NHS Sustainability Day Nottingham Road Show 2014

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Information about NHS Sustainability Day Nottingham Road Show 2014
Health & Medicine

Published on March 4, 2014

Author: 4allofus

Source: slideshare.net

Welcome to the Nottinghamshire Healthcare NHS Trust NHS Sustainability Day Road Show #Dayforaction

Sustainability in Practice Neil Alcock, Energy and Environmental Manager and Sustainability Adviser 2

Hits and Misses from the practical world of sustainability 3

Nottinghamshire Healthcare  Nottinghamshire Healthcare is a provider of integrated healthcare services, including mental health, learning disability and community health services.  Over 8,800 dedicated staff provide these services in a variety of settings, ranging from the community through to acute wards, as well as secure settings.  The Trust has a revenue income of £435 million for the present financial year.  The Trust delivers services from approximately 60 sites it owns and operates, but also operates from many sites which are not owned by the Trust, for example at least 26 sites owned by NHS Property Services but where the Trust is the majority occupant.  Total utility budget of approximately £3.5 million for owned and operated sites. 4

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Carbon Reduction the Big Picture A decrease of 26% overall 6

4 main NHS carbon sectors 7

All scopes carbon footprint 2010/11 to 2013/14 8

A decrease of 24% overall 9

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Hits All scopes carbon footprint reduced by 26% in four years. Core building carbon emissions reduced by 24% in four years. Procurement footprint reduced by 42% in four years. Misses Year on year comparisons made difficult by change to Trust structure and quality changes in data sources. Procurement footprint greatly influenced by decline in the capital spend. What will happen when capital spend increases again? 11

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Travel Scoreboard Hits Staff have been provided with a range of more sustainable travel option. Sustainable travel days have been held to publicise the options. Misses No parking charges and a lack of parking restrictions at Trust sites means lack of impetus to reduce car use. No measureable reduction from carbon emitted due to staff travel to date. 13

Voltage Optimisation Scoreboard Hits Voltage optimisation units installed at 4 of our largest sites, and delivering saving of up to 11% on electricity use. Misses A large increase in staff occupancy at one location has reduced the apparent savings. 14

Electric Vehicle Trial Hits Nissan Leaf and Peugoet Ion EV trialled successfully at two sites. Cost of charging very cheap. Misses Purchase price too high to make them cost effective. 15

Bicycle User Group Set Up Hits Secure cycle storage facilities requested by the BUG installed . Changing and shower facilities programmed for installation. Misses Need to engage with our Health Partnership Division. 16

Green Spaces Initiative Hits Attractive low maintenance green spaces provided for staff and service users. 280 trees planted as part of the NHS Forest scheme. Misses 60 bird feeders and hedgehog dens installed across the Trust. Initiative driven by the environmental team. Concepts need to be adopted by our G&G more widely. 17

Waste and Re-cycling Hits Waste now being recycled at 96% of Trust owned and operated sites. E training package being developed to aid efficient waste management. Misses Continuing adoption of new sites make waste compliance an on-going challenge. 18

Sustainable healthy food Hits Low sugar and low fat menu options selected. Seasonal food sourcing adopted. Cooking oil re-cycled to fuel delivery vans. Where possible Fair Trade, Rain Forest Alliance and other ethically traded goods are used. Misses Some sustainable foods still appear more costly so budget constraints may limit action in this area. 19

…………….and finally Hits Many more hits than misses. Misses More needs to be done to make sustainability core to Trust thinking ……………. any question? 20

Warwickshire County Council Electric Vehicles for Rural GP Practices Warwickshire Case Study Mike Woollacott ~ Greenwatt Technology NHS Sustainability Day Tuesday 25th February

Warwickshire County Council Project Partners

Warwickshire County Council Trial Aims & Purpose “to assess the applicability of electric vehicle (EV) technology in rural transport situations” Purpose: • Visible use of EVs in the rural community • Obtain data on actual vehicle usage • Gain insight into user experience • Test business model with GPs

Warwickshire County Council Trial Outline • Duration18 months from August 2012 • Three pilot GP Practices participating • EVs being used as: a pool vehicle for GPs on home visits and meetings delivery vehicle for pharmacy staff community taxi service to/from surgery • Each vehicle fitted with a data logger (Quartix) • Dedicated charging point at each surgery (British Gas wall/post)

Warwickshire County Council What’s in it for Medical Centre partners? • Demonstrating community leadership and local information source • Subsidised vehicle for the trial period (subsidised 18-month contract hire terms) • Charge point supplied and installed by British Gas • Opportunity to evaluate benefits of EV transport for Medical Centre • Local, regional and national media coverage

Warwickshire County Council Project Launch August 2012 “Warwickshire GP surgeries plug in to green machines” Handover of keys from Mr Tim Zimmerman, CEO Peugeot UK to Brookside Health Centre

Warwickshire County Council Health Centres~ EV handover Bidford Health Centre The Revel Surgery, Brinklow

Warwickshire County Council Driver Training Efficient EV driving – EcoDrive Ltd Vehicle familiarisation – Peugeot UK

Warwickshire County Council Typical Weekly Data Log Report

Warwickshire County Council One Year Usage Summary Miles travelled: Practice 1 – Patient & community transport Practice 2 – Prescription deliveries Practice 3 – GP home visits, personal use 1436 miles 2780 miles 6322 miles annual miles 7000 6000 5000 4000 Practice 1 3000 Practice 2 2000 Practice 3 1000 0 Practice 1 Practice 2 Practice 3

Warwickshire County Council Annual Costings

Warwickshire County Council Practice Managers’ Feedback “Fantastic alternative to petrol vehicle” “Welcome savings made on running costs” “Very reliable” “Many favourable comments from patients” “All our patients now look out for DORIS (as we have named her) making prescription deliveries around the villages”

Warwickshire County Council Driver Survey (Coventry University) • Drivers have found driving the electric vehicle ‘better than expected’ in terms of noise, comfort, speed, acceleration, braking, charging and informatics • As a result of driving the EV since September 2012 drivers comment include: – – – – “we like driving the electric car” “we find them as safe as our diesel vehicles” “there are good savings on running costs” “EVs will have an important future role” • Some concerns expressed about performance in cold weather .... “driving in the cold/frosty weather significantly reduced the range”

Warwickshire County Council Warwickshire Rural Electric Vehicle Trials Next Steps • All three GP Practices have extended their lease for a further 12 months • Stratford EV Town Project (with British Gas) • Warwickshire Rural Electric Vehicle Project (WREV) • Housing Association – assisted living (pool EV)

Warwickshire County Council Rural Electric Vehicle Trial Dedicated user website www.evs4gps.org.uk Project Manager - Mike Woollacott mike@greenwatt.co.uk

Luciana Berger MP Shadow Public Health Minister #Dayforaction

Changing Shape of Energy NHS Sustainability Day February 2014 38

PROTECT - PROPRIETARY What is the energy context in the UK? Supply • Electricity generated in 2012 fell by 1.3% Carbon • Low carbon electricity‘s share of generation increased from 28.1% in 2011 to 30.7% in 2012 Cost • Energy price trend is set to continue & non energy cost increasing rapidly Wholesale Power Prices 2001 – 2030 12.00 Historic High 8.00 p/kWh Central Low 2030 2020 2010 0.00 2001 4.00 Source: DECC Oct 2012 39 NHS Sustainability Day February 2014 © EDF Energy plc. All rights Reserved. May 2013

PROTECT - PROPRIETARY Challenges – the energy dilemmas 2011 Typical unit rate £78/MWh 40 2014 Typical unit rate £102/MWh PROTECT COMMERCIAL - Energy Services Overview © 2013 EDF Energy plc. All rights Reserved. May 2013

PROTECT - PROPRIETARY 41 PROTECT - PROPRIETARY - Connecting to Performance © EDF Energy plc. All rights Reserved. May 2013

PROTECT - PROPRIETARY Changing processes, upgrading technologies Temperature control Lighting system upgrades Mechanical retrofit Air quality improvement ―Achieve a 34% reduction in carbon dioxide equivalent emissions from building energy use, travel and procurement of goods and Utilities auditing Chiller compliance & efficiency Ventilation upgrades 42 Building management system services by 2020‖. Generators for Demand Response On-site technical resource management Source: Sustainable Development Strategy NHS Sustainability Day February 2014 © EDF Energy plc. All rights Reserved. – Protect Commercial May 2013

PROTECT - PROPRIETARY Changing attitudes Advanced, open and willing to listen to new ideas… • Executive Sponsorship • Employee Engagement • Job Isolation • Job Focus Source FT Nov 2011 43 NHS Sustainability Day February 2014 © EDF Energy plc. All rights Reserved. May 2013

PROTECT - PROPRIETARY Energy Performance Contracts (EnPC) What is it? How Does it work? Strategic Energy Partnership Guaranteed savings Fit for purpose technologies Generates value through a blend of measures 44 Turnkey approach to an estate A range of financial options NHS Sustainability Day February 2014 © EDF Energy plc. All rights Reserved. May 2013

PROTECT - PROPRIETARY Energy Performance Contracts (EnPC) benefits Strategic Technical Capital investment in your estate Improving existing assets Hedge against price fluctuations Performance risk borne by Delivery Partner Immediate savings Increased security of supply Energy Expert resource 45 NHS Sustainability Day February 2014 © EDF Energy plc. All rights Reserved. May 2013

PROTECT - PROPRIETARY How an EnPC works in practice Energy Savings per Project Total Energy Savings Agg. Single Projects EnPC (bundle) £50k £0k £250k 2 year payback Investment Criteria Limit £0k Payback Period NB: Within the EnPC the highest individual project payback was 4.6 years Orange icons indicate single projects, Green icons indicate projects part of an EnPC 46 NHS Sustainability Day February 2014 © EDF Energy plc. All rights Reserved. May 2013

PROTECT - PROPRIETARY Why now is the time to start thinking about EnPCs • • Ageing assets that are approaching the end of their life • Finance constraints • Credible delivery partners • 47 Challenging carbon targets Support networks and procurement frameworks (such as RE:FiT, Building Research Establishment (BRE), Carbon Energy Fund) NHS Sustainability Day February 2014 © EDF Energy plc. All rights Reserved. May 2013

48 NHS Sustainability Day February 2014 © EDF Energy plc. All rights Reserved.

PROTECT - PROPRIETARY An easy way to see the energy change in context Objectives Outcomes 49 NHS Sustainability Day February 2014 © EDF Energy plc. All rights Reserved. May 2013

Understand the risks - 2011 wholesale energy price made 2/3rd of standard contract total cost 50 NHS Sustainability Day February 2014 © EDF Energy plc. All rights Reserved.

2014 Energy Prices: Non energy cost expected to rise 70% of the 2014 increase is non energy cost What does this tell us? • Non Energy Costs are getting higher • Non Energy Costs will be the volatile component of your bill 51 NHS Sustainability Day February 2014 © EDF Energy plc. All rights Reserved.

Tea/Coffee & Networking #Dayforaction

25th February 2014 NHS Sustainability Day Nottingham Resource efficiency through effective behaviour change Ann Durrant Managing Director

A bit about me and M4C … M4C: • Sustainability specialists • Strong focus on comms • In business over 8 years Who we’ve helped … Ann: • Chartered Engineer • Ex British Rail and AstraZeneca • Associate lecturer at Salford Uni

A very quick bit of … Behavioural Psychology

Culture change A place where sustainable behaviours are the norm

Make it a habit

Make it a habit Pavlov’s dog

A couple of … Case studies

Northern Rail Project Manager engagement Objective – to get project managers to consider sustainability initiatives at the beginning of a project

Northern Rail

SABMiller Level assessment process Objective – improve performance across all sustainability priorities

SABMiller • KPIs • Level assessments 0 1 2 3 Below minimum Minimum standard Progressing Developing leadership • Areas of risk • Good news stories 4 Best practice 5 Leading edge

SABMiller

SABMiller Result

Keele University Recycling campaign Objective – to increase their recycling rate from 44% to 60%

Keele University Keele University – 64th Annual waste management costs 40% = £116,460 60% = £102,285

Northern Rail Employee engagement Objective – to get employees to take ownership of environmental challenges in the work place

Northern Rail • • • • • Email Online Phone Face to face Internal mail

Case study - Northern Rail

Summary • • • • • • • • • • • Tell people what to do Make it easy Make it normal Use intrigue Make it fun Use memory joggers Provide feedback Competitions Set goals Give rewards Link to their values

Other events Webinars: An introduction to behaviour change techniques • 6th March – 13.00 www.nhssustainabilityday.co.uk/webinars 1 day CPD accredited course: Energy savings through communication and engagement • 7th April – Watford • 15th May – Salford www.m4c-sustainability.co.uk/cpd

Ann Durrant ann@m4c-sustainability.co.uk 01625 501832 07951 642747 www.m4c-sustainability.co.uk

Private and public sector partnerships 25th February 2014 © British Gas Trading Limited 2011

By definition ―A partnership is an arrangement in which parties agree to cooperate to advance their mutual interests‖

Health and wellbeing at the core of a sustainable NHS Source : Department of Health

Deprivation and its impact on health and wellbeing Sources : Marmont Review, Office of National Statistics

The health risks associated with cold homes <16 C (61 F) - Reduced resistance to respiratory infection. <12 C (52 F) - Increase in blood pressure and blood thickness. Risk of circulatory and heart disease, can be fatal. <9 C (47 F) - After two hours, deep body temperature falls leading to hypothermia, can be fatal.

Taking action on fuel poverty

By definition ―A partnership is an arrangement in which parties agree to cooperate to advance their mutual interests‖

Tower Hamlets Each year, Tower Hamlets suffers from around 330 excess winter deaths that are attributable to Fuel Poverty. Tower Hamlets is one of the worst affected areas in the UK.

The vision ―Improving the energy efficiency of the existing [building] stock is a long-term, sustainable way of ensuring multiple gains, including environmental, health and social gains.” The Health Impacts of Cold Homes and Fuel Poverty, Marmot Review, 2011

Our approach 1. Training of healthcare professionals 2. Utilisation of outpatient letters 3. In-hospital comms

What we are learning  Engaging appropriate stakeholders key  It takes time and resource  Language barriers  Quality of information will impact conversion rates

Where we are with the project  43 people trained  Letter process up and running  Referrals generated  First completed installs

Raising the profile Left: Living Warm Living Well featured in the Barts Health Life magazine, which goes out to staff and patients Below: Living Warm Living Well also featured in the East End Life before Christmas.

Next steps  Customer satisfaction surveys and feedback  Review what worked, what didn‘t  Consider implications of changes to ECO

Partnerships principles 1. Discuss wider goals 2. Take calculated risks, and be realistic (considering resource, BAU activity etc.) 3. Measure success 4. When things don‘t work, learn from it 5. When things do work, repeat and share best practice

Thank you Chris Barrass Senior Business Development Manager chris.barrass@britishgas.co.uk 07789 573639

Collaborating on Sustainability within the NHS Nottinghamshire Healthcare NHS Trust February 25th 2014 12/09/2013 90 Titre de la présentation

Agenda  Introduction to Cofely  Collaboration within the NHS  Cofely GDF SUEZ approach to Sustainability  Local Action Plans  Case Study Examples (broader sustainability) — — — 91 Pilgrim Hospital Rampton Hospital Queen Elizabeth Hospital

GDF SUEZ Energy Services & Cofely  Cofely is primary B2B brand of GDF SUEZ Energy Services  Cofely operates in over 30 countries, serving 100,000 public & private sector customers  £13 billion revenues  No.1 service provider in France, Belgium, Netherlands & Italy  95,000 employees worldwide 92

Cofely in the UK £1 billion UK turnover* 15,200 employees in UK* 14,000 sites managed in UK 23.6 million m2 of space managed * Including pro-rata full consolidation of Romec JV 93

Service Areas for Customers 94

12/09/2013 95

12/09/2013 96

Local Engagement on Sustainability 12/09/2013 97

Pilgrim Hospital Energy Centre, Boston Titre de la présentation 98

Pilgrim Hospital Energy Centre, Boston  15 year contract for Energy Supply and Operation  Awarded in April 2008  Design, build and operation of Energy Centre  Steam raising biomass, gas & CHP  Updated control system  New water treatment plant  First installation of steam biomass boiler supplied to the NHS within the UK 99

Background: Pilgrim Hospital, Boston, Lincolnshire  Pilgrim Hospital opened in 1976  Serves South & South East Lincolnshire  24hr major Accident & Emergency department  569 beds, serving a population of 350,000  Full range of acute services 100

Phase I: Construction & Installation  COFELY designed, installed and operate the Energy Centre.  The Security of Supply was essential at all times: — Hospital fully operational at all times throughout the project  Fuel flexibility 101

Phase II - Operational  COFELY have total responsibility for the plant  Working in close partnership with the NHS Trust through a Liaison Committee to procure fuel  We sell steam, electricity and hot water to the Hospital  £90K per annum carbon trading savings  5,732 tonnes reduction in CO2 emissions per annum  51% reduction in CO2 102

Behavioural Change  Awareness Campaign for new Energy Centre  Educational materials & Energy boards  Open day for stakeholders  Supplier forum  Engaging local press  Training & Awareness  Awareness of practices that can be used outside of the workplace at home 103

Other initiatives Titre de la présentation 104

Rampton Hospital Energy Centre     Carbon Energy Fund framework contract to construct, operate and maintain a new Energy Centre Due for completion by the end of 2014, Energy Centre will provide heating, hot water and electricity to the hospital. Will meet approx 87% of the total electricity demand — — — — 1MW biomass boiler, 1.2MW combined heat and power (CHP) engine 3 x high efficiency dual-fuel boilers running on gas. A new building management system will also be installed.  Reducing CO2 emissions by 8,000 tonnes per annum  Projected financial savings of around £112,000 per annum 105

Queen Elizabeth Hospital  Onsite energy manager oversees hospital site‘s £10 million energy spend  We support the operational team in contract delivery to guarantee onsite energy performance  Energy reduction strategy implemented across the 185,000 sqm estate means the combined hospital trusts are already operating 12% more efficiently than the original performance target. 106

Welcome back #Dayforaction

Lunch #Dayforaction

Welcome back #Dayforaction

Sustainable Water How Bart's NHS are Saving Britain‘s Water with AquaFund©

Why worry about water? • Water scarcity • Rising cost of water • Population growth • Unpredictability of climate 01753 833 880 ask@aquafund.com © Advanced Demand Side Management 2014.

Population Growth & Food

What do you use? 150 litres 3,400 litres Chocolate 01753 833 880 ask@aquafund.com Butter Beef © Advanced Demand Side Management 2014.

Climate change

Water cost & CO2 • Rising costs • The nexus of Energy & Water 01753 833 880 ask@aquafund.com © Advanced Demand Side Management 2014.

Better water management • Sustainability • We should use less • Not simply because it is right, because it is necessary 01753 833 880 ask@aquafund.com

How Bart's NHS are Saving Britain's Water

The Trust had specific objectives • Reduce water consumption and cost • Reduce Carbon emissions • Environmental performance & impact • Strengthen data management 01753 833 880 ask@aquafund.com To sustainably manage its water resources © Advanced Demand Side Management 2014.

The partnership • Lower water consumption • Financial savings • No budget • A comprehensive approach 01753 833 880 ask@aquafund.com NHS Trusts are eligible for a £200,000 £500,000 grant © Advanced Demand Side Management 2014.

Engineering expertise • In-depth surveys of the entire portfolio • State of the art water-saving technologies • Automatic Meter Readers 01753 833 880 ask@aquafund.com © Advanced Demand Side Management 2014.

Strengthening the Trust‘s data • Full water bureau service • Monthly Monitoring & Targeting Reports • Total visibility 01753 833 880 ask@aquafund.com

Environmental • Consumption profiling and environmental information • Levels of Carbon saved • Continually monitoring, preventing anomalies or leaks 01753 833 880 ask@aquafund.com © Advanced Demand Side Management 2014.

Humanitarian aid 420,000 people out of water poverty

Delivering on the Trust‘s objectives • Reduce water consumption and cost • Reduce Carbon emissions • Strengthen data management • Environmental performance & impact 01753 833 880 ask@aquafund.com To sustainably manage its water resources © Advanced Demand Side Management 2014.

A comprehensive approach • Billing Data • Water-saving equipment • Continually monitoring 01753 833 880 ask@aquafund.com © Advanced Demand Side Management 2014.

Our impact

Framework OJEU REFERENCE: 2011/S 186-304473 01753 833 880 ask@aquafund.com www.adsm.com @AquaFund 01753 833 880 ask@aquafund.com © Advanced Demand Side Management 2014.

Fuel Poverty

When is a household in fuel poverty? Old definition: more than 10 % of income spent on fuel to maintain a satisfactory heating regime. New definition: fuel costs are above average or where heating adequately would leave an income below the poverty line In 2011 under the new definition 2.4 million 1 were classed as fuel poor rather than 3.2 million 2 1. DECC, Annual report on fuel poverty statistics 2013 (May 2013) 2. DECC, Fuel poverty report: Updated August 2013 (August 2013)

Fuel Poverty - the causes & consequences Low Income High energy prices Poor efficiency Under occupancy FUEL POVERTY Fuel Debt HEAT HOME DON’T HEAT Ill health Condensation Disrepair

Who is at risk? Households with a low income particularly if it is fixed – Older people Parents with young children People with disabilities and or long term illnesses Single people – under occupied People without access to advice and information Households that are not on the gas network

CSE Fuel Poverty Indicator 2012

Health issues associated with fuel poverty Cold homes can be a significant risk to health 18 - 21°C – No risk to sedentary, healthy people Below 16 °C – diminished resistance to respiritory infections Below 12 °C – increased blood pressure and viscosity Below 9 °C – after 2 or more hours deep body temperature falls

Excess Winter Mortality associated with fuel poverty In 2012-13 there were 31,100 excess winter deaths in England. This is a a 29% in increase compared with the previous winter. In Britain a cold spell during a mild winter is followed: 2 days - Rise in heart attacks (1/3) 5 days - Rise in strokes 12 days - Rise respiratory illnesses Reports on Excess Winter Mortality – Public Health England (PHE) and ONS

Identifying Fuel Poverty

Listen out for people talking about it Anyone can identify fuel poverty, particularly those in contact with public Fuel bills are too high Home is usually too cold Living in one room to keep warm Rationing fuel Using prepayment meter to avoid debt Home is draughty Child / family member has respiratory problems

Look for evidence of it Severe condensation on windows Curtains kept closed to retain heat Mould stains on wall or curtains Portable bottled gas or electric heaters Heating controls absent / not working Blocked / covered vents Heating appliances aren’t being used e.g. dust on heating elements

Sense it when visiting homes Feel – Cold Smell – damp, musty Feel – Draughts Feel - Large differences in temperature between rooms maybe only heating one room

Fuel Poverty Solutions

Improve income Accessing benefits can increase incomes available grant schemes and other services

Reduce fuel costs Using the cheapest fuels for heating, hot water and appliances • Switching energy suppliers can save up to £420 a year* • Comparison sites such as energyhelpline, uswitch, moneysupermarket • Make sure you are on the cheapest tariff • Try to pay by Direct Debit if possible (Figures from uswitch)

Improve the energy efficiency of homes Insulation Energy efficient heating systems Renewable and Micro generation technologies

26% 33% 18% 3% 12% 8%

Loft Insulation Loft Insulation is one of the easiest and most cost-effective ways of improving the energy efficiency of your home. • Save up to £175* every year on bills • Your home will stay warmer for longer • Can help to reduce condensation • Effective for at least 40 years • An un-insulated roof can lose up to 25% *Source Energy Saving Trust

Cavity Wall Insulation If your home was built after 1920 its external walls are likely to be made of two layers with a gap or cavity between them. Cavity wall insulation fills that gap • Save up to £135* every year • Homes stay warmer for longer • Can help to reduce condensation • Effective for at least 40 years • Un-insulated walls lose up to 33% *Source Energy Saving Trust

Solid Wall Insulation • Layer of insulation material is fixed to the walls • External insulation may change appearance • May need planning permission:

Renewable energy systems • Ground source heat pumps • Air source heat pumps • Biomass boilers (wood) • Solar thermal • Solar photo voltaic (P.V.) Incentives: • Renewable heat incentive (RHI) • Feed in tariff (FIT)

Grants, Schemes and Services

Green deal Launched in January 2013 Reduces upfront costs of energy efficiency measures Repay the cost of improvements through the savings on your energy bills No eligibility criteria

Energy Company Obligation (ECO) • Government’s new energy efficiency programme • Replaces the CERT, CESP & Warm Front programmes • Works alongside the Green Deal • Provides additional support for energy efficiency • Support for vulnerable households & communities • Funding is provided from energy companies to install: • Loft & Wall insulation • Replacement energy efficient boilers • Communal heating

Carillion Case Study – Birmingham 7 Towers The 7 towers project is part of the Birmingham Energy Savers Programme 480 social housing flats in tower blocks owned by Birmingham City Council Two fuel poor areas of the city Installation of energy efficiency improvements including: • External wall insulation • Flat roof insulation • EcoPod district heating

Carillion Case Study – Birmingham 7 Towers Project delivery was significantly more that the ECO funding alone. Carillion worked with Birmingham City Council to include other funding: • DECC Go Early • DECC Fuel Poverty • European Regional Development Fund Example of measureable impacts on fuel poverty on a flat in Metchley House: • Average annual fuel bill prior to installation £550 • Average annual fuel bill after EWI and EcoPod installation: £350 • Average overall annual saving: £200

Thank you !

Welcome 154 GPS London Event Jan 2014 © EDF Energy plc. All rights Reserved. Protect Commercial

EDF Energy Workshop Presenter: Vicki Evans, EDF Energy GPS London Event Jan 2014 © EDF Energy plc. All rights Reserved. Protect Commercial

An easy way to see the energy change in context Objectives Outcomes 156 NHS Sustainability Day 2014 © EDF Energy plc. All rights Reserved. GPS London Event Jan 2014 © EDF Energy plc. All rights Reserved. Protect Commercial Protect Commercial

Scoping out delivery costs 157 NHS Sustainability Day 2014 GPS London Event Jan 2014 ©© EDF Energy plc. All rights Reserved. EDF Energy plc. All rights Reserved. Protect Commercial Protect Commercial

Electricity network Transmission Balancing Distribution 158 NHS London Event Jan 2014 © EDF Energy plc. All rights Reserved. GPS Sustainability Day 2014 © EDF Energy plc. All rights Reserved. Protect Commercial

Non energy costs are rising 2% Other 2% 7% 2011 65% Low carbon generation 26% Delivery 12% 30% 56% 2014 Wholesale energy 2011 – Typical unit rate £78/MWh 2014 – Typical unit rate £102/MWh Delivery charges are predicted to increase by 50% to represent an increase from around 26% to 30% of the average unit price. Based on average customer 159 NHS London Event Jan 2014 © EDF Energy plc. All rights Reserved. GPS Sustainability Day 2014 © EDF Energy plc. All rights Reserved. Protect Commercial

• Significant investment to maintain network and connect new, often intermittent, low carbon generation • Ofgem regulates their revenues with price controls • TNUoS = c.5% of business energy bills • Triad management opportunities 160 NHS London Event Jan 2014 GPS Sustainability Day 2014 © EDF Energy plc. All rights Reserved. © EDF Energy plc. All rights Reserved. Protect Commercial

• 6 DNOs manage 14 regional networks • DNOs‘ investment plans and revenues are long term and regulated by Ofgem • DUoS = 20% of businesses energy bill. Charges vary by region 161 NHS London Event Jan 2014 © EDF Energy plc. All rights Reserved. GPS Sustainability Day 2014 © EDF Energy plc. All rights Reserved. Protect Commercial

• National Grid acts as System Operator (SO) to balance demand & generation • BSUoS = 1% of business energy bills • Balancing contracts (e.g. STOR) provide opportunities to be paid for reducing consumption / increasing generation to help balance the system 162 NHS London Event Jan 2014 GPS Sustainability Day 2014 © EDF Energy plc. All rights Reserved. © EDF Energy plc. All rights Reserved. Protect Commercial

Rising fast Rising Variable All costs in £ billions 163 NHS London Event Jan 2014 GPS Sustainability Day 2014 © EDF Energy plc. All rights Reserved. © EDF Energy plc. All rights Reserved. Protect Commercial

Options to save The only way to avoid non energy costs is not to use the unit. Non Energy Costs are passed through or included in your unit rate these charges always apply Produce your own 164 NHS London Event Jan 2014 GPS Sustainability Day 2014 © EDF Energy plc. All rights Reserved. © EDF Energy plc. All rights Reserved. Use less Protect Commercial

Produce your own – example • An NHS Trust uses a CHP plant to generate electricity • Unused generation was being spilt back to the grid • The Trust was not receiving payment for what they spilt • The Trust set themselves up to export • A Power Purchase Agreement (PPA) is set up • Customer is paid for the excess energy they generate ** **Depending on volume generated 165 NHS Sustainability Day 2014 ©© EDF Energy plc. All rights Reserved. GPS London Event Jan 2014 EDF Energy plc. All rights Reserved. Protect Commercial Protect Commercial

Power Purchase Agreements (PPAs) Fixed price PPA: • • • Sets the price you sell, provides income certainty All-inclusive rate Volume tolerance options Index-linked PPA: • • • 166 Achieves a price that is linked to the wholesale market Suitable for new generators, variable or intermittent export volumes Flexibility around how and when you forecast your output NHS Sustainability Day 2014 ©© EDF Energy plc. All rights Reserved. GPS London Event Jan 2014 EDF Energy plc. All rights Reserved. Protect Commercial Protect Commercial

Use less – example • NHS Trust requests assistance to help them understand their energy consumption patterns • Their energy provider gives access to day +1 reporting portal • The Trust uses data to get control on when they use electricity • The Trust contacts an energy services provider to find out more • Provider identifies a number of options to reduce usage through on-site and desk research 167 NHS Sustainability Day 2014 ©© EDF Energy plc. All rights Reserved. GPS London Event Jan 2014 EDF Energy plc. All rights Reserved. Protect Commercial Protect Commercial

Use less – your options Pay back timing Savings • • • • • • • Short-term Long term ECM hurdle rate Carbon Volume Value Extra income Energy awareness Volume reduction • • • • CRC Scheme Impact Audience Promoting Renewable generation Audit & Reporting change Technology 168 • • • • Refurbishment Established Innovative Volume management NHS Sustainability Day 2014 ©© EDF Energy plc. All rights Reserved. GPS London Event Jan 2014 EDF Energy plc. All rights Reserved. Increased visibility Operational Excellence • • • • • Installation Consumption Alternatives Increase awareness Understanding, visibility and control • • • • • • Around change Basis for strategy Site Maintenance Consistency Disaster recovery process Smart Response Protect Commercial Protect Commercial

A good place to start Understand energy usage Produce targeted business cases for investments Highlight wastage or over consumption Pinpoint areas for improvement Within energy function Establish benchmarks With external stakeholders Engage with frontline staff and create engagement strategies Communicate with senior management Plan for changes within the organisation e.g. expansion 169 NHS Sustainability Day 2014 ©© EDF Energy plc. All rights Reserved. GPS London Event Jan 2014 EDF Energy plc. All rights Reserved. Protect Commercial Protect Commercial

GPS London Event Jan 2014 © EDF Energy plc. All rights Reserved. Protect Commercial

Reduction of carbon emissions and associated costs by 25% (2009-2014) Sid Siddiqui DCHS Environmental Manager Mark Armstrong-Read DCHS Strategy and Planning Manager

EMISSIONS SCOPE: Cost ENERGY WATER WASTE TRAVEL

How? ENERGY • Capital • Improve buildings and energy using plant • Low cost energy efficient innovations • Renewables • Rigorous maintenance • Back-log – draught proofing, heating controls • Pro-active – plant & equipment ppm, water meters • Reactive – windows, doors, heating, water leaks

How? WATER • • • • • Strict leakage monitor and control Low cost water saving devices Working closely with water supply companies Behavioural change ISO 14001

How? WASTE • • • • • Adopting ‗waste hierarchy‘ approach Meticulous waste separation & segregation Reducing landfill waste WEEE ISO 14001

How? TRAVEL Green Travel Plan • • • • • • Teleconferencing and back to back meetings Remote and agile working providing hot desks E-pay: Electronic mileage claims Salary sacrifice lease cars Car share website, public transport, cycle to work pool cars

Managing CHANGE • initiative •Carbon Champions •The Voice •Mail shots/Newsletters

CO2 vs. TARGET 2850 tonnes saved against BAU scenario

£’s vs. TARGET Actual cost savings to date £600k (£1600k against BAU)

Our FUTURE • Beyond 2014 – Retain and embed achievements and good practices – Develop new sustainability strategy to take us into 2020 – Sustainable procurement to play significant role in reducing CO2 emissions and costs – Minimise landfill waste – Low carbon buildings and technologies

Thank you for listening Questions?

Sustainability in NHS Property Services Ltd

Why NHS Property Services? • We manage, maintain and improve NHS properties and facilities • In partnership with NHS organisations • To create safe, efficient, sustainable and modern healthcare and working environments.

Our portfolio

Our objectives 5 of 6 To ensure our estate is managed sustainably and that we support wider government initiatives in this area

Benefiting the NHS 1. Focus on Estates and Facilities provision, we can deliver a more streamlined, strategic and professional focus 2. Provide quality buildings, one building many providers 3. Clinical providers can concentrate on quality of care. Patients come to one building for range of care

We look forward to working with you • Scope to redesign or add value only realised through co-operation with commissioners and providers

An Exciting Vision • The NHS is now under pressure to adopt new patient care pathways. NHS Property Services will respond by making the estate fit for the future • NHS Property Services can lead the way in reducing the impact of the NHS on the environment

How will NHS Property Services achieve its energy saving targets? • • • • • Audit its estate Establish its carbon footprint Target improvement Implement improvement strategies Work with partners/tenants in achievement of their own sustainability objectives

What does NHS Property Services plan in the future? • Establishment of good quality data • Use of EPC to improve efficiency of buildings • Work with tenants to improve efficient use of resources - leads to lower charges • Greater negotiation with transport providers • Work with tenants to identify electric vehicle charging points • Work with commissioners to identify areas for investment and de-investment

Matthew Smith BEng(Hons), DipNEBOSH, EnvDipNEBOSH, AIEMA Matthew.smith@property.nhs.uk

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