Building resilience to overheating into UK 1960s hospital buildings within the constraint of the national carbon reduction target: adaptive strategies

The National Health Service (NHS) Estate in England includes 18.83 Mm2 of acute hospital accommodation, distributed across 330 sites. Vulnerability to overheating is clear with 15,000 excess deaths occurring nationally during the July 2003 heatwave. The installation of mechanical cooling in existing hospitals appears to be the inevitable recommendation from NHS patient safety risk assessments but the carbon implications would undermine the NHS Carbon Reduction Strategy. NHS CO2 emissions constitute 25% of all public sector emissions, equivalent to 3% of the UK total. In the post-2008 economic climate, the likelihood of wholesale replacement of the NHS Estate is significantly diminished; refurbishment is now of increasing interest to the Trusts that together make up the NHS. The research project ‘Design and Delivery of Robust Hospital Environments in a Changing Climate’ seeks to understand the environmental performance of the current NHS Estate and, from this, to establish its resilience. To this end, hospital buildings operated by four NHS Trusts are being monitored and simulated using dynamic thermal models calibrated against measured data. Adaptive refurbishment options are proposed and their relative performance predicted against the existing internal conditions, energy demands and CO2 emissions. This paper presents findings relating to one representative type building, a medium-rise ward block dating from the late 1960s. It shows that this particular type may have more resilience in the current climate than might have been expected, that it will remain resilient into the 2030s, and that relatively non-invasive measures would extend and increase its resilience whilst saving energy.