Following last week’s BBH article telling how NHS trusts could save enough money to fund more than 20,000 heart bypass operations by implementing simple energy-saving measures, MATT FULFORD , head of low carbon buildings at carbon reduction consultancy, Sustain, explores how this can be done without impacting on services
With the continuing animosity over the Health and Social Care Bill and neither side wanting to back down, NHS reform will continue to occupy our minds for some time yet.
Leaving aside the ideological battle over the NHS, the need to cut costs while protecting frontline services is clearly of paramount importance. Yet, while health service managers continue to agonise over how to do this, there is one solution that is frequently overlooked – cutting utility costs.
We have found that by doing this the NHS could save at least £100m a year – a sum of money which could fund 12,260 heart bypass operations. And £100m is just the start – there is actually potential to save £150m a year.
Leaving aside the ideological battle over the NHS, the need to cut costs while protecting frontline services is clearly of paramount importance
With increasing cuts to public services, this kind of money should be very attractive to the NHS, which needs to make £20billion in efficiency savings by 2015 in order to meet government targets.
In order to determine the size of savings possible we analysed NHS utilities spend in England via the Estates Return Information Collection (ERIC) database. This contains all the information available relating to buildings within the NHS. We then benchmarked the data by ranking it according to utility spend and against information from external organisations including the Carbon Trust and CIBSE. Our experts then assessed the data.
There is no evidence that the NHS doesn’t want to implement these measures; it is rather that individuals don’t understand the real impact they could make
The average individual NHS trust spends £1.3m on energy, but has the potential to save at least £250,000 of that. Looking at the combined NHS trusts across England, the more conservative £100m saving across the NHS could pay for 12,260 heart bypass operations, or the treatment of 21,600 stroke patients.
One might ask why, if this is the case, more NHS hospitals are not seizing this opportunity with both hands. The issues we tend to come across are three-fold: Not knowing what to do, not having the time to be able to do it, and that the person responsible for utility spend – usually the energy manager – struggles to get the ear of the board where, ultimately, decisions are made.
The key to success is presenting the decision-makers, not with a problem, but a solution
With the right knowledge and business case, the NHS’s utility spend could be transformed. The kinds of measures NHS trusts could easily adopt are tried-and-tested measures that have been proven to work. These include changing lamps in existing light fittings, making sure existing heating systems are running well and appropriate temperature settings are in place to reduce running time, as well as insulating buildings and boiler rooms. These ideas may seem simplistic and far from the more popular renewable energy schemes but, cumulatively, and combined with other well thought-out measures, they could save the NHS a fortune.
There is no evidence that the NHS doesn’t want to implement these measures; it is rather that individuals don’t understand the real impact they could make. Where they do understand impact, it seems that another issue is the ability to implement the measures across the whole estate, rather than just the pilot project.
To help develop a business case for presentation to a board struggling with other pressures and priorities, there are some first steps that those responsible for utility spend can take.
An initial audit of how much is currently spent is a good starting point. Once this is established, it is worth examining where and how energy is used. Hospitals are obviously 24/7 operations. However, not every single part of the hospital falls into that category – there are offices, and most outpatient clinics do not operate at weekends. By powering down in these areas over weekends and Bank Holidays, savings could be made. Over a year, these all add up and help to reduce overall costs.
It’s not that utility saving in the NHS has been tried and found wanting, more that it hasn’t been tried at a complete and broad level of basics at all
The key to success is presenting the decisionmakers, not with a problem, but a solution. What finance director, if presented with a well-laid out business case for saving millions of pounds a year, is going to say ‘no’?
It’s not that utility saving in the NHS has been tried and found wanting, more that it hasn’t been tried at a complete and broad level of basics at all.
