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: Design detail
Public access to facilities Security between
Site designed around a “high ground & floor 1
street” Landscaping for
Significant landscaping SUDS & ecology
Benefits: Specific benefits
More community involvement
Better setting for staff 98% staff retention
(cf 85% prediction)
More facilities for staff 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 – [Link]
Staff productivity and retention:
Office Productivity network –
[Link]
Detailed sustainability costings:
- Sean Lockie, Faithful & Gould – [Link]
- Isabel McAllister, Cyril Sweett – [Link]
- Brendan Patchell, Bucknall Austen – [Link]
