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According to specialist in optimised resource management, Veolia, combined heat and power (CHP) 'has been proven for its effectiveness in reducing carbon emissions, thanks to the efficient way that the technology simultaneously derives power and heat from the combustion process'. However, as Mark Atkinson, the company's operations manager, explains, it is only through specifying and designing the plant accurately that the correct load, and therefore the desired savings, can be realized.

In 2013 Peter Sellars, head of Profession for Estates & Facilities Policy at the Department of Health, successfully bid for £50 million from the Treasury to help finance a range of 'spend-to-save' energy efficiency initiatives across the NHS in England. In all 117 energy efficiency projects were initiated across 48 English NHS organisations--funded through a dedicated NHS Energy Efficiency Fund. An independent analysis for the DH, NHS Energy Efficiency Fund Final Report, Summary 2014, by Professor Alan Short of Cambridge University's Department of Architecture, says the projects are already on track to save 100.6 million kg of CO2 annually, and some 2.4% of the entire 2012 NHS building energy-related carbon footprint, delivering annual energy savings of 160.5 million kWh (equivalent to boiling 3.34 billion cups of tea a year.) The Report--reproduced in large part here--summarises the schemes' preliminary outcomes, and makes recommendations for policy-makers implementing similar energy-saving funding schemes in the future.

Writing on behalf of the Building & Engineering Services Association (B&ES), Ewen Rose, an experienced journalist specialising in building engineering services, reports on a number of presentations at October's IHEEM Healthcare Estates 2014 conference where the focus was very much on how healthcare estates and facilities and healthcare engineering teams can save energy and cut carbon emissions through more efficient monitoring, and, if necessary, subsequent adjustment, of key HVAC plant. Among the key conclusions were that basic energy efficiency measures could 'shave millions of pounds from NHS estates' running costs', and that hospitals and other healthcare buildings face both 'an air-conditioning legal crisis', and a growing threat from outdoor air pollution.

Keen to address one of the major priorities on its backlog maintenance list, and, in the process, to significantly reduce both its carbon footprint and energy bills, Yeovil District Hospital NHS Foundation Trust has recently entered into a 15-year Energy Performance Contract (EPC) with Cynergin which involves the conversion of the existing steam-based heating and hot water infrastructure at Yeovil District Hospital to a considerably more economical, efficient, and future-proof, low temperature hot water (LTHW) system which should also provide added resilience.

As little has been written to describe the electrical energy required to deliver anaesthesia, we undertook to measure the total electrical energy consumption for a day's clinical anaesthesia. Daily energy consumption related to anaesthesia was measured with commercially available 'plug-in' power and energy meters, and additional in-use energy estimates were based on direct observation made in theatre and from measuring the power consumption of anaesthetic gas scavenging system (AGSS) pumps. Total energy use for anaesthesia per day was 28 kWh, and cost the modest sum of around pound 2.24 per day. Disproportionately large amounts of energy were required to run the anaesthetic gas scavenging pumps and the overhead radiant heaters. Energy saving can be safely obtained by switching off AGSS out of hours, and placing radiant heaters on timing or thermostatic controls.

With the NHS having committed to reduce its carbon footprint by 10% by 2015, Alan Newman, a partner at building services engineers, Troup Bywaters + Anders (TB+A), describes how, with the company's expertise and help, customer, the East and North Hertfordshire NHS Trust, 'surpassed the targets two years in advance'. As he explains, the key element of an ambitious carbon reduction scheme that won the 2013 IHEEM Healthcare Estates Sustainability Award (HEJ - November 2013) was a new combined heat and power-based energy centre at the Trust's Lister Hospital in Stevenage.

In our other article based around operating theatres in this issue of HEJ (see pages 64-72), we examine how some of the latest technology is benefiting users, but in this article--with all areas of the NHS charged with reducing energy consumption and cutting carbon emissions--Darren Jones, MD at carbon and energy management specialist, Low Carbon Europe, takes a detailed look, with the help of a 'real-life' case study based on recent experience at London's Heart Hospital, at operating theatre optimisation and HTM 03-01 audits.

A looming energy crisis will hit the UK within the next five years, energy regulator Ofgem has warned on a number of occasions already this year, and public sector organisations, commercial businesses, and households, can all expect a series of price hikes as demand outstrips local resources. So says Shamir Jiwa, founder and MD of MAXIM Eyes UK, a Surrey-based energy consultancy that serves business and organisations across the UK and Poland. Here he gives his personal view on some of the key short- to medium-term energy and resource management issues facing both hospitals and other healthcare facilities, and the wider UK, in the face of dwindling supplies of some, and especially fossil-fuel derived, forms of energy.

In the latest of our series of articles designed to provide healthcare engineers with sound technical guidance on equipment or technology-related topics, John O'Leary, key account manager at Trend Controls (who in April's HEJ discussed the benefits of natural ventilation in healthcare settings), explains the functions of a building energy management system (BEMS), and the vital that role such equipment can play in helping healthcare estates teams reduce carbon emissions and save money, as well as ensuring the most comfortable environment for patients, staff, and visitors.

Over the past few years medical air and vacuum have seen a number of significant innovations. The major benefit to the estates and facilities manager has been to open up new avenues for reducing energy costs. Medical gas equipment specialist, BeaconMedaes, has been particularly active in this respect, and here Andy Tudor, the company's product and marketing manager, explains how some of the key technologies work, and outlines the long-term benefits.

According to steam system specialist, Spirax Sarco, 'condensate contains about a quarter of the energy of the steam from which it came--a significant amount of heat available to an energy centre'. Ensuring that existing condensate recovery systems are as efficient as possible is therefore 'key' to reducing energy centre costs, the company says. Paul Mayoh, product manager, Spirax Sarco, considers ways to ensure that as much condensate as possible is re-used.

Steve Kearney, business manager for Newey & Eyre - Energy Saving 24/7, a team of 'energy experts' established early last year within one of the UK's leading distributors of electrical supplies, discusses the technologies and simple measures now available to reduce emissions and cut wastage generated by lighting in healthcare facilities, at a time when the NHS, especially, is under increasing pressure to reduce its carbon footprint.

As the U.K.'s largest organisation, with an annual purchasing budget of around pounds 17 billion, the NHS has an enormous part to play in reducing the country's energy consumption and emissions. Graham Williamson, general manager of Commercial Heating at Ideal Commercial Heating, considers the key measures healthcare facility operators can take to save energy, and how heating companies can help.

Steve Ruddell, division manager, Discrete Automation and Motion, at ABB, outlines the advantages of fitting variable speed drives and high efficiency motors into HVAC systems at a time when, faced with the need to cut costs, estates and facilities teams are having to look more closely than ever at reducing their buildings' energy consumption.

In an article based on a paper presented at the Institute of Hospital Engineering Australia's (IHEA) 2008 National Conference, Glen Hadfield, manager, assets & sustainability systems, Sydney West Area Health Service, discusses the benefits of cogeneration, highlighting the experiences and conclusions gained via a number of recent projects at hospitals in New South Wales.

In a paper presented at the Institute of Hospital Engineering Australia's (IHEA) 59th Annual National Conference in Canberra last year, Klaas Visser, of KAV Consulting, examines effective ways to reduce CO2 emissions and water use in hospitals.

Bobby Hancock, senior director of facility management for the Bloorview Kids Rehab facility in Toronto, describes how features such as a 37 kW penthouse roof solar array, thermal glazed windows, rainwater harvesting, and air handling units with variable speed drives and heat recovery wheels, contribute to the "green" credentials of Canada's largest children's rehabilitation centre.

Health Estate Journal reports on wide-ranging and successful work undertaken by the Medway Maritime Hospital's estates team to cut energy consumption at, and reduce the carbon footprint of, the Kent hospital since the Medway NHS Foundation Trust signed up, last August, to the Chartered Institution of Building Services Engineers' (CIBSE) 2008 "100 Hours of Carbon Clean Up" campaign.

The installation of what is believed to be the largest array of solar thermal panels currently in use at a UK NHS hospital has taken place at an ideal time for the facility in question, Harlow's Princess Alexandra Hospital, with the hospital's gas bill alone having risen by 153% over the past nine months thanks to soaring energy prices, and the estates department keen to mitigate the effects in any way possible. Jonathan Baillie reports.

Phil Gusack gives his personal slant on a recent Architects for Health (AfH) workshop on Sustainability in Hospitals and highlights the Department of Health's existing eco-achievements and the challenges it faces in enhancing the "green" credentials and environmental performance of its sizeable estate.

Soaring fuel costs continue to put the squeeze on already tight health service budgets. Yet it is estimated that combining established good practice with improved technologies could save between 10% and 30% of fuel costs for boilers. Paul Mayoh, UK technical manager at Spirax Sarco, examines some of the practical measures that healthcare organisations can take to gain their share of these potential savings.

In the last few years, healthcare engineering professionals in the U.K. have started to consider seriously how to reduce carbon emissions by replacing, or supplementing, fossil fuels with biofuels.

Paul Lakra of Planer explains his personal experience of using the company's Assure24seven monitoring system to cut the firm's heating bills.

A major healthcare sector project involving the supply of chilled water, steam and emergency power for facilities in Queensland, Australia, is detailed in this article. The review was prepared by Donald Glynn, energy manager/plant operations, Royal Brisbane Hospital.