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Sustainable Healthcare Buildings Sustainability options: Costs and benefits

Growth Area RPHG Seminar 8th March 2005

Increasing complexity

Sustainability Agendas

Sustainable Development Sustainable Communities Sustainable built environment Sustainable Construction

Source: Sustainable Construction – Future R&I Requirements, CRISP 1999

Increasing number of actors

Sustainable Communities Key issues
Regeneration
Urban integration
Engagement with the local community
Sharing facilities
Training opportunities
Public transport
Etc……….

Responsibility
Development Cos
Clients/ designers

Key stakeholders
Planning (UDPs)
Local communities

Sustainable Building Key issues:
Fitness for purpose
Flexibility
Safety and security
User health and well-being
Energy efficiency
Landscaping & biodiversity
Whole life value
Etc……….

Responsibility
Clients & funders
Designers/advisors

Key stakeholders
Service providers
Users/staff
Building control
Constructors

Sustainable Construction Key issues:
Contaminated land & waste
Local employment
Noise and disturbance
On-site health and safety
Pollution prevention
Decanting and temporary accommodation
Etc……….

Responsibility
Constructors
Clients/ advisors

Key stakeholders
Service providers
Users/staff
Neighbours

Sustainable construction Treatment of contaminated land (Photo: CIRIA)

On-site waste recycling (Photo: CIRIA)

Benchmark

National Guidance & Targets

Targets, guidance

Trust identifies need Strategic Outline Case (SOC)

Client Advice, need

Outline Business Case (OBC) Public Sector Comparator (PSC)

Benchmark

Bidding & Selection Process

OJEC Pre-qual PITN

Bid-team Focus

FITN BAFO Preferred Bidder Financial Close (FC) Final Business Case (FBC)

Detailed negotiations & contract

Major Sustainability Intervention Points:

Making the case

Key Intervention Points

Construction

Operation & variations

Slide courtesy of Faber Maunsell

Compliance & Variations. Operator engagement

BBC White City/ media village Approach:

Design detail


Public access to facilities
Site designed around a “high street”
Significant landscaping


Security between ground & floor 1
Landscaping for SUDS & ecology

Benefits:

Specific benefits


More community involvement
Better setting for staff
More facilities for staff


98% staff retention (cf 85% prediction)
Local input to focus groups and trainees

Glasgow Homeopathic Hospital Approach:
A therapeutic garden space
A courtyard form
Maximum daylight and natural ventilation

Benefits:
Within standard cost yardsticks
Positive feedback from staff and patients – see quotes! * Source: People & profit, CIEF/CIRIA 2004

“I feel a calmness here… so have a productive working environment”

“I wonder if you realise how important it is for us… for its environment to calm us, strengthen us and then send us out into the world to cope for another while”

Fairfield Housing Co-operative Approach:

Original stats


Improve external environment (e.g. landscaping)
Improve site layout
Design of low-allergenic houses


80% unemployment
75% wanted to leave
<33% occupancy

Benefits:
Increased occupancy (& hence rental income)
Reduced crime (and hence costs of anti-vandalism/ maintenance)
Possible 30% reduction in the need for anti-asthma drugs (£500 pppa) * Source: People & profit, CIEF/CIRIA 2004

Post-regeneration
19% unemployment
1% want to leave
0 empty properties

Princess Margaret Hospital Approach

Investments








£47k energy efficiency
£147k social measures

Waste minimisation Use of recycled materials Investment in energy efficiency Health & Safety on site


Liaison with local communities

Benefits
£1,786,388 net environmental savings for Carillion*

Cost savings
£384k energy use
£434k waste
£1.15m materials

* Source: Sustainability Accounting in the construction industry, CIRIA 2002

Specific examples
Daylighting - energy efficiency & IEQ
Landscaping and biodiversity
Energy - consumption and renewables

Daylighting, energy efficiency and internal environment Costs
May be additional capital costs
May be additional design costs
Will require more thought

Benefits
Gains in staff productivity, recruitment and retention
Improvements in patient recovery rates
Reductions in energy costs
Other benefits e.g. wayfinding

St Bartholomew’s Hospital (photo: Greenhill Jenner Architects)

Landscaping and biodiversity Costs
May be additional capital costs
May be additional design costs
Will require more thought

Benefits
Evidence of impacts of natural environment on health and wellbeing of the building users (patients and staff)
Links between external views and daylighting/energy use Royal London Hospital (photo: Ecology Consultancy)

Energy consumption and renewables generation Costs
May be additional design costs
May be additional capital costs
Will need more thought

Benefits
Reductions in operating costs
Managing the risk of future energy cost rises
Watch out for who pays – incentivise the contractor e.g. volume risk shares in the payment mechanism

University of Gloucester - PV (photo: Fielden Clegg Bradley & ESD)

Internal environment - benefits Staff productivity, recruitment & retention
Office Productivity Network
BA Waterside, RBoS HQ (photo: Buro Happold)

Patient recovery
Bryan Lawson research
Roger Ullrich studies

Further information
Good practice BRE, NHS Estates, CABE etc.
Socially responsible construction: Engage-construct – www.engageweb.org
Staff productivity and retention: Office Productivity network – www.officeproductivity.co.uk
Detailed sustainability costings: - Sean Lockie, Faithful & Gould – www.fgould.com - Isabel McAllister, Cyril Sweett – www.cyrilsweett.com - Brendan Patchell, Bucknall Austen

– www.bucknall.com