Ross Crighton, Senior Aftermarket Sales Manager, Grundfos Commercial Building Services, North West Europe
Healthcare buildings are among the most demanding environments in the built sector. Hospitals and clinical facilities operate continuously and must maintain strict standards for air quality, hygiene, and resilience, which creates significant pressure on infrastructure and, inevitably, on energy and water consumption.
At the same time, healthcare providers are under growing pressure to reduce operational emissions and modernise ageing estates. According to NHS England, the healthcare industry is estimated to account for 40 per cent of public sector emissions in England[1], with building-related energy use, water consumption, waste, and refrigerants responsible for a considerable proportion of that footprint.
The challenge is that sustainability in healthcare cannot be approached in the same way as it might be in a standard commercial office. Hospitals cannot simply reduce ventilation rates or scale back operations in pursuit of lower energy use. Patient safety and operational continuity must always come first.
This is why the conversation is shifting away from isolated efficiency measures and toward whole-building optimisation. Recent research carried out independently by Evalueserve suggests healthcare facilities could reduce energy consumption by up to 30 per cent through improved integration and optimisation of energy, ventilation, and water systems.
That finding reflects a wider issue across the sector. In many healthcare environments, inefficiencies are not caused by a single system failure. Instead, they develop gradually through ageing infrastructure, disconnected controls and fragmented upgrades that no longer operate efficiently together.
Many hospitals still rely on legacy plant infrastructure that was never designed to support modern energy management strategies. HVAC systems, pumps, ventilation equipment, and water systems often operate independently rather than as part of an integrated building approach. The result is unnecessary energy use, inconsistent performance and rising operational costs.
One of the clearest opportunities lies in building management and automation systems. Modern Building Management Systems (BMS) provide facilities teams with greater visibility of how buildings are performing in real time. Rather than relying solely on reactive maintenance, operators can monitor demand patterns, identify inefficiencies earlier and optimise systems dynamically.
Evalueserve’s research notes that healthcare facilities implementing advanced BMS strategies can achieve energy savings of between 20 and 30 per cent, while also improving operational reliability and predictive maintenance capabilities.
This is not simply about reducing energy bills. Improved system visibility supports compliance requirements, helps maintain stable indoor conditions and reduces operational risk.
Ventilation remains one of the most significant pressures on healthcare estates. Healthcare facilities require high air exchange rates to maintain sterile environments and control airborne contaminants. Those requirements create substantial heating and cooling demand, particularly in older buildings where systems may already be operating inefficiently.
As a result, there is growing interest in technologies such as Energy Recovery Ventilation (ERV). These systems recover heat from outgoing air and transfer it to incoming fresh air, reducing the load on HVAC systems while still maintaining required ventilation standards.
Smart ERV systems can also adjust ventilation rates dynamically based on occupancy, humidity, and indoor air quality conditions. According to the report, energy recovery systems can typically deliver reductions of 10 to 15 per cent in water and energy consumption.
Finally, water management warrants closer attention. Healthcare buildings consume substantial amounts of water for sanitation, sterilisation, cooling, and general operational use. In many older facilities, hidden leaks, ageing pipework, and inefficient fixtures contribute to avoidable wastage.
The report identifies several strategies becoming increasingly relevant across healthcare estates, including leak detection, pressure optimisation, rainwater harvesting, and greywater recycling. Many of these measures can be introduced incrementally as part of wider refurbishment and decarbonisation programmes, rather than requiring full infrastructure replacement.
Alongside operational pressures, government policy is accelerating the need for action, with initiatives including the NHS Net Zero Strategy and the Public Sector Decarbonisation Scheme increasing focus on building performance and infrastructure upgrades across healthcare estates.
What is clear is that healthcare sustainability is no longer just an environmental discussion. Building performance now directly affects operational resilience, maintenance planning, long-term running costs, and patient environments.
The strongest outcomes are typically achieved when building systems are treated as interconnected rather than separate disciplines. Energy, ventilation, and water systems all influence one another, particularly in complex healthcare environments operating continuously under variable demand.
As pressure grows to deliver lower-carbon healthcare infrastructure without compromising operational performance, optimisation of existing buildings is likely to become one of the most important priorities across the sector.
[1] https://www.england.nhs.uk/long-read/five-years-greener-nhs-progress-forward-look/#:~:text=The%20Net%20Zero%20Supplier%20Roadmap,sustainability%20journey%20and%20demonstrate%20progress.
