit.
Case studyWhat are other hospitals doing?
The two natural gas CHP units run by MiltonKeynes General NHS Trust date back to the early1990s and have shown ongoing savings inelectricity. Both machines qualify for exemptionfrom the CCL. Together, the units provided around20% of the hospital’s total electricity consumptionduring 2000/01.
The two gas-red CHP plants installed in 1991 and1994 at Gleneld Hospital have helped to reduceelectricity consumption by 21.5% — a reduction of
1,256,272 kWh. A key benet of the CHP system isthe security of the energy supply to the hospital’soperating theatres and critical care facilities. Inaddition, the hospital saves around £20,000 a yearthrough exemptions from the CCL.
Did you know?
CHP can have nancial, environmental andstrategic benets. A well-designed and operatedCHP plant can reduce carbon dioxide emissions.However, CHP schemes represent a signicantlong-term investment so the economics need tobe studied carefully before a decision is made.
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Undertake regular walk rounds
Carry out regular good housekeeping walk rounds. Notedown and act on any maintenance measures needed inorder to avoid expensive problems later on. As patternsof energy use vary throughout the day, it is advisable to
carry out a series of walk rounds at different times to geta better idea of where and when energy is being wasted.
A walk round helps to:
Establish current operating practices•
Identify wasteful practices and ensure they do not recur•
Demonstrate commitment to improving•
energy performance
Identify further opportunities for savings.•
Responsibility at all levels
Every staff member must be on board in order to makea hospital energy efcient. Establish a clear energypolicy and have it endorsed by the Trust board.Communicate this throughout all levels of staff. Consider
appointing ‘energy champions’ or an energy team as thiscan improve involvement and awareness on-site.
Involve staff
All employees should be aware of areas of waste andtrained to operate equipment and controls correctly. Itis important to emphasise the cost of wasting energy,and how it impacts on Trust resources. Motivate staff– ask their opinions and encourage them to review theirown working practices to increase energy savings.Competitions, campaigns and team projects are greatways to get buy-in.
Reinforce the benets of improving their work area andgive them a sense of ownership of energy management.
Good housekeeping and energy managementGaining everyone’s involvement is crucial if energy savingsare to be achieved and maintained.
Most savings are within the control of staff. It isimportant to ensure that all staff members are aware ofthe benets that energy efciency can bring to ahospital in order to get them involved and committed toan energy management programme. Benets include:
A better environment for patients which may help•
their recovery time
Healthier and more productive working conditions•
for staff
Cost savings which can be spent on improving•
healthcare facilities.
Whether starting an energy conservation programmefrom scratch or simply checking the effectiveness of anexisting management system, there are a number ofbasics to consider.
Further information
For information on staff involvement, seeCreating an awareness campaign (CTG001) available from the Carbon Trust.
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During a walk round, look at all parts of the building,including the heating, lighting and building fabric, as wellas any electrical equipment.
Base an energy walk round on the information in thisoverview. Further tips and a sample checklist can befound in Assessing the energy use in your building(CTL003) , available from the Carbon Trust.
Monitor energy use
Understand the hospital’s energy consumption byreviewing energy invoices over the last year. This shouldhelp build a picture of the site’s monthly performance.Larger hospitals may have meters recording half-hourlyelectricity consumption and these data are likely to beavailable from the energy supplier. Inspecting half-hourlydata is also a good way to see when (and sometimeswhere) energy is being used, and is an effective way toidentify potential savings.
If the unit does not have a half-hourly electricity meter,at least check and record monthly gas and electricitymeter readings. Compare this information with thehospital’s invoices to check for accuracy.
The information gathered can provide a picture ofcurrent energy use which can be used to monitorongoing performance, showing where savings havemade a difference. As well as measuring progress, thegures can be used to compare the site with similarhospitals to see how it is performing.
Did you know?Sample environmental policies and energyefcient procurement policies are providedin Enco 2de 2006 – available on the Departmentof Health Knowledge and Information portal.
Maintenance contractors
Ask maintenance contractors for advice onhow to maintain optimum conditions whilstminimising energy costs and upkeep. Why notadd a clause in their contracts which stipulatesthe importance of energy efciency as partof their regular services? It could act as anincentive to reduce energy costs and everyonewill benet.Did you know?
It is possible to save 5 -10% of a healthcarebuilding’s total energy costs by implementingsome common sense, good housekeepingmeasures. Even better, energy savings madethrough good housekeeping yield immediateresults and require no nancial investmentor specialist skills.
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Set targets
Tell staff how much energy is currently beingconsumed. Then, when the energy saving programmegathers momentum, it will be possible to track progressand highlight energy savings. Set targets – mostorganisations in the UK could reduce their energyconsumption by 10–40%. However, it is important to berealistic: many start by aiming for 5% savings each year.
Submetering
Submeters can be helpful in understanding how energyis used across the estate. The information they providecan highlight areas where cost savings can be made andjustify investment. Target particularly energy-intensiveareas, such as laundries and catering. Submetering, andany subsequent monitoring and targeting of energy use,can act as an incentive for managers to reduce energycosts by providing some nancial reward for doing so.
Case StudyWhat are other hospitals doing?
There are approximately 25 properties in theWolverhampton City Primary Care Trust portfolio.One energy manager was using annualconsumption gures to compare the per formanceof similar buildings when he noticed that aparticular community health centre was faringmuch better than its comparators. Upon furtherinvestigation, he found that one person’s hardwork to encourage everyone to switch of f lightsand electrical equipment had led to a signicantreduction in the centre’s electricity bills.
One Trust in Oxfordshire was spending £2.5million on energy each year but had no dedicatedenergy manager. The Trust designated an energymanager on the basis that savings made through
the energy manager’s work would pay their salary.The energy manager subsequently achievedsubstantial savings and more than recovered theirown costs through energy-efciency measuresand the introduction of combined heat and power(CHP) plant.
The energy management team at Worcester RoyalInrmary set up an incentive scheme withinterdepartmental competitions. This helped togive everyone a sense of ownership of the
corporate policy. After only ten months, thehospital had saved £35,000. As a result, the HealthAuthority awarded a £3,500 cash prize to thehospital which went towards the purchase of afoetal heart monitor.
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Step 1. Understand your energy use
Look at your hospital and identify the major areas ofenergy consumption. Check the condition and operationof equipment and monitor the power consumption overone week to obtain a base gure against which energy
improvements can be measured.
Step 2. Identify your opportunities
Compile an energy checklist. Walk round your buildingand complete the checklist at different times of day andnight to identify where energy savings can be made.Build a checklist based on the one on page 33 or orderan example from the Carbon Trust: Assessing theenergy use in your building (CTL003) .
Step 3. Prioritise your actions
Draw up an action plan detailing a schedule ofimprovements that need to be made and when, alongwith who will be responsible for them.
Next stepsThere are many easy low and no-cost options to help save moneyand improve the energy performance of your hospital.
Step 4. Seek specialist help
It may be possible to implement some energy savingmeasures in-house but others may require specialisthelp. Discuss the more complex or expensive optionswith a qualied technician.
Step 5. Make the changes and measurethe savings
Implement your energy saving actions and measureagainst original consumption gures. This will assistfuture management decisions regarding yourenergy priorities.
Step 6. Continue managing your businessfor energy efciency
Enforce policies, systems and procedures to ensure thatyour business operates efciently and that savings aremaintained in the future.
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Download
Download this checklist of energysaving measures to tick off as you go.
Action checklist
Appendix
H os p it a ls 2 5
4 Action
Settemperaturecontrols to suitthespace andonly haveheating onwhen required
Minimiseheatwastage byclosing doors andkeeping radiators unobstructed
Maintainboilersand pipeworkforoptimal operation
Revisecontrol options —consider optimumstart,compensators andTRVs
Fitwater-saving devices
Tryto ventilateandcool withnatural methods
Checkthatheating andcooling arenotop eratingatthe sametime
Switchoff all non-essential lights
Findthe mostef cientlighting options
Install controls —consider timeswitches,occupancy sensors anddaylightsensors
Wirelights to switchin parallel
Turnoff unusedelectrical andof ce equipment
Consider lifecyclecosts whenpurchasing equipment
Checkfor air loss throughtheb uilding fabricof oors,walls,roofs andwindows
Repair gaps inthebuilding fabricimmediatelyso heated or cooledair is notescaping
Insulateas muchas possible,including pipework
Getall staff involved— writeanenergy policyand runan awareness campaign
Monitor energyusagebychecking meter dataand bills
Consider sub-metering,especiallyin laundries andkitchens
Settargets anddevise anaction plan
Consider combinedheatand power if thehospital sitehas appropriatedemand
ContacttheCarbon Trustfor further guidanceand supporton improving energyuse.
Action checklist
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Technology guidesAir conditioning (CTG005 )
Creating an awareness campaign (CTG001)
Heating control (CTG002)
Variable speed drives (CTG006)
Health Technical Memorandum: Enco2de [Synopsis] (CTC605)
Further information
Related publications
The following publications are available fromthe Carbon Trust:
Fact sheetsAssessing the energy use in your building (CTL003)
Technology overviewsBuilding fabric (CTV014)
Energy management strategy (CTV022)
Heating, ventilation and air conditioning (CTV003)
Lighting (CTV021)
Low temperature hot water boilers (CTV008)
Ofce equipment (CTV005)
Practical energy management (CTV023)
Refrigeration (CTV002)
Useful websites
The full version of Health Technical Memorandum:Enco2de and its accompanying CD-ROM is available topurchase from the TSO. To order, visit www.tso.co.uk .
NHS NetworkThe NHS Network facilitates the exchange ofexperience and information relating to energyissues and the sustainable use of energy tohelp support NHS organisations.
Visit nhsnetwork.carbontrust.co.uk .
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Carbon footprint calculator – Our online calculator will help youcalculate your organisation’s carbon emissions.
www.carbontrust.co.uk/carboncalculator
Interest free loans – Energy Efciency Loans from the Carbon Trust are a costeffective way to replace or upgrade your existing equipment with a more energyefcient version. See if you qualify.
www.carbontrust.co.uk/loans
Carbon surveys – We provide surveys to organisations with annual energy billsof more than £50,000*. Our carbon experts will visit your premises to identify energysaving opportunities and offer practical advice on how to achieve them.
www.carbontrust.co.uk/surveys
Action plans – Create action plans to implement carbon and energysaving measures.
www.carbontrust.co.uk/apt
Case studies – Our case studies show that it’s often easier and less expensivethan you might think to bring about real change.
www.carbontrust.co.uk/casestudies
Events and workshops – The Carbon Trust offers a variety of eventsand workshops ranging from introductions to our services, to technical energyefciency training, most of which are free.
www.carbontrust.co.uk/events
Publications – We have a library of free publications detailing energy savingtechniques for a range of sectors and technologies.
www.carbontrust.co.uk/publications
Need further help? Call our Customer Centre on 0800 085 2005
Our Customer Centre provides free advice on what your organisationcan do to save energy and save money. Our team handles questionsranging from straightforward requests for information, to in-depthtechnical queries about particular technologies.
* Subject to terms and conditions.
Go online to get moreThe Carbon Trust provides a range of tools, services and information to help youimplement energy and carbon saving measures, no matter what your level of experience.
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