Decarbonising the Healthcare Estate


The HSE recognises the importance of reducing Green House Gas (GHG) emissions in line with the Paris Agreement goals of 1.5°C and 2.0°C limits on global temperature rise.  It is committed to fulfilling a leadership role in the public sector – by playing its part in Ireland’s decarbonisation journey and taking on an evolving role in helping to address the health impacts of climate change, writes Peter Smyth, AND Climate Action & Sustainability, HSE Capital & Estates.

Increases in climate change impacts have been shown to have significant impacts on health and wellbeing. These impacts include increased UV and Sun exposure with greater risk of skin cancer and air pollution which can give rise to increased levels of respiratory illnesses.

The HSE has reduced its direct and indirect energy-related emissions by 19% and 36%, respectively, from 2009 to 2019, giving rise to a total energy-related emissions reduction of 26% since 2009

There are also significant impacts from extreme weather events (Windstorms /Flooding /Heatwaves /Cold), including risk of physical injuries or mortality, as well as risk of disease from pathogens or toxic agents, such as waterborne infectious diseases, after an extreme event. Adverse impacts to mental health from extreme weather events can also have an indirect effect on society through factors such as stress, loss or displacement.

In November this year, the Government launched the Climate Action Plan 2021, an ambitious plan to put Ireland on a more sustainable path, cutting emissions, creating a cleaner, greener economy and society, and protecting us from the devastating consequences of climate change.

The Climate Action Plan 2021 follows the Low Carbon Development (Amendment) Act 2021, which commits Ireland to a legally binding target of net-zero greenhouse gas emissions no later than 2050. It also sets out a number of decarbonisation targets for the public sector which must be achieved by 2030, including a 50% improvement in energy efficiency, a 50% reduction in energy-related GHGs and a requirement that all public buildings must have improved Building Energy Rating (BER).

These targets, as set out under legislation, apply to direct and indirect GHG emissions arising from energy use in the HSE’s buildings (both owned and leased); these are Scope 1 direct emissions from fossil fuels, such as gas, oil and LGP, and Scope 2 indirect emissions from electricity. The HSE’s focus to date has been primarily on Scope 1 and 2 infrastructure energy utilisation opportunities and the HSE has reduced its direct and indirect energy-related emissions by 19% and 36%, respectively, from 2009 to 2019, giving rise to a total energy-related emissions reduction of 26% since 2009.

In order to achieve the new 2030 and 2050 targets, the HSE has significantly expanded its capacity in this area by establishing a Climate Action & Sustainability Office within the HSE Estates and Capital Department. This includes an Energy Unit with dedicated Regional Energy Officers who support local Healthcare Energy Management Teams.

The establishment of the Climate Action & Sustainability Office builds on the work done since 2018 when HSE Capital & Estates partnered with the Sustainable Energy Authority of Ireland (SEAI) and established a joint co-funding Memorandum of Understanding (MoU) to progress the Energy Efficiency agenda in the HSE. The shared objectives of the SEAI and the HSE are to develop a scalable model for energy management and retrofit investment in the HSE’s building stock in the achievement of national policy targets.

The HSE/SEAI MoU supports the HSE’s Energy Bureau Initiative which manages the progression of the energy and decarbonisation agenda through regional Energy Bureaux. The agreement has also supported the establishment of Local Energy Management Teams in top energy using facilities, the implementation of an Energy Efficient Design (EED) approach for all new and replacement buildings and a programme of retrofit works comprising capital works (major and minor) and centrally coordinated retrofit projects of varying scales.

HSE Capital & Estates have also recently developed a Preliminary Infrastructure Decarbonisation Strategy and Implementation Plan which outlines a roadmap to achieving both 2030 and 2050 targets, with a focus on Scope 1 & 2 Emissions and on infrastructure energy usage. 

A key element of this strategy is a Pilot Pathfinder Programme, which will identify a decarbonisation pathway for existing healthcare facilities. This is a partnership programme with SEAI which is being progressed at 10 Pilot HSE facilities. It will identify design solutions, financial implications and will evaluate technology options that can contribute to the HSE’s decarbonisation and energy efficiency goals, and which are appropriate for use in the healthcare sector. The detailed information and learnings from the pilot will be utilised to develop a strategy to progress and deliver a large-scale renovation programme across the wider health sector.

While reduction in Scope 3 emissions are not currently required under legislation, the HSE will also take action to mitigate the adverse health effects these emissions. These Scope 3 emissions are the result of activities from assets not owned or controlled by the HSE, but that the HSE indirectly impacts in its value chain, for example the procurement of goods and services. HSE Estates and Capital will lead out on an approach to reduction of scope 3 emissions relating to construction services through adaptation of Modern Methods of Construction and utilising a Circular Construction Economy approach in the design and construction of healthcare facilities as part of its delivery of the Capital Programme.

It is envisioned that through these actions the HSE will act as an exemplar, providing leadership and inspiring the necessary climate action in wider society to reduce Ireland’s greenhouse gas emissions in line with the targets for 2030 and 2050.

Case Study: Upgraded facility using 75% less energy

HSE Estates and Capital completed a pilot energy deep retrofit of three residential facilities for adults with disabilities in Co. Meath in partnership with the Sustainable Energy Authority of Ireland (SEAI). The objective of the project was to:

  • Establish the extent and scale of works achievable without impacting on residents (whilst they remained in their home)
  • Establish typical cost per square metre of these works
  • Identify potential barriers to implementing renewable energy solutions
  • Identify benefits to the living environment for residents, staff and visitor experience

Works included new exterior wall and attic insulation, replacement of windows and doors with triple glazing, hot water system upgrades and ventilation upgrades to improve air quality. The existing fossil fuel heating systems were replaced with a heat-pump system. The project also encouraged ongoing innovations throughout the process and minor design changes were made to the initial scheme.

Heat pump
Boiler room
Boiler room

The works were progressed with minimal disruption to residents with an improvement in the three facilities from a D rating to a BER A3 level.

Analysis after the retrofit project showed the facilities are using between 75% and 72% less energy.

Residents and Staff reported a much more comfortable living environment.