NHS Sustainability Day 2015 - Gloucester Road Show

Welcome to the Gloucester NHS
Sustainability Day 2015 Road Show
#Dayforaction

Welcome and Introduction
Ingrid Barker, Chair Gloucestershire Care
Services NHS Trust
#Dayforaction

ENERGY: climate change,
health and four small steps
Professor Anthony Kessel
Director of International Public Health
Public Health England
NHS Sustainability Roadshow
Gloucester, February 5th 2015

PHE has four functions
• protecting the public’s health from
infectious diseases and other public
health hazards
• Securing improvements to the public’s
health through our own actions by
supporting government, local authorities
and the NHS to secure the greatest gains
through evidence based interventions.
• Playing a key role in improving
population health through sustainable
health and care services
• Ensuring the public health system
maintains the capability and capacity to
tackle today’s challenges and the
challenges of the future.
4
What does Public Health England do?

Climate Change - Evidence
• Atmospheric concentration of CO2 is increasing (pre-industrial approx.
280ppm, currently near 400ppm);
• Other greenhouse gases (methane, nitrous oxide) have also increased.
• Observed changes to the Earth’s climate system include:
 increase in global surface temperatures
 sea level rise
 ocean acidification
 shrinking ice sheets
 more extreme events
IPCC 2013, 5th AR

“Populations of all animal species depend on supplies of
food and water, freedom from excess infectious disease,
and the physical safety and comfort conferred by climatic
stability. The world’s climate system is fundamental to this
life support.” (WHO, 2008)
7 Sustainable Development and Public Health England
Public Health Challenges

Health Effects of Climate Change in the UK
Climate Change and Health
• Current evidence and climate
projections
• Temperature Effects
• Air Pollution
• Aeroallergens
• Indoor Environment
• Ultraviolet Radiation
• Floods
• Vector borne diseases
• Food and Water borne Diseases
• Health Co-benefits of Policies to
Reduce Greenhouse Gas Emissions
www.hpa.org.uk/hecc2012

ENERGY USE: Small steps to consider our
environmental impact [FEET]
1. Food
2. Energy use (at work)
3. Energy use (at home)
4. Travel
10 FEET (One Small Step)

Small steps : Food
Reduce methane production, carbon emissions and direct
environmental impact by:
1. Reducing consumption of animal products (meat and dairy)
2. Consuming fresh, locally-produced, seasonal products
3. Avoid drinking bottled water

Small Steps : Energy – at work
Transition to a healthy, sustainable, low-carbon future by:
1. Making action on sustainable development an integral part of
strategic planning and business processes (in organisational
business plans; annual reports; Director of Public Health annual
reports; service specifications)
2. Capacity building to increase knowledge of climate change impacts
3. Working in partnerships with others to create momentum for change

Small Steps: Energy – at home
1. Insulation and simple draught-proofing measures.
2. Use of electrical goods: turning off appliances; turning down the
thermostat; using energy-efficient light bulbs and appliances with
good energy efficiency ratings
3. SWITCHING TO A SUPPLIER THAT PROVIDES 100% ELECTRICITY
GENERATION FROM RENEWABLE SOURCES

MAKE ONE SMALL STEP …
Switching to a supplier that provides 100% electricity generation from
renewable sources:
We cannot advise on specific electricity suppliers, but you can find
information on how to choose a 100% renewable electricity supplier
(rather than a so-called “green tariff”):
http://www.ethicalconsumer.org/buyersguides/energy/greenelectricitysup
pliers.aspx;
http://www.energysavingtrust.org.uk/domestic/content/buying-green-
electricity

Small steps: Travel
1. Walking or cycling whenever and wherever you can
2. Using public transport rather than the car or start a car sharing
scheme
3. Avoiding flying - take the train
4. Working from home if your organisation supports this, use
videoconferencing and teleconferencing

RenéDescartes(31March1596–11February1650)

ImmanuelKant(22April1724–12February1804)

JohnStuartMill(20May1806–8May1873)

Environmental philosophy
INSTRUMENTAL VALUE
(MORAL WORTH)
VS
INTRINSIC / INHERENT VALUE
(MORAL WORTH)

PLAY YOUR PART on ENERGY
Small steps to protect the planet
22 FEET (one Small Step)

Supporting E-mobility in car clubs
save money, reduce car ownership, create envrionmental
benefit

Co-wheels – existing provision
• Nearly 30% of the fleet
• EVs – across the UK
• iOn/ i-miev, C-zero
• Nissan LEAF
• Renault Zoe
• Twizy
• Renault Kangoo van trialled
• Nissan e-NV200
• Hybrid – across the UK
• Toyota Auris
• Toyota Prius Plug in (and plug in plus)
• Toyota Yaris Hybrid
•E-Bikes – Inverness
• Giant E-bikes
save money, reduce car ownership, create environmental benefit

Co-wheels – utilisation
• EVs often 1st choice
• Organisation’s policy
• Member preference
• Lower costs
• E-bikes
• 63 members (Nov 14)
• 80km + cycled
• Approx. 22 hours per bike per month – even in Inverness, in
November
“As a Co-wheels member I am really pleased to see the number of electric cars available
increasing. I would always chose to drive EV where possible, not just because of the lower
environmental impacts, but also as they are so fun and easy to drive.”
Yvonne, Co-wheels member, Newcastle

Operational Set Up
• Pay As You Go
• From £3.75 per hour
• 13p per mile (free for EV)
• Managed Pool Cars
• Flexible options
• Franchise
• Community operations
• Informal Tourism
• Technology options
• E-Bikes

Opportunities for EVs
• Fleets – EVs as managed pool cars
• Excellent journey profiles
• Local Authorities
• NHS Trust
• Housing Associations
• Easier Management
• Internal champion
• Charging in place
• Good reporting
• Carbon Reductions
• Out of hours access to residents
• Lower risk

Supporting Systems
• Fleet Analysis
• Current situation
• Sweet spot identification
• Biggest gains, Co2, cost
• Specific vehicle requirements
• Benefits beyond EVs
• WAV, e-bikes, load bearing
• System development opportunity
• More advanced systems
• New deployment models easier to facilitate – future proofing

Maximising the Potential
• Floating cars
• Multi driver trips
• One way trips
• Integration with public transport
• E-bikes
• Intelligent vehicle selection
• Intelligent booking scheduling

Thank you!
liz@co-wheels.org.uk
www.co-wheels.org.uk

Our experience of an electric
pool car
Mark Armstrong-Read
Strategy and Planning Manager
Derbyshire Community Health Services NHS
Foundation Trust

Infrastructure
• Pedestal charge point –
2 sockets, each 22KWh
• £10,000 total costs for
equipment and
installation
• Fully funded from OLEV
(75%) and Derbyshire
County Council (25%)

Key Facts
• The Leaf Arrived End of August
• Between September and December:
– 600-700 miles per month (less in Dec)
– 80 journeys/bookings (used almost every
work day)
– Average 29 miles per journey
– Longest journey 67 miles
– 6 regular users, 4 occasional users
• There is access to an alternative pool car
on site – low emission Aygo

User’s
perspective
“I was due to be seconded from my post to undertake a placement
including a one year university course, but I still had my foot in a ‘boot’
following an accident. It was suggested I use the Nissan Leaf as it didn’t
require me to use my left foot to drive. I did and it was brilliant! It gave me
the chance to start my course and be independent again.
Myself and two colleagues, also on the course, now use the pool car
nearly every week for two days to attend Derby University. I have
experienced no problems with the electric pool car; it’s easy to drive and
easy to plug back into the charging port. We travel around 38 miles to the
university and back and we still have approximately 20-30% battery life on
return. I would definitely recommend using an electric car.”

User’s
perspective
“It is a challenge in the winter months to plan the use of this car, due to
when needing to use windscreen wipers heater etc. The power is used up
quickly and if visiting in a ‘hilly’ area it goes even quicker. I have been
worried that I won’t get back! I have been very cold due to switching the
heater off in a bid to save the power!
The other problem is having to disconnect/connect it in the rain and the
cables can become very muddy and me very wet! Also defrosting the car
etc. uses power.
I really like the car, but as I said it is a challenge in the winter!

Learning Points
• EVs can work really well for most journeys
• Hills and winter weather reduces range,
but not a reason to avoid EVs
• Users learn when EV can be used
• Some users will be real advocates – only
need a few to make EVs successful
• Being automatic is an advantage

Future Plans
• Applied for latest OLEV funding (75% of
costs for 2-year lease and infrastructure)
• At least 3 pool cars and 2 fleet vans
(asked for more if funding is available)
• Identified Mitsubishi Outlander as
preferred pool car to trial:
– Hybrids (up to 30 miles on electric)
– Large vehicles (lots of space for equipment)
– 4 wheel drive

CAN WE BE MORE COST-EFFICIENT
AND YET OFFER A BETTER LEVEL OF
SERVICE TO PATIENTS

One click access
Access from anywhere
No physical meeting room
Full size video
Document share
DEMAND
MORE…

MEET
ANYWHERE
AS THOUGH
YOU WERE
THERE

iMEET APPS FOR ALL YOUR DEVICES
48
Makes it easy to host, manage, and join a meeting
from anywhere.

INVITE OTHERS TO MEET AND COLLABORATE
49
Add guests right from the meeting via email or just have iMeet
call them.

50
CONNECTS YOU AUTOMATICALLY
WITH AUTO-CONNECT

MEETING CALLS YOU –
NO PASSCODES TO REMEMBER
51
Or, click “Call My Computer” to bypass the phone
all together.

MEET USING VIDEO. ANYTIME, ANY DEVICE.
52
More personal face-to-face meetings, even when you’re not in the
same room.

HOST OR ATTEND MEETINGS WITH
UP TO 125 PEOPLE
53
An online experience that’s easy-to-use, personal
and professional.

iMEET ALERTS YOU WHEN SOMEONE’S
WAITING TO MEET
54
One-click to join your meeting or send a message
to your guests.

YOUR FILES ARE READY AND WAITING
TO BE SHARED
55
iMeet’s cloud-based file cabinet allows you to store,
access and share files – anytime.

WANT SOMEONE ELSE TO DRIVE
THE PRESENTATION?
56
Pick a guest and pass control.

DVR WITH MEETING MINUTES CAPTURES
IT ALL
57
Your recording and the transcript of the meeting
is ready to share, email or post.

Embedding EVs within
your Trust
Jonathan Mitchell

Energy
security
4.
2013 ULEV STRATEGY RECAP: POLICY DRIVERS

PLUG IN GRANTS – ELIGIBLE VEHICLES

PLUG-IN GRANTS (CUMULATIVE)
NISSAN ENV200 AUDI A3 E-TRON KIA E-SOUL VW E-GOLF & PHEV
GOLF
Mercedes B Class
Electric
Mitsubishi Outlander
PHEV

PLUG IN GRANT – RECORDS, RECORDS…
2011/12 2012/13
2013/14
14/15

INFRASTRUCTURE
 Grants to 7 TOCs to install over 300
chargepoints at train stations
 Grants to 59 public sector orgs to install
over 1,000 chargepoints on their own
estate
 Over 5,700 chargepoints installed
through 8 PIP projects.
Plus…
 Over 5,000 chargepoints
installed by the private sector

Is the media warming to ULEVs?

GOVERNMENT FLEETS
 £5m project launched to help
increase uptake of ULEVs
across Government
 Government to lead by
example in making ULEVs
commonplace in fleets
 Fleet reviews already started
for 10 departments
 Project now extended to wider
public sector

THANK YOU
jonathan.mitchell@olev.gsi.gov.uk
www.gov.uk/olev
@OLEVgovuk

Tea/Coffee and Networking
#Dayforaction

adsm.com
© Advanced Demand Side Management 2014.
AquaMark
UK’s National Water
Benchmarking
Project
3 years’ fully-funded services

adsm.com
AquaMark / UK’s National Water Benchmarking Project
Who we are
Water efficiency
experts for over
20 years
Government
advisors since
1999
On a mission
to save
Britain’s water

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Why save Britain’s water?
Population
growth
Climate change Water scarcity

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Benchmarking for sustainability
• Why worry about benchmarking?
• Measure our performance
• Compare our performance
• Identify inefficiencies
• Save money and waste by
using less water
“You can’t
reduce what you
can’t measure”

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Current Benchmarking
• WaterMark
• HM Treasury
• Typical and best practice benchmarks

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Water consumption in an NHS Trust

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Water Consumption per Hospital vs Industry
Published Benchmarks
0
50,000
100,000
150,000
200,000
250,000
300,000
Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5 Hospital 6 Hospital 7
12monthsWaterConsumptionm3
Consumption in 2013

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AquaMark
• £500m of water is going to drain each year through
the lack of benchmarking data
• Largest and most in-depth project in the UK
• Establish 500 different building benchmark
classifications
• Robust, complex and more sophisticated
benchmarks

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AquaMark
• Putting Britain at the forefront of commercial water
benchmarking
• Greater sustainable water supplies and increased
water security for thousands of organisations
• 10,000 sites already taking part in the project
• We need you

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Fully funded for you
• Three years’ free bill validation by
award-winning bureau service
• Monthly consumption reports
• Identification of high consumption anomalies
• Benchmarking toolkit
• De-regulation of the water market
• Save a 1/3 on water bill

adsm.com
How do you take part?
• ADSM provides you with an email to send to
your water supplier, then we take care of all
the rest
• Future bills are sent to us for assessment &
validation
• Within 24 hours we send them back to you
• Participation is completely anonymous
• Data completely secure
• Absolutely no cost to you what-so-ever

adsm.com
How benchmarking can help the
NHS?
• If all of the UK participated we could
save an estimated £500 million per
annum
NHS alone
could save 1/3
on it’s water
costs

adsm.com
Your participation
ask@adsm.com
01753 833 880
www.adsm.com
Thank you

Creating Social Value through
Volunteering

“We will be recognised as a
leading sustainable business
and the leading sustainable
support services company.”
Richard Howson
Chief Executive
Carillion’s 2020 Sustainability Vision

Volunteering & Community Engagement
Employee Volunteering
• Making a difference to our communities, clients, people
and Carillion
• Carillion’s Vision – 50% of staff using the paid leave
programme towards community work by 2020
• Current target of 10% for working with schools,
unemployed and hard to reach groups
Volunteering & Community Engagement Programme
• Enables employees to apply annually for six paid
volunteering days
• www.carillionplc.com/volunteering

Why Get Involved?
• Personal development
• Employee pride
• Long Term Customer Relationships – up to 30 years –
embedded in local communities
• We recruit from local communities – today’s special needs
individual could be tomorrow’s Catering supervisor
• Volunteering enables us to help our ‘extended family’ – our
‘NHS Good Corporate Citizen’

Business in the Community
• Born out of BITC’s Business Action on Homelessness
campaign, Ready for Work has supported over 3,000
people into work since 2001.
• Carillion provide job coaches and work experience
placements and employment opportunities.
•Ready for Work is a national
programme from Business in the
Community (BITC) that engages
business to support
disadvantaged groups,
particularly people who have
experienced homelessness, into
employment.

‘together’ charity partnership
Our Charity partner – Barnardo’s
• Raised nearly £50,000
• Provided practical assistance through volunteering our time and skills
• Barnardo’s biggest challenge is finding the funding to support its
services for the thousands of children and young people who depend
on them.
• Barnardo’s is proud that 92p in every £1 raised goes directly towards
its work.
- £5 provides books and pens, essential for early learning in a children’s centre.
- £15 provides a hot meal and a personal care kit for a homeless teenager.
- £60 pays for warm winter clothing for a child living in poverty.
- £100 pays for 3 psychology sessions for a child who has been sexually abused.
- £2,700 provides skills and training for a young person to get out of the poverty trap
and turn their life around.

Creating the world’s leading
meat-alternative business

Who is Tim Finnigan???
• Married, two children (grown up)
• Likes running up hills and likes a pint
• 30 years R&D in Food and Drink
• PhD Oilseed rape protein, Government food research, APV,
General Foods and...

Q2. What’s he going to talk about?
The 1960’s and a time of great concern about food
security and the origins of Quorn
The current context, the link between diet health and
the environment - and the need to change
Why we need “ healthy new proteins with a lower
environmental impact”
How Quorn could help address the ambitions within
the NHS for sustainability by making huge savings in
fat, calories and environmental impacts

The 1960s was a time of
huge achievements...
Quorn in context

....And growing concerns
Quorn in context

A man with a big idea
Quorn is born

103
From 1964 to 1985 – time flies……….

Another 30 years on in 2015, and what has changed

+ a large number of ducks, rabbits, horses, turkeys…
..3 camels and one unfortunate mule
Chickens 110,000
Pigs 2,630
Sheep 922
Goats 781
Cows 557
The scale of livestock production is driven by our desire
for cheaper and more plentiful meat, but there are damaging
consequences, which at the moment are forecast only to intensify
The current context…

http://www.fao.org/fileadmin/templates/wsfs/docs/expert_paper/How_to_Feed_the_World_in_2050.pdf
http://www.tristramstuart.co.uk/FoodWasteFacts.html
http://ecowatch.com/2014/04/11/agricultures-greenhouse-gas-emissions-2050/
Challenge Consequence
To feed 9bn in 2050 FAO say we need a 60% increase in food production
some of the true costs of cheap and plentiful animal protein
Challenges for a scalable meat based
sustainable food future

Challenges for a scalable meat based
sustainable food future
Our biggest lever globally is to eat less meat

http://www.eating-better.org/uploads/Documents/Let'sTalkAboutMeat.pdf
Challenges of behaviour change in an excellent new report

Diets link environment and human health
New Thinking Links the trilemma of diet,
environment and health

http://www.independent.co.uk/environment/hav
e-we-reached-peak-food-shortages-loom-as-
global-production-rates-slow-10009185.html

“The need for new
business models that help
address the 9bn challenge
- including a healthy new
protein with a lower
environmental impact….”
Prof. Alan Knight Single Planet Living
Big steps toward small footprints

Transition away from meat made more difficult by
decline in cooking skills

113
Tasty, Health and Convenient

114
Must fit into routine and repertoire

At the heart of all Quorn foods is
mycoprotein…
So, what is it?
Natural appeal
..Our 50 year ‘overnight success’

116
Additional Interest
SCFA production
Fibre (chitin and ẞ-glucans)
Mycoprotein as a food ingredient
Physical
Properties (shape)
Denny, A, Aisbitt, B and Lunn, J (2008) Mycoprotein and health. BNF Nutrition Bulletin 33: 298 – 310.
Bottin, J. (2014) Nutrition and Surgical Influences on appetite regulation in obese adults. PhD Thesis Imperial College London
BENEFITS
Texture creation
• Authentic meat-like texture
• Creation of fibrosity through fibre assembly
General Nutrition
• High quality protein
• Low fat content (membrane
phospho-lipids)
• High fibre (cell wall)
• Low energy density
Clinical Research
Programmes
• Lowering serum cholesterol
• Satiety
• Insulinemia and
glycemia in diabetics
Composition

117
No other protein can create the meat like
textures achieved by Quorn
Unique attributes

Sustainability
Raw Data Key Comparisons vs Quorn
GHG
(kg/kg)
Land
(ha/kg)
Water
(L/kg)
Beef Mixed 30 0.0035 19500
Beef Grazed 121 0.0049 21800
Chicken 9 0.0007 3900
Quorn Mince 3.4 0.0004 1900
Quorn Pieces 3.4 0.0003 1650
GHG LAND WATER
Beef
Mixed
x9 more
GHG
x9 more
land
x10more
water
Beef
Grazed
x36 more
GHG
x12 more
land
x11 more
water
Chicken
x3 more
GHG
x2 more
land
x2 more
water

An easy way to remember this…….
Member of the FUNGI family
That’s grown by FERMENTATION
And is FILAMENTOUS
That helps us to create FIBROSITY
Which we achieve through FREEZING
The Seven F’s
And creates nutritious new FOOD
With a low environmental FOOTPRINT

Quorn can help deliver massive savings
What if all Beef mince served within the NHS were
replaced by Quorn mince

Is innovation the answer?
Emma Wood
Group Sustainability & CR Manager

Time to Vote
What was the most ‘ environmentally sustainable’
change that your Trust made last year?
Technology
Investment
Changed
product
New Procedure

The scale of the challenge
• No one can ignore the scale of the
challenge, either globally, nationally or for
the NHS
• We must learn to live more sustainably
• But do big challenges necessarily
demand big, transformative changes?

Sustainability headliners
• Innovation often linked to breaking
with traditional consumerism and
promoting more sustainable service
models
• Generally large consumer businesses,
products not services
• Is it relevant to talk about ‘disruptive’
change for services like the NHS?

The power of small changes
• Sustainability as evolution not (just) revolution
• The risk of relying on big commitments:
–Can disruptive change really work in a service
environment like the NHS
–Big commitments can be quietly side-lined as political or
economic climates change
–Sustainability viewed as something for others to do
–People feel powerless to effect change
• Challenge to make sustainability commonplace &
everyday

What keeps the NHS working day in, day out?

Examples where you least expect it….
• Don’t assume that sustainability
messages have to be ‘big ticket’ stories
• Some of most powerful stories might
be small, existing measures
• Social science research identified that
people much more likely to act in a
desired way, if they feel that this is
consistent with their values and
previous actions

Where will improvement come from ?
• SDU research clearly highlights carbon hotspots and
opportunities for cost effective improvements

Pharmaceuticals
• Pharmaceuticals represent Number 1
carbon hotspot for NHS
• Over-prescription & wastage all controlled
by individuals
• Simple, regular checks and calibration
of fridges could reduce wastage

Waste
• Segregation key!
• RCN estimated savings of £5.5 million per
annum if 20 % of ‘infectious’ waste classified
as ‘offensive’
• Reliant on understanding balance of infection
control and sustainability and dominance of ‘just
in case’ thinking

Personalise your message
“Over its lifetime, using this hand dryer will save 4,500
kWh of electricity”
“…this hand dryer will save
£450 of electricity cost”
“…this hand dryer will
save 2,420 kg of CO2e”
“…this hand dryer will save enough
energy to power your ward for 1 week?”

Thank you
www.phs.co.uk
emmawood@phs.co.uk

Sustainability
Resource
Planning
www.trakeo.com @trakeonews
For Healthcare

Trakeo Sustainability Resource Planning -
a comprehensive system to track, monitor
and enable more sustainable practice

➢ Motivating behaviour
➢ Real time feedback
➢ Boosting financial returns
➢ Guided by GRI
➢ Supply chain impact
➢ Break down and baseline
➢ Risk modelling

“People love chopping wood. In this
activity one immediately sees results.”
Albert Einstein

% agreeing Global
sample
Highly
engaged
Unsupporte
d
Detached Disengaged
Organisation
conducts
business
activities with
honesty and
integrity
58% 84% 61% 47% 27%
Organisation is
highly regarded
by general
public
57% 81% 59% 46% 29%
Towers Watson Global Workforce Study
Company Image

2020 and beyond
➢ Going forward the focus of emissions reduction will be on
procurement. There will be less potential to reduce
emissions in the building energy sector given the low level
that would exist at that time.
➢ 31% of all NHS organisations have already reduced
building energy consumption by more than 10% (from a
2007/08 baseline)
➢ 78% believe performance against reducing carbon should
be measured and managed as part of core business.

CO2e Reduction Potential for NHS England

Lunch and Networking
#Dayforaction

Salix Finance
solving energy
efficiency in the
NHS
Tim Morozgalski,
Programme Co-ordinator
tim.morozgalski@salixfinance.co.uk
0207 406 7658

Introduction
Knowledge sharing and case studies
Summary of the loan application process
To demonstrate how Salix can help NHS Trusts
Our goals for today

Introduction to Salix funding model

Who we are
Established in 2004
Independent, publicly funded, not-for-profit company
100% interest-free capital finance for the public sector
Funded by DECC, Scottish and Welsh Government, EfA, DfE, and
HEFCE
Support public sector bodies such as local authorities, educational
establishments and NHS Trusts
Working throughout England, Wales, Scotland and N. Ireland

Minimise wasted energy – controls
and awareness raising
Efficient conversion –
installing energy
efficient technology
Salix focus
capital investment to
reduce energy and
save carbon
Energy hierarchy
Onsite
renewable
energy

Over 12,000 projects totalling over £320 million of funding
£1.2 billion of savings generated for the public sector over
projects lifetime
For every £1 invested, almost £4 is saved
Carbon reduction of over 6.6 million tonnes of CO2 saved over the
lifetime of projects
Now fund over 120 different energy efficiency project types
Data up to October 2014
Since 2004

Programmes
Recycling Fund
England,
Scotland, Wales
Loans
Schools Loans
(DfE)
Salix/HEFCE
Revolving
Green Fund 4
(RGF4)
CIF (Education
Funding
Agency)
Salix/EAUC
College Energy
Fund
Salix programmes

Loan funding by public sector body type
(April 2010 – October 2014)
Local Authority - 49%
Higher Education Institute - 31%
National Health Service - 10%
School - 5%
Further Education Institute - 3%
Emergency - 1%

Salix funding for the NHS
Worked with over 40 NHS Trusts in England
Over 460 projects totaling over £33 million
Annual savings of over £10 million and 58,000 tonnes CO2
Lifetime savings for the NHS estimated at £140 million
Data up to October 2014

NHS sector in England
Top ten technology types funded (2012/13 to Q2 2014/15)
Technology type Number of Projects Technical cost
Combined Heat and Power 2 £2.7m
Heat recovery 4 £2.4m
LED lighting 53 £996k
Heating and hot water 7 £778k
Boiler replacement 1 £473k
VSDs/Motor Controls 6 £261k
Building management systems 8 £231k
Lighting upgrades 5 £185k
Ventilation and cooling 4 £172k
Lighting controls 5 £106k

Knowledge sharing and case studies

Northampton General Hospital - case study
Pre project conditions –
• Mixed 40 acre estate with buildings ranging in age
from 1793 to 2008
• Issues with BMS control, heating networks,
pipework lagging, heat loss, and inefficient lighting
Salix funded solution –
• Total project cost £381k
• Cavity wall and pipework insulation, draught
proofing, BEMS upgrades, pool covers, and T5/LED
lighting
• 3 year payback
Project overview
Salix helped Northampton General Hospital to deliver a suite of new
projects across their estate saving the hospital £127,484 per year

New Salix case studies are available to download from the
website
Salix project case studies

Project knowledge slides
Sharing of knowledge between clients
Completed projects
Before and after
Supporting comments
experiences
lessons learnt
supplier
contact details

BEFORE
• Fixed speed control on existing AHU and cold
air through entrance area
• Electricity 509,308 kWh/year consumed
• Gas 217,918 kWh/year consumed
• £57,469/year running cost
• Poorly designed public entrance
• Uncomfortable for staff, patients and visitors
Project knowledge –VSD and air curtains by
Medway NHS Foundation Trust
AFTER
• Variable Speed Drive (VSD) installed on
existing AHU to reduce motor speed and air
curtain to stop excessive amounts of cold air
entering the building (£93,750)
• 418,092 kWh/year savings
• £30,396/year savings
• 3 years payback (average)
• 164 tCO2 saved per year
Project completion dates – Sept 13 Mar14

Supporting Comments:
Project knowledge –VSD and air curtains by
Medway NHS Foundation Trust
• VSDs - The running costs were estimated based on measure running current and run hours. Air
curtains - These were based on calculated air loss through the doors and the cost of providing
heat
• Energy prices 10 p/kWh Electricity and 3 p/kWh Gas
• Trish Marchant developed the project and suppliers were Schneider Electric and JS Air Curtains
• Install BMS control on the air curtains rather than rely on individuals turning them on and off
• Be clear that your air changes will still be achieved when reducing fan motor speeds
• Remember to consider the cable runs and isolations needed to carry out the works. Consider
which manufacturers the maintenance team use across the site to minimise the need for training
on new numerous differentVSD controllers
Client – Medway NHS Foundation Trust Client contact –Trish Marchant
Tel – 01634 833843 Email – trish.marchant@medway.nhs.uk

SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTORWWW.SALIXFINANCE.CO.UK
Salix application process

Changes for 2014/15
New online application process

Six simple steps to apply
1. Log on to the Salix website salixfinance.co.uk/loans
2. Select the NHS loans page
3. Complete the compliance tool with project details
4. Complete an online loan application
5. Submit your application online
6. Salix will do a technical assessment

Project compliance tools: version 29
3 Tools:
– Single Fuel Compliance Tool
– Multiple Fuel Compliance Tool
– Multiple Project Site Tool

Summary
Funding available to NHS Trusts with no maximum loan amount
We offer support through-out the process
NHS Trust information packs available at our stand
Work together on long-term funding plans, estates strategies,
and carbon management plans

Thank you
4 All of Us and NHS Sustainability Day
tim.morozgalski@salixfinance.co.uk
0207 406 7658

Smart Grid Energy Balancing Services
for the Health Sector
Presentation to: Sustainability, Coventry 2015

About | Open Energi
Open Energi works with large
energy users to generate
revenue from energy-intensive
equipment. We are:
•Helping National Grid to balance
electricity supply and demand
•Building the world’s first demand
side power station
•Cutting UK CO2 emissions
•An approved National Grid
Demand Response Aggregator

Health Service | Challenges & Initiatives
How to monetise energy intensive equipment to offset rising energy
and health service delivery costs
*Source: Energy Live News

Supply | Old Energy Economy
• Linear value chain with limited demand-side participation
• Does not support the UK’s* or European Commissions* targets to
transition to a renewable energy policy by 2020
• New policy has created change - customers now take and provide
service back to grid
* 30% UK target / 20% European Commission target

Supply | New Energy Economy
• Bidirectional “smart-grid” value chain provides the opportunity to
participate in the revenue generating demand-side balancing market

Supply | Capacity Crunch
Fears of a capacity crunch as energy
surplus falls below 2%

Supply | Capacity Crunch
3.7 GW power production closing or at risk for winter 2015

Supply | The Renewables Challenge
30% of the UK’s electricity supply to come from renewables by 2020
Major changes to the way electricity is
generated:
•Need to develop infrastructure to
accommodate rapid growth in wind
generation
•Unpredictable wind generation creates
additional balancing costs currently
passed to energy consumers
•Open Energi’s solution helps the UK move
to a low carbon future reducing balancing
costs with increased flexibility

Balancing | Market Position
Open Energi fills
peaks & troughs
Peaking power
typically coal
Base load power
typically nuclear /
gas
The graph represents a 24hr winter profile taken from the National Grid
demonstrating base / peaking power and Open Energi’s service positioning

Grid | Balancing
• National Grid has a statutory mandate to keep power balanced
between 49.50 - 50.50Hz
• Power supply would fail without grid balancing services

Frequency Response | Example Event

Grid | Demand Response Markets
Balancing
Services
Dynamic
Frequency
Response
FCDM
STOR
DSBR
Peak Price
Avoidance
TRIAD
Management
DUoS Charge
Management
Capacity
Market
Capacity Market
DSR
Distribution
Network
LCNF
Energy
Trading
Imbalance
Avoidance
Day Ahead
Trading

Demand Response Markets
Balancing
Services
Dynamic
Frequency
Response
FCDM
STOR
DSBR
Peak Price
Avoidance
TRIAD
Management
DUoS Charge
Management
Capacity
Market
Capacity Market
DSR
Distribution
Network
LCNF
Energy
Trading
Imbalance
Avoidance
Day Ahead
Trading
Dynamic
Demand

Service | Proposition
The health service can generate revenues from energy intensive equipment
including a range of standard hospital energy assets

Value | Comparison
Dynamic Demand delivers more value than any other balancing service

Market | Value
Monetise hospital energy loads in an established £1 billion UK market*
*Source: National Grid: Note: The dip in value reflects the UK’s recession

Availability | Payments
Turning energy-intensive equipment into income
High
Response
Low
Response
Paid for
Availability
Only 5%
(average)
Switched

Hardware | Architecture
Typical installation layout

Customers | Case Studies
Open Energi works with large energy users across the public and private
sector to generate new revenues and support their sustainability goals
“The data I receive from Open
Energi is incredibly useful. Now I
know exactly how, why and when
we are using energy, and the
equipment that was costing us the
most to run is now generating an
income.”
Manoj Chohan | Energy Manager
Southend University Hospital NHS
Trust

Working | With Us
• Process
• Project management
• Client actions
• Payment
• Account management
Installing Dynamic Demand is a straight forward process, we work with
customers from needs analysis through to strategic account development

UK Head Office
1 Pemberton Row
London
EC4A 3BG
+44 (0)20 3051 0600
www.openenergi.com

The Growing NHS Forest
at Gloucestershire Care
Services
Georgina Smith

Official Opening of the green gym

Mobilisation
Gardens
for all
Insurance –
professional
indemnity
Public liability
GPs

Planting our new coppice
Recently planted a
coppice (sweet
chestnut) which will
allow us to do wood
crafts in the future –
in 10 years!

Stroud General & Maternity Hospital – Our 3rd Site
Opened NHS Sustainability
Day March 2014

Winner of the NHS Forest Award – Best community
Engagement

Andy Heaysman
Energy & Utilities Manager
Estates & Facilities Division
what cost
CARBON REDUCTION

Our NHS Trust
Gloucestershire Hospitals NHS Foundation
Trust is one of the largest hospital trusts in the
country, providing services at Gloucestershire
Royal and Cheltenham General Hospitals.
We are the second largest employer in
Gloucestershire, with more than 7,400
employees and we provide high quality acute
elective and specialist care for a population of
more than 612,000 people.

Our Carbon Emissions
• The total carbon emitted by The Trust in 2011 -2012 was in the
region of 24,500 tCO2.
• In 2012 – 2013 we had a bad year, mainly due to the weather
where the energy used sent emission's to over 26,000 tCO2
1500
1700
1900
2100
2300
2500
2700
2900
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
GHNHSFT CRC Emissions/Targets
2011/12 -1.5% Target -5% Target Actual Reduction

Our Plan for 2020 and beyond
• The Trust secured a £1M grant for a new CHP at
Cheltenham General Hospital
• Who would install and operate the CHP and what
else should we do to capitalise on the funding
opportunities.
• Using consultants from the Carbon Energy Fund
we decided to appointed Vital Energi as our
Partners on a 15 year energy supply contract.
• Vital Energi have installed and now manage the
CHP as a next step in reducing the Trust Carbon
emissions.

Creating Sustainability with Viability.uk
leading innovator in efficient energy provision

Agenda
 Introductions
 Trust Objective’s
 Project Scope CGH & GRH
 Service Delivery
Introduction

 Gary Oldham Regional Business Manager
 Stuart Russ Contract Manager
 “We provide sustainable and viable energy solutions for our clients
which not only meet their current energy requirements, but also
anticipate their future energy demand. Our solutions are future
proofed and flexible, allowing us to generate and distribute energy
and then provide the management solutions to monitor, measure and
reduce energy consumption and ensure those systems operate at
optimum performance and clients receive the most benefits”
 “By using this approach we have been able to continuously reduce
our clients’ carbon emissions and save them money on their energy
bills each year”
www.vitalenergi.co.uk
Introduction
Introductions

 To improve the carbon and energy performance at both
Gloucestershire Royal Hospital and Cheltenham General Hospital
 We have engaged with trust to improve site infrastructure, security of
supply and resilience though investment to:
– Meet and exceed 2015 carbon reduction targets
– Deliver carbon and energy savings
– Provide flexibility to support future development of the site
– Reduce backlog maintenance
– Guaranteed Savings in terms of energy costs
Trust Objectives
Trust’s Objectives

 What is an CHP ?
 Combined heat and power (CHP) is the use of a heat engine to
simultaneously generate electricity and useful heat.

Project Summary
Project Scope
Cheltenham General Hospital
Core Bid
(18 years)
Install 1.28MWe high efficiency gas fired CHP P
Install 0.7MW CHP exhaust gas heat recovery unit P
Install LTHW distribution system from Energy Centre to
College Rd and 2A Day Surgery plant rooms
P
Upgrade existing steam boiler plant at ECA to
BG001/INDG436
P
Upgrade Energy Centre ventilation system to meet current
standards
P
Install new flue (within existing mast) for CHP unit P
Install SCADA plant control and optimisation system P
Upgrade 435 light fittings P
Upgrade BMS system P
Install site wide metering system P
Civil and M&E works integrating the new plant into the
existing heat & power networks
P
Operation Maintenance, Repair & lifecycle services for the
duration of the contract
P
Gloucestershire Royal Hospital
Core Bid
(15 years)
Install 1.99MWe high efficiency gas fired CHP P
Install 1.0MW CHP exhaust gas heat recovery unit P
Install MTHW distribution system from ECA to ECB P
Install LTHW distribution system from ECA to Tower & Wooton
Lawn plant rooms
P
Install 990kW wood chip steam biomass boiler plant P
Upgrade existing steam boiler plant at ECA to BG001/INDG436 P
Upgrade ECA ventilation system to meet current standards P
Install new flue (within existing chimney) windshield for CHP unit P
Install free standing chimney for biomass boiler P
Install SCADA plant control and optimisation system P
Install new (additional) hotwell in ECA P
Install 50 kWp solar PV array P
Upgrade 427 light fittings P
Upgrade BMS system P
Install site wide metering system P
Civil and M&E works integrating the new plant into the site’s heat
& power networks
P
Operation, Maintenance, Repair & lifecycle services for the
duration of the contract
P

Project Scope
12,000
14,000
16,000
18,000
20,000
22,000
24,000
26,000
28,000
2005 2010 2015 2020 2025 2030
TonnesCO2e
Year
Gloucestershire Trust Carbon Footprint
C&G Carbon Footprint
DoH CO2 Reduction
Strategy Target
2015 CO2 Reduction
Target
2020 CO2 Reducion
Target
Vital Energi Solution at CGH
Vital Energi Solution at GRH
Carbon Impact v Trust Targets

www.vitalenergi.co.uki.co.uk
Summary of Service Delivery
 Experienced mobile service engineers operating the equipment to optimise
the efficiencies and sustainability
 The Energy Centre was initially operated as part of the Interim service with
daily site visits. Following the Practical Completion it will be fully automated,
to run on an “unmanned” basis
 To achieve this the existing boilers will be upgraded for safe remote
operation in accordance with all HSE Guidance Notes
– including INDG436 (PM5), SAFed
 SCADA system will control and optimise the plant, including alarm
Management to a 24/7 Remote Monitoring Centre
 Vital Energi technicians will attend site every 72 hours to carry out
– Operational duties
– Maintenance activities
– Efficiency activities
– Sub contractor liaison and management
– Account Management / liaison
– Pressure systems annual insurance inspection
Service
Delivery

Monitoring and Verification
 M&V process will cover:-
– Annual CHPQA reporting
– Regular calibration of CHPQA meters
– Monthly review of the contractual KPI’s and service delivery
– Detailed annual efficiency reports for Boilers and CHP
– Monthly reports on site energy trends and include on-going project
specific outcomes
– BMS and Lighting savings start before Practical Completion
– Continuous energy monitoring and identifying potential savings during
the term of the contract
Service
Delivery

Thank You For Your Time
leading innovator in efficient energy provision
Questions

NHS Sustainability Day 2015 - Gloucester Road Show

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