NHS Sustainability Roadshow Manchester

1. #DAYFORACTION
WELCOME
#dayforaction

2. Refill partnership with
City to Sea

3. Chance to win a water
station worth £2000
and installed!

4. Deadline March 14th
Ceremony May 16th-
Leeds

5. #DAYFORACTION
Session 1: Top down & Bottom up
approaches to embedding sustainability
#dayforaction

6. Greater Manchester and Sustainability
Making a difference in health and social
care

7. • In 2016, Greater Manchester took control of its health
and social care system.
• At the same time we launched our five-year plan to
improve health and social care, called Taking Charge
• It involves NHS, councils, voluntary, community & social
enterprise, Healthwatch, other public services
•
•
•
•
•
•
•
•
•
•
.
Taking Charge

8. •
• More children reaching a good level of social and
emotional development - ready for school
• Fewer people dying from: cancer, heart and lung disease
• Supporting people to stay well and live at home for as long
as possible
• Ensuring we contribute in a leading way to a ‘sustainable’
system
•
•
•
•
•
•
.
A Reminder of Our Aims – by 2021

9. GMHSCP Partnership Opportunities
•
•
•
| 9
GMHSCP
Partnership
Opportunities
Carbon
Neutrality
(2038)
Environmental
Plan
GM Spatial
Framework
Industrial
Strategy
Clean Air Plan
Air Quality
Strategy
Transport
Strategy and
Made to Move

10. Health Benefits of
Action
•
• Cleaner Air
• Warmer Homes
• Healthier Eating
• Active Travel
• Green Space and Biodiversity
• Community Cohesiveness
• Healthier, Sustainable Economies
• Resilient communities and
health/social care system
•| 10

11. Locality
• Carbon Literacy Training
• Plastic & paper reduction
• Recyclable stationary
• Advocacy
• Social Value Strategy

12. Greater Manchester –
Advocacy

14. Phil Korbel
•
• Co Founder/Director Carbon Literacy Project
• Board Member, G Mcr Low Carbon Hub
•

15. Just think
•
• how different it would be if…
• everyone ‘got it’
• thought low carbon
• acted low carbon
• how much more effective would your existing SD measures be?
•

16. Carbon Literacy is
•
• a day’s-worth of adaptable, relevant, action-based
learning-and-doing on climate change that you deliver
• the foundation for upping your game on climate change
• is not about polar bears
• about health
•
•

18. Meanwhile, in Greater Manchester
•
•
•

19. •





• Carbon neutral by 2038, 15% annual reductions from
now on
•

21. The bosses agreed
•
• tackling climate change is part of the job
• is rarely a high priority
• why?
• “…because I won’t get fired if I don’t…”
• What gets measured gets done
•

22. What leeway does ‘Devo Manc’ offer?
•
• align with the GMCA plan
• standing agenda item
• Providers Board action group
• what gets measured gets done
• embed in funding contracts??
• spread best practice nationally
•

23. •
www.carbonliteracy.com
@Carbon_Literacy
#CarbonLit
phil@carbonliteracy.com
•

24. Sustainability
Solutions
14th February
2019
Paul
Broadberry
Manchester
Sustainability Solutions | CIS10315 Rev. A

25. Single-use device
remanufacturing
Overview -
Safety & Efficacy
Sustainability Solutions | CIS10315 Rev. A

26. Dedicated to your
sustainability goals
§ Remanufactured devices are backed by
Stryker’s comprehensive quality
system
§ All devices are individually tested to
ensure the highest quality
§
Patient Care sustainability
§ Maximise savings through case
support, business reviews,
education and utilising Stryker’s
entire remanufacturing program
§ Leverage partnership to provide
purchasing power and price
containment
Financial sustainability
§ Purchasing and collection processes
designed to minimise waste
§ Alignment to prioritize the reuse of
remanufactured devices
Environmental sustainability
Sustainability Solutions | CIS10315 Rev. A

27. Sustainability Solutions | CIS10315 Rev. A

28. ‘Single-use’ devices (SUDs)
§ Most SUDs cannot be reused
§ The‘single use’label is determined by
the manufacturer, not the regulatory
body:
• Perceived limitation of liability
• Reduced scrutiny by regulatory body
• Increased sales and profits
§ Specialised technology and knowledge
allows manufacturers to
remanufacture certain SUDs
DVT
HARMONIC
SCALPEL
Sustainability Solutions | CIS10315 Rev. A

29. § OEM devices are studied to identify critical
quality attributes and establish performance
specifications
§ Multiple Considerations:
• Analysis of the product
• Materials characterisation
• Chemical compatibility
• Generation of intermediate level
product description, including
engineering drawings
• Analysis of clinical application to
produce a specification
§
Reverse engineering
Sustainability Solutions | CIS10315 Rev. A

30. § Complex medical devices must often be
disassembled
• Enables thorough cleaning
• Allows replacement of components
worn out during original use
• Increases yield
§ Replacement components are designed
and sourced based on OEM
specifications
• Validated as equivalent to new
Remanufacturing
requires
disassembly to
facilitate cleaning
Disassembly and replacement
components
Sustainability Solutions | CIS10315 Rev. A

31. § Receiving and Sorting
• All orders are ticketed to ensure order
content integrity and traceability
• Gross rejects, heavily soiled items, and
unapproved products are removed
• Devices are identified according to OEM
convention
§
§ Device Marking/Tracking
• All devices are indelibly marked with
Unique Device Identifiers via pad
printing, bar coding, laser etching, etc.
• Allows traceability for cycle counts, reject
reconciliation, and potential post-market
field actions
Identification and traceability
Sustainability Solutions | CIS10315 Rev. A

32. § Accepted devices undergo comprehensive cleaning that incorporates prolonged
soaking, cleaning and rinsing in pH-neutral enzymatic cleansers and sanitisers
that are compatible with all device materials
§
§ Residual levels of organic materials, such as protein, hemoglobin and total organic
carbon are quantified and compared with acceptable standards
§
Decontamination and cleaning
Sustainability Solutions | CIS10315 Rev. A

33. § Performance is compared to baseline catheters
§
§ Testing performed in house and/or by third party
Material strength and
performance testing
Tensile
Strength
Tensile
Strength FatigueFatigue Joint Seal
Testing
Joint Seal
Testing
Introduction
&
Withdrawal
Introduction
&
Withdrawal
Torsion /
Deflection
Torsion /
Deflection
Bending /
Buckling
Bending /
Buckling
Sustainability Solutions | CIS10315 Rev. A

34. § DEPCTS (Diagnostic EP Catheter Test System)
§
§ Complete electrical profile testing including isolation and continuity
• Isolation test
• Captures internal and/or minor insulation breakdowns that can result
in cross-talk or noise on the electrogram signals
•
• Continuity test
• Closely mimics actual clinical use
• Verifies that the signal from each electrode is consistent and unbroken
•
• Both tests are performed during active deflections of the test catheter
Electrical integrity testing
Sustainability Solutions | CIS10315 Rev. A

35. § Requirements
• Package variation (i.e. lot to lot)
• Storage
• Human interaction (i.e. shipping)
§
§ Validation Steps
• Validation Plan
• Material/Design Qualification
• Performance Qualification
• Product Qualification
§
§ Testing
• Shock/Drop Test, Vibration Test, Seal/Package Strength, Ship
Test
• ISO 11607, ASTM D4169, ASTM F-1140-00, ASTM F1980-02
• Accelerated Aging (thermodynamic temperature coefficient)
Packaging and shelf life testing
Sustainability Solutions | CIS10315 Rev. A

36. § Conventional Release
• Biological Indicators
• 72 hour quarantine
§
§ Sterilisation validation:
• AAMI/ANSI/ISO 11135
• EN550
• Annual Revalidation
• SAL of 10-6
• EO Residuals: ISO 10993-7; TIR 19
• Not an irritant to patients or clinicians
Sterilisation
Sustainability Solutions | CIS10315 Rev. A

37. 37
Sustainability
Solutions
Remanufacturing
services portfolio
Sustainability Solutions | CIS10315 Rev. A

38. Remanufacturing
in the EP / cath lab
• Diagnostic ultrasound catheters
(3D mapping catheters)
• Electrophysiology catheters
• Electrophysiology interface
cables
• Catheter introducer sheaths
EP catheters
Diagnostic ultrasound catheters
Catheter introducer
sheaths
EP cables
Stryker Corporation or its affiliates own, use, or have applied for the following trademarks or service marks:
Stryker. All other trademarks are trademarks of their respective owners or holders.
Sustainability Solutions | CIS10315 Rev. A

39. • Laparoscopic devices (trocars and
directed energy – bipolar and ultrasonic)
•
• Arthroscopic devices (shavers and
wands)
•
• Orthopedic devices (bits / blades / burs
and external fixation devices)
§
Trocars
Harmonic scalpels
Sealer / dividers
Stryker Corporation or its affiliates own, use, or have applied for the following trademarks or service marks:
Stryker. All other trademarks are trademarks of their respective owners or holders.
Remanufacturing
in theatre
Sustainability Solutions | CIS10315 Rev. A

40. Regulatory Activities
Sustainability Solutions | CIS10315 Rev. A

41. Safety evidence
§ Reprocessors have been regulated since
2000
§ Millions of SUDs have been reprocessed
with no evidence of increased
infection rates.
§ No deaths have been attributed to
reprocessed devices in the FDA’s
Manufacturer and User Facility Device
Experience (MAUDE) database.
2008 GAO report: Of the 320,000+ adverse events filed with FDA between
2000 and 2006, only 65 adverse events “actually involved or were
suspected to involve a reprocessed SUD and that the reprocessed SUD
was one of several possible causal factors in the adverse event. In
reviewing these 65 reports, FDA found that the types of adverse events
reported to be associated with the use of reprocessed SUDs were the
same types of events that were reported for new devices.”
2008 Government Accountability Office (GAO) report: noted the findings
of FDA’s Medical Product Safety Network (MedSun) Program and
confirmed that “none of the representatives of MedSun hospitals who
participated in the FDA focus groups reported being aware of any
infections related to the use of reprocessed SUDs.”
Established record
Sustainability Solutions | CIS10315 Rev. A

42. Protecting your patients
§ Remanufacturing of single-use devices is
regulated by governmental authorities
§ Remanufactures must obtain premarket
clearance and comply with the same medical
device regulations as original equipment
manufacturers
§ Premarket clearance is intended to validate that:
• The remanufacturing is able to clean
and sterilise the device
• Functional performance of the
remanufactured device is
equivalent to the predicate device
§ NO BATCH TESTING – every device is fully
function tested
Regulatory oversight
Sustainability Solutions
§ FDA QSR compliant
§ 105+ premarket clearances
for reprocessing
§ ISO 13485 certified
Sustainability Solutions | CIS10315 Rev. A

43. Regulatory
§ MHRA issued remanufacturing guidance document
§
§ BSI is Stryker’s notified body
§
§ EU Council’s and Parliament’s Committees on ENVI endorsed
remanufacturing agreement
§
§ Stryker Sustainability received CE mark for select vascular devices
Market activities
Regulations
Sustainability Solutions | CIS10315 Rev. A

44. The
Stryker
difference
Financial &
environmental
sustainability
Sustainability Solutions | CIS10315 Rev. A

45. Remanufacturing: making a
difference
In 2017, our
single-use
medical device
remanufacturing
programs helped
our U.S.
customers:
$326 million
in supply costs
13.4M lbs.
of waste from landfills
Save Divert
Sustainability Solutions | CIS10315 Rev. A

46. 3_89
Effective remanufacturing prices will be determined as a 10-45%
discount from OEM prices, depending on Market Share commitment.
• Hospitals/GPOs will provide usage data, including pricing. List price can
be used as a starting point when actuals are not available.
•
• Each individual system may have variations with OEM prices and annual
volumes.
Tier 1
Less Than
10% Market
Share
Tier 2
10% Market
Share
Tier 3
20% Market
Share
Tier 4
30% Market
Share
Tier 5
40% Market
Share
Tier 6
50% Market
Share
10% 15% 21% 28% 36% 45%
% Market Share of Customer Spend
(Please state if discount or actual price is being offered)
Pricing and contracting plan

47. Current
Annualized
Expenditures
Total
Remanufactured
Spend at 30%
Adjusted OEM
Spend
Total Adjusted
Spend
Total Adjusted
Savings
Total Adjusted
% Savings
£ 1,227,293 £ 143,152 £ 905,743 £ 1,048,894 £ 178,399 15%
14% 86%
Total KG
Collected
Rate
Total Waste
Savings
10,000 £ 0.20 £ 2,000
Total Savings
Remanufacturing Savings +
Waste Savings
£ 180,399
Customer Spend & Remanufacturing Savings
Summary of Total Annualized Savings
Waste Savings
3_89
Savings Opportunities:
1. Sustainability devices
2.
3. OEM price erosion
4.
5. Waste diversion
6.
7. Totals
Savings analysis
1 2
3
1 2 4
4

48. Case study
Sustainability Solutions | CIS10315 Rev. A

49. Collections process
Establish account
Collection materials
supplied
Set up & training
Collections
Shipment
Inspection, tally and
reporting
Sealer / dividers
Harmonic scalpels
Trocars

50. Dedicated to your
sustainability goals
§ Remanufactured devices are backed by
Stryker’s comprehensive quality
system
§ All devices are individually tested to
ensure the highest quality
§
Patient Care sustainability
§ Maximise savings through case
support, business reviews,
education and utilising Stryker’s
entire remanufacturing program
§ Leverage partnership to provide
purchasing power and price
containment
Financial sustainability
§ Purchasing and collection processes
designed to minimise waste
§ Alignment to prioritize the reuse of
remanufactured devices
Environmental sustainability
Sustainability Solutions | CIS10315 Rev. A

51. Questions?
Thank you!
Sustainability Solutions | CIS10315 Rev. A

52. 52
References:
Anderson, L. (2013, April). Clinical business strategies. Retrieved from: www.hpnonline.com
Ferguson, M. & Toktay, B. (2007, July). Effects of competition on recovery strategies. Retrieved from: www.insead.edu
NuRep. (2015, April 23). Are repless models the answer to PPI cost management? Retrieved from: www.nurep.com
Scott, B. (2016, April 22). Savings war: The pros and cons of SUD reprocessing growth. Retrieved from:
www.dotmed.com
White, B. (2016, May 4). Single-use device Options – Promoting Cost Savings and Infection Prevention. Retrieved from:
www.medicaldealer.com

53. © 2015 JRP Solutions Ltd
The information in this document is the property of JRP Solutions Ltd and may not be copied or communicated to a third party, or used for any purpose other than that for which it is supplied without the express written consent of JRP Solutions Ltd. This information is given in good faith based upon the latest information available to JRP Solutions Ltd, no warranty or representation is given concerning
such information, which must not be taken as establishing any contractual or other commitment binding upon JRP Solutions Ltd or any of its subsidiary or associated companies.
Saving Energy Through Staff Engagement
George Richards
14th February 2019

54. Discussion Framework
• Introductions
• Who are JRP?
– What do we do?
– Who do we work with?
• Energy Training
– Why do it?
– Levels of training
– eLearning
– Costs
• Any questions?
•
•

55. Why do it?
ü NHS annual energy spend of approximately £544m
ü Increased consumption due to more energy hungry technology
ü Pressure on to deliver savings
ü Little capital available to invest in energy saving projects
ü Inefficient building stock
ü Effecting behavioural change is low cost and delivers immediate benefits
ü A 5% - 10% reduction in energy use would realise a £30 - £60m annual saving
ü We all have a moral duty to change what we do and prevent waste wherever possible as
we face ‘A Climate Emergency’

56. Energy Awareness Training
Harness the inherent knowledge of your staff – they know
your business better than any consultant!
JRP provide five levels of training from Level 1 General Energy
Awareness to Level 4 Embedding Energy Culture Change ensuring it
is always relevant, engaging and practical

57. Making it relevant
Level 1 – General Energy Awareness Training
ü Face to face or eLearning modules
ü Fundamental principles of energy – what it is, where it comes
from, what it costs, security of supply, environmental impacts
ü The impacts of inaction in the home and workplace
ü Can be bespoke for larger organisations
ü EUSR approved

58. Energy – the big picture
•
•
•
•
•
•
•
• Provides a universal understanding of what energy is, where it comes from and why CO2
emissions are so harmful to the planet

59. Energy at home
Looks at how energy is used within a typical home and provides some useful tips to help
reduce energy consumption and reduce energy bills at home

60. Energy at Work
Every day £000’s of energy is wasted at work with lights, heating & cooling and equipment
being left on when it’s not actually needed.
This module looks at simple ways in which energy consumption can be reduced to help make
the workplace more sustainable and save the NHS significant amounts of money.

61. Energy Awareness via eLearning
https://jrpsolutions.learnupon.com/users/sign_in

62. Making it relevant to the NHS
• Relevant to all staff – clinical, medical and support
• Builds universal understanding of energy and CO2 through modules
• Adds personal value by relating energy to the home environment
• Relates to NHS priorities and values e.g. improved patient comfort
• Can be used for Induction Training, Team Talks or as a complete course
• Very affordable @ £3k per annum with unlimited usage in each Trust
•

63. © 2015 JRP Solutions Ltd
The information in this document is the property of JRP Solutions Ltd and may not be copied or communicated to a third party, or used for any purpose other than that for which it is supplied without the express written consent of JRP Solutions Ltd. This information is given in good faith based upon the latest information available to JRP Solutions Ltd, no warranty or representation is given concerning
such information, which must not be taken as establishing any contractual or other commitment binding upon JRP Solutions Ltd or any of its subsidiary or associated companies.
Any Questions?
Contact: George Richards
e: george.richards@jrpsolutions.com
m: 07870 394601

64. Thank you

65. Nerys Simmons
Manchester University NHS
Foundation Trust
Embedding Reuse

66. Why have a reuse system?
• £100s disposing of unwanted items
• £1000s procuring same items
• Match up the 2
üAvoid waste
üReduce carbon footprint from procurement
üSave ££££££

67. In figures
Since February 2016 we have….
• Registered 1252 colleagues as users
• Reused 3558 items over 861 transactions
• Saved estimated £175k in procurement costs
• Avoided 25 tonnes of waste

68. Things to consider
• Know your stakeholders
• Know your own resources
• Know your audience
• Keep it fair
• Keep it in focus
•

69. Know your stakeholders
• Procurement and budget holders
• Health and Safety, Infection Prevention, Fire Safety
• Medical Engineering, Informatics
•
• Capital Works/Property and Estates
•

70. Know your own resources
• Time, transport, storage
• Be clear on everyone’s responsibilities
• Accept there are limitations

71. Know your audience
• What do people want?
• What items have restrictions on procurement
• Use popular items to promote the system

72. Keep it fair
• Everything for reuse goes through Warp It
• Everyone has an equal chance to claim
• Users are expected to give as well as receive

73. Keep it in focus
• Case studies in staff newsletter
• Sign-up at events
• Criteria for Green Impact award
•
•

74. Thank you
Nerys Simmons
Waste and Sustainability Officer
Nerys.simmons@mft.nhs.uk
0161 276 6349

75. #DAYFORACTION
Refreshment Break
#dayforaction

76. #DAYFORACTION
Session 2: Injecting finance into the NHS
and creating savings
#dayforaction

77. Reducing waste in every way
NHS Sustainability Roadshow
Manchester
14th February 2019

78. Introductions
MJ Rose - Business Development Manager
Kerry Jones – Sales Director
www.forwardwaste.co.uk

79. The importance of segregation…
The way we handle waste has to change!
Volume of wastes going to UK landfill - In 2016, 15.7 million tonnes of municipal
waste was sent to landfill. Of this, 7.7 million tonnes was biodegradable
municipal waste.
Around 10 million tonnes of food and drink was wasted in the food chain in 2015
- around 60 per cent of this is avoidable.
The problem with plastic…
8.3 billion tonnes of virgin plastic created to date
9% recycled
12% incinerated
79% accumulated in landfills
If this trend continues, roughly 12 billion tonnes will be landfilled by 2050
www.forwardwaste.co.uk

80. The waste hierarchy…
www.forwardwaste.co.uk

81. Where can your general waste go?
www.forwardwaste.co.uk
EfW
General waste incinerated to produce energy, with
incineration temperatures reaching over 850
degrees celsius
Reduction in greenhouse gas emissions between
32% - 41% compared with sending to landfill
Local EfW facility generates enough electricity for
50,000 homes
23% of renewable energy comes from energy from
waste – equivalent to 726,000 tonnes of oil

82. Where can your food waste go?
www.forwardwaste.co.uk
Anaerobic
Digestion
Uses microorganisms to break down food waste in
an enclosed system, without oxygen
As it breaks down, methane is produced which is
collected and converted to biogas
Biogas used to generate electricity, heat or
transport fuels
Also creates a nutrient-rich fertiliser for use in
agriculture

83. The importance of segregation…
Higher chance of achieving zero to landfill
Valuable, recyclable materials recovered at source with lower
disposal charges, or rebates achieved
Full traceability of waste destinations
www.forwardwaste.co.uk

84. Efficient waste management in the NHS
www.forwardwaste.co.uk
or…
BEDS? BINS?
Simple Choices…

85. Case study – the problem
NHS hospital trust
13 tonnes of unsegregated waste produced per month
general waste and cardboard all in together!
Increased container collections per annum, leading to a high carbon footprint
Health & Safety concerns and disruption to site through high container frequency
www.forwardwaste.co.uk

86. Case study – the solution
General waste
collected from around
the hospital
Residual general
waste loaded into
portable compactor
www.forwardwaste.co.uk
Waste taken for
onward recycling.
Cardboard segregated
at source and baled.
Collected every 2 months
with rebate achieved. Compactor emptied
once a month.

87. Case study – the outcome
Reduction in general waste by 50%
Collection frequency's reduced from 2 visits PCM to only 1 PCM – 50%
reduction!
Cardboard waste generating income
Carbon footprint reduction in general waste movement.
Baler hire costs covered by rebate.
www.forwardwaste.co.uk

88. What should be happening…
Elimination
Minimisation
Diversion
Waste
Management
Risk Reduction
Legal
Compliance
Cost Control
Environmental
Consultancy
Removal and
Disposal
www.forwardwaste.co.uk

89. Any questions?

90. Thank you for your time.
mj.rose@forwardwaste.co.uk
kerry.jones@forwardwaste.co.uk
www.forwardwaste.co.uk

91. In It Together:
Creating a Whole
Trust Approach

92. Introduction
•2.4 million patient contacts
•+- 15,000 staff
•A 900-year history
•Almost £1.5 billion annual turnover
•6,659 babies born
•+- 5,000 tonnes of waste p.a.
•Awarded TWM contract in 2014
•Close working relationship
•Education & communication
•Innovations & initiatives
•
•

93. About us
Partnership Approach
•Recycling & Resource Management company - contract lead
•Dedicated staffing – team of 35 on site
•Sustainability Director & Team
•
•
•
•
•
•
Head of Health &
Sustainability
Contract Manager
Key Coordinator Supervisors
Waste/ Obsolete Porters
Guy’s and St Thomas’ sites
Trust Waste Manager
Logistics Assistant
Sustainability
Team

94. About us
Initiatives
•SAVE - savings of up to £150,000 p.a.
•Waste data from Byweigh mini-weighbridge
•Senior Management buy in & SAVE Champions
•Support for events and sustainability activities
•Staff induction education
•
•
•
•
•
•
•

95. About us
Mini-weighbridge system
•Identifies and weighs every bin - ward/ department level tracking
•Bespoke software and tagging system
•Performance and cost - real-time, to pin-point problem areas
•Staffing and efficiency benefits
•

96. About us
Reuse and Food recycling
•Reuse
•Trust signed up to Warp-it in November 2017
•12 months savings of £76,000
•Initial Roll Out - Ward Clerks and
Procurement Buyers
•Procurement decisions for purchase are
prompted to use StockDoc
•Food waste
•Tonnage from 1 tonne to 14 tonnes per
month
•Training of Food Service Assistants

97. About us
Single – use packaging
•Installed August 2018 at
St Thomas’
•4,000 bottles refilled
since being introduced
•Machine also to be
installed at Guy’s and in
community sites
•

98. About us
Single – use packaging – market reactions
•Customer enquiries and questions
•Commitment and leadership
o Unilever – 100% plastic
packaging fully
recyclable,
compostable, reusable
by 2025. Increase
recycled content in
packaging to 25% by
2025
o Costa – 500million single-
use coffee cups recycled
in the UK

99. About us
Inspiring action and useful resources
•Leading by example
•Spread the word enthusiastically
•Resources out there:
•https://www.ellenmacarthurfoundation.org
/
•https://skyoceanrescue.com/
•https://thesra.org/
•https://lessplastic.co.uk/
•https://
www.flipsnack.com/Bywaters/new-flipbook-fti01qafh.html
•
•
•

100. The Right People

101. The Right People

102. Sustainability

103. Ed van Reenen
07818560650
e.vanreenen@bywaters.co.uk

104. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Securing funding to deliver cost-saving
energy efficient technologies
Thursday 14th February 2019
Liam Gillard, Salix Finance

105. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Overview of Salix Finance
Independent, not-for-profit company working in partnership with the Public Sector
since 2004
Salix provides interest-free funding to accelerate investment in energy efficient
technologies
National profile working in England, Scotland and Wales
Funded by the Department for Business, Energy and Industrial Strategy (BEIS), the
Department of Education, the Welsh Government and the Scottish Government

106. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Salix focus

107. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Funding model Funding committed
following successful
application
Project delivery and
installation
(interim payments available)
Salix loan paid out
on completion
Financial and
carbon savings
achieved
Repayments made
back to Salix
(10 equal instalments over 5
years)

108. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Our achievements
*calculated using emissions factors published by government for carbon foot printing
client pilot
schemes
Salix funding
allocated
£930,000
energy saving
per annum
6,000*
tonnes CO2
per annum
£3.4m19 500
client projects
committed
tCO2e*
annual
saving
766k*2301
Salix funded
projects
£692m
energy
saving per
annum
£158m
client projects
committed
16,656
Clients
supported
2004
2018

109. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Technologies supported
Salix funding can support over 100 energy
efficiency technologies
Boiler replacements
Building energy management systems
Combined heat and power
Heat recovery
Heat networks
Heating and hot water upgrades
Building fabric insulation
LED lighting upgrades
Street lighting
Solar PV

110. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Salix Finance and the NHS
Funding criteria – 5 year loan payback (no technical payback anymore), costs less
than £172 to save tCO2e over lifetime of the project
Funding can be used to improve existing equipment or to install equipment to
achieve higher standards in new build developments
Funding can be secured over multiple years to support Sustainable Development
Management Plans and long term estate strategies (including EPCs)
NHSI approve of Salix’s Invest to Save model

111. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
£70.5m
100,000
£19.5m 63
236
£567.5m
Salix working within the NHS
*Calculated using emission factors published by government for carbon footprinting
63
227
TOTAL TRUST ENERGY
SPEND 2017/18
£567.5m
TOTAL SALIX LOAN
VALUE
ESTIMATED ANNUAL
tCO2e*
TOTAL ANNUAL
SAVINGS
£71m
100,000
£19.5m

112. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Top Salix NHS clients
Imperial College Healthcare NHS Trust
East Kent University Hospitals NHS Foundation Trust
Wrightington, Wigan and Leigh NHS Foundation Trust
Frimley Health NHS Foundation Trust
George Eliot Hospital NHS Trust
Northern Devon Healthcare NHS Trust
University Hospitals of Morecambe Bay NHS Foundation Trust
Lewisham and Greenwich NHS Trust
North West Anglia NHS Foundation Trust
Northampton General Hospital NHS Trust

113. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Salix project knowledge slides
Sharing of knowledge between clients
Before and after project delivery
Supporting comments
Lessons learnt
Supplier information
Contact details
NHS knowledge slides
Gaining internal approval

114. •
•
BEFORE
• 3 x 4.5MW LTHW boilers
• Annual energy spend of £407,000 gas and £1.6m electricity at Whiston
Hospital
• Whiston Heating System is maintained by Vinci Facilities. The heating
demand from Whiston hospital is approx. 3,728Kw in the coldest
months of the year.
Project Knowledge – CHP and Heat Recovery by
St Helens & Knowsley NHS Trust
AFTER
• CHP providing 1.28MW of electricity and 1403kW of Low
Temperature Hot Water
• FluAce direct contact gas condensing economiser fitted to current
boilers to recover ~20% of the energy currently in the flu gas
•
•
•
•
•
•
Project completion date – October 2018
• Project value
£2,108,365
• 8,986,157 kWh
annual
electricity
saving (51%)
• £713,258/year
savings
• Payback 2.96
years
• 1,638 tCO2 saved
per year
•
•
•

115. Supporting Comments:
Project Knowledge – CHP and Heat Recovery by
St Helens & Knowsley NHS Trust
• Proposed savings derived from a)Use of expected kwh reductions from initial feasibility study ‘plugged’ into Trust invoicing
monitoring spreadsheet, and b) Pre and post consumption (kwh) figures and cost per kwh also plugged into the SALIX
compliance tool to test payback <5years.
•
• Electricity costs of 9.16 p/kWh and gas costs of 1.80 p/kWh at Whiston Hospital
•
• Clark Energy, Cogenco and Centrica put in a bid in our tender for the installation and maintenance of the CHP and Flue-Ace
heat recovery unit. Centrica was the chosen supplier.
•
• Advice/lessons learned:
• Consider whether your site has an A and B electrical supply, which is usual in modern hospitals. If this is the case
you may have to consider the electrical demand of one of these supplies, rather than total site demand, when
sizing the CHP.
• Ensure you have a good log of constant temperature hot water return data and primary heating loop temps prior to
the project.
• Be patient from initial SALIX approval through to feasibility to actual completion….. 3 years, we are however a PFI
trust so were held up with Deed of Variation and Funder approval.
• SALIX had equal patience with our delays……Thank you.
•

116. Measurement of Savings:
Project Knowledge – CHP and Heat Recovery by
St Helens & Knowsley NHS Trust
• The savings for December and
January are greater than the
expected savings amount.
This is because the expected
savings calculation took into
account unforeseen
downtime, scheduled
downtime, Scheduled
maintenance, and peak
summer intervals over the
course of the year.
• There aren’t any aspects of the
savings calculation we would
approach differently after
considering post verification
results.
•
Graph 2 –
Metered
consumptio
n to Jan 19
•
• Savings have been monitored on this project using manual mains meter readings, STARK smart meter readings, utilities bills
and the Web portal supplied by the CHP contractor which details Gas used as well as electrical and thermal energy
generated.
•
•
•
Graph 1 –
Metered
consumption
to Oct 18

117. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Salix case studies

118. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Supporting project delivery
FeasibilityFeasibility Internal
Consultation
Internal
Consultation ProcurementProcurement MobilisationMobilisation InstallationInstallation
Business case
checks
Meet with finance
department
Offer reservation of
funding for Trust Board
Workshops and calls with
other Trusts for advice
Interim Payments
Phase works over
financial years

119. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Summary
100% interest free funding available for NHS Trusts and
Foundation Trusts – no maximum loan amount
Cost neutral - loan repaid through savings
Supporting long-term funding plans, Sustainable
Development Management Plans and estates
strategies
Helping the NHS achieve energy and carbon reduction
targets
Reduce energy bills at your Trust

120. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Thank you
liam.gillard@salixfinance.co.uk
0203 714 5655

121. #DAYFORACTION
Lunch
#dayforaction

122. #DAYFORACTION
Session 3: Sustainability in action
#dayforaction

123. Powering Performance:
Helping major energy users in the healthcare sector to improve
energy efficiency and operational performance through onsite
generationTony Orton
Centrica Business
Solutions
Thursday 14th February
2019

124. Centrica Business Solutions
The energy landscape is evolving
Powering business advantage 124124Centrica Business Solutions
CENTRALISED
ENERGY
MICROGRIDS RENEWABLES
STORAGE
DISTRIBUTED
GENERATION
DEMAND SIDE
RESPONSE
Centralised energy supply is
giving way to distributed
technology, providing
businesses with smart,
secure and affordable
solutions to the energy
challenges they face.

125. Centrica Business Solutions
Energy
supply
Wholesal
e
energy
Energy
insight
Energy
optimisation
Energy
solutions
Centrica Business Solutions has been created to
develop new thinking, new technologies and new
ways of working to help our healthcare customers
We assist organisations to improve their operational
efficiency, ensure site resilience and unlock new sources
of value with energy insight, optimisation and technical
solutions.
125Centrica Business Solutions
2022 annual
revenue
target
£1bn >2k
Enterprise
customers
£700m
Investment
to 2020

126. Centrica Business Solutions
The rising cost of non-commodity charges
126
Capacity market subsidy
A subsidy to encourage flexible
generation to meet peak demand.
Contract for difference
Subsidies for large scale low carbon
generators, to replace the closing
renewables obligation.
Feed-in tariffs
A subsidy for small scale renewable
generators, e.g. solar panels.
Transmission network
charges
Paid to National Grid to cover build
and maintenance costs of Britain’s
high voltage network.
Distribution network
charges
Paid to regional networks to cover
the cost of transporting energy from
National Grid to customer meters.
Renewables obligation
Subsidies for large scale low
carbon generators, e.g. wind
farms.
Balancing Services Charge
Paid to National Grid for their work
ensuring supply and demand are
always equal.
Supplier costs
Debt costs, operating expenses and
profit.
Wholesale energy costs
Energy purchased on the wholesale
market plus the cost of any
‘imbalance’ caused by changes to
our forecast consumption.
42%
19%
14%
8%
5%
4% 3%
2%
2%
Note: British Gas forecast 2018 costs for sample customer

127. Centrica Business Solutions
Tracking the continuing rise of non-commodity costs in the UK
127
Environmental Levies
Balancing Services
Transmission Network
Charges
Distribution Network
Charges
Wholesale Energy Costs
31% 57% 64% Non-Commodity cost as % of
total

128. Centrica Business Solutions 128
21 3
Panoramic Power’s non-invasive, self-powered wireless sensors can be
installed quickly and easily, with little or no disruption or downtime to your
operations. Enabling access to energy data and analytics through a single
platform.
Sensor installation
Easily attach the non-invasive
self-powered sensors to the
outgoing electrical wire. Each
individual sensor will start
tracking the energy usage of the
device, equipment or process.
Analysis and action
Capturing energy data in a single
platform provides a powerful interface
to monitor, measure, report, and
understand energy consumption from
multi-site level to individual device
level.
Monitoring and data
Data is continuously received from
the sensors and wirelessly
transmitted to the analytics platform
via cloud technology, all in real-time.
Panoramic Power
Energy insights

129. Centrica Business Solutions 129
Cloud based analytics platform for understanding your
consumption

130. Centrica Business Solutions 130
Energy Insights
Device level visibility and
energy insights
14bn global data points
across 53k sensors and in
30 countries
Demand Side
Response
Additional revenues from existing
assets
Europe’s #1 Demand Side Response
provider with c. 5GW under
management globally
Battery Storage
Additional revenue
Patented battery optimisation
driving industry leading
returns
Roosecote 49MW and
Gateshead 3MW battery
developed, 18MW battery live
this week in Belgium
Combined Heat and
Power
25% increase in energy
efficiency
UK’s largest CHP provider,
with over 3k units in market
Integrated
Solutions
Platform
Solar
100% renewable generation
150MW of solar power
managed globally with 6.5k
solar panels in the UK
Delivering an integrated approach

131. Centrica Business Solutions
Optimising the value of onsite generation
131
Connection and
supply
e.g. Bord Gáis, British
Gas and Direct Energy
Wholesale market
trading
Energy insight
Operations
and
maintenance
Power generation
e.g. back up-
generator
Automated
Demand Side
Response
Combined heat
and power
(CHP)
Energy efficiency
e.g. solar panels, LED
lighting, heating, ventilation
and
air-conditioning (HVAC)
Battery
storage

132. Centrica Business Solutions 132
Combined Heat and
Power
Solar
PV
Battery storage
charge
Battery storage
discharge
Grid
import
An illustrative Distributed Energy strategy

133. Centrica Business Solutions
CHP helps hospital cut carbon emissions to the
equivalent of removing 1,000 cars
Customer objective
• Offer healthcare services for three million
• Make cost effective energy decisions
• Produce sustainable energy
The solution
Centrica Business Solutions installed a brand new
Combined Heat & Power (CHP) unit that:
• Reduced electricity consumption
• Cut energy spending
• Slashed energy-related concerns
• Created healthcare investment opportunities
University Hospitals of the North Midlands (UHNM)
133
“We chose Centrica Business Solutions because
their product offered the best fit for our needs. It
offered the best savings in consumption, cost and
carbon over the 15 year life of the installation. I
would definitely recommend them for CHP
installation and maintenance.”
Charlie Cox
Energy Manager
University Hospitals of the North Midlands, NHS Trust
£500
K
2,000 20
CHP unit saves £500,000 annually
Carbon emissions cut by 2,000 tonnes
Carbon cuts same as hiring 20 nurses

134. Centrica Business Solutions 24
Thank you
If you have any questions please contact us:
Tony Orton
Distributed Energy Sales Manager
Centrica Business Solutions
Email: Tony.Orton@centrica.com
Centrica Business Solutions
Email: CentricaBusinessSolutions@centrica.com
Website: www.centricabusinesssolutions.com
Twitter: @CentricaSoln_UK

135. “Sustainable Solutions
for a
Circular Economy”

136. IntroductionTo Sterimelt
and a Sustainable Recycling Solution for
Clinical ‘SterilisationWrap’
• Burton Queen’s Hospital
• Sterilisation Wrap
• Legal and Compliance
• Sterimelt
• Benefits to Health care industry
• BBC News – NHS News - Awards - Social Media
• Ongoing Solutions, Projects and Opportunities
• Questions and Comments
•
October 2018 www.tcg.ltd136
Today’s Presentation Agenda

137. October 2018 www.tcg.ltd137
Where would you rather see your NHS money being spent..??
BEDS BINSOR

138. October, 2018
www.tcg.ltd
138
Burton NHS FoundationTrust

139. SterilisationTheatreWrap
Typical operating room featuring “Wrap”
• Clinical “Wrap” is a non-woven polypropylene
sterile wrap that is used to maintain the sterility
of instruments and equipment and can also be
used as bed sheets, drapes and covers in the
operating theatre.
• “Over 4 Million Operations are performed across
the NHS in England each year”- Natalie Roddis,
Waste and Sustainability Officer- NHS Burton
• WHO estimates, 75-90% of waste from healthcare
facilities is non-hazardous.
• Queen’s Hospital Burton produces about 16 tonnes
of “Sterilisation wrap”-previously sent for
incineration at very high cost.
• Merged with the Royal Derby NHS in August 2018
to become University Hospitals Of Derby And
Burton NHS FoundationTrust.
October 2018 www.tcg.ltd139

140. October 2018 www.tcg.ltd140
Legal and Compliance
Independent EmissionsTest
Environment Agency &
Natural ResourcesWales Independent Lab Report

141. October 2018 www.tcg.ltd141
Ø Reduction inVolume by 80 to 85%
Ø Operator Free for Other Duties During Densification Process
Ø Diverts From Landfill and/or Incineration - Sustainable
Ø 100% Compliant Recycling Process – Circular Economy
Ø Current Revenue Stream from PP
Ø Processed Blocks Re-Manufactured–Circular Economy
Ø
Ø ”Savings from disposal costs for the UK of Circa £12,750,000
should Sterimelt be implemented across the NHS.The
revenue created for the UK could reach £6,500,000”-
Natalie Roddis, Waste and Sustainability Officer- NHS Burton
Ø Save on disposal costs
Ø Earn Revenue for tonnages recycled
Ø

142. The Simple Sterimelt Process

143. October 2018 www.tcg.ltd143
BenefitsToThe Healthcare Industry

144. October 2018 www.tcg.ltd144
BBCWales – NHS – Awards – Social Media

145. TCG Ltd- Further Projects, Solutions and Opportunities…….
• Single Use Disposable PatientTransfer Sheets
• Successfully processed PTS supplied by
M.I.P. UK Ltd (Formerly Cromptons)
• Significant opportunity to recycle yet more
“single use disposable” products.
October 2018 www.tcg.ltd145
• Disposable Curtain Recycling – Innovate UK
• Ongoing trials of volume reduction and
recycling of disposable curtains
• Significant opportunity to recycle yet more
“single use disposable” products.

146. www.tcg.ltd
“World First Sustainable Healthcare Innovation”
ThankYou ForYourTime And Attention
--Any Questions….???

147. Delivering Energy Savings
through ‘Low Cost’ Interventions
Presented by:
Darren Jones BSc (Hons), C.Eng. FCIBSE LCC LCEA
Manchester NHS Sustainability Day Roadshow – 14th February 2019
www.lowCO2.eu

148. An overview
1. Hospital Energy Efficiency; the Drivers & Barriers
2. BMS Optimisation
3. Operating Theatre Optimisation - Case Studies
4. Lighting Upgrades & Controls
5. Steam and Condensate Systems
6. Chiller Upgrades & Optimisation
7. Summary - Technological Improvements
8. Summary - Non Technical Opportunities
9.
10.

149. Ø
Ø Economic: Electricity and other energy prices are rising, NHS Trusts
are currently in financial deficit.
Ø Political: Global, European and National Targets. Climate Change
Act, Carbon Reduction Targets.
Ø Environmental: Reducing energy waste reduces GHG emissions
and accompanying environmental impacts.
Ø Social: Energy efficiency has health benefits, both in the home and
at work. Fuel poverty impacts on the whole health economy.
Ø
Hospital Energy Efficiency – The Drivers

150. Common barriers include:
Ø Financial Restrictions
Ø Economic Uncertainty and Risk
Ø Information and Skill Gaps
Ø Poor Commissioning
Ø Poor Maintenance
Ø Sub-optimum Engineering Design
Hospital Energy Efficiency – The Barriers

151. Ø Avoid a wide range of set temperatures. Adopt a heating
schedule policy.
Ø Ensuring a dead band of at least 3 C (+/-1.5ºC) is factored into○◦
BMS strategies will help to prevent simultaneous heating
and cooling taking place.
Ø
Ø Reviewing temperature and pressure sensor calibration on a
frequent basis will help maintain optimum control
efficiency.
What you see on the BMS, is often not the reality…
•
Quick Win – BMS Control Set-point Optimisation

152. Recommendation – Repair Fresh Air Actuator
Issue – Faulty Actuator
Annual Energy Saving – 30,000kWh
Annual Cost Saving – £1,350
Implementation Cost – £350
Payback Period – 3 Months
Damper Actuators

153. Recommendation – Replace Fresh Air Actuator
Issue – Actuator Removed
Annual Energy Saving – 190,000kWh
Annual Cost Saving – £9,500
Implementation Cost – £500
Payback Period – Under 1 Month
Damper Actuators

154. Ø The cooling and heating control
valves on many AHUs ‘let-by’,
which isn’t always evident
from the BMS head-end.
Ø A more invasive inspection of
plant will identify this type of
issue. Replacing or repairing
control valves on AHUs will
prevent losses across the
system.
AHU Heating/Cooling Emitters

155. Ø Chiller Flow Temperatures – 5 Degrees C. too low!!
Ø 1 Degree C. increase equates to a 3% performance improvement…
Ø
Ø
Ø
Ø
Ø
Quick Win – Control Set-point Optimisation
Office Building Sever Room

156. Simultaneous Heating and Cooling

157. Simultaneous Heating and Cooling

158. Thermal Wheels - Heat/Coolth Reclaim
Can reduce plant running
costs by up to 50%

159. Recommendation – Clean Coil Face
(Jet or Steam)
Issue – Soiled Coil Face
Annual Energy Saving – 300,000kWh
Annual Cost Saving – £15,000
Implementation Cost – £500
Payback Period – Under 1 Month
Heating/Cooling - Soiled Coil Faces

160. Filter Media
What impact does dirty
filter media have on
energy consumption?

161. Variable Speed Drives - Interlocked with BMS
Ø Chiller Compressor Control
Ø Chiller Condensing Fan Control
Ø Chilled Water Circuits
Ø Condensing Water Circuits
Ø Heating Water Pump Control
Ø Ventilation Fan speed control

162. Ø We have proved that by improving
the air supply in one theatre
alone, a Trust could save in the
region of £5,000 a year.
Ø
Ø If this figure was extended to all the
Trusts in England, it could mean a
saving of more than £10m and a
reduction in carbon emissions of
80,000 tonnes a year!
Operating Theatre Optimisation

163. Operating Theatre Optimisation
Mile End Hospital

164. Rec.
No.
Complexity (1
= Simple,
3 = Complex)
Relates
To:
Recommendation Est. Cost (£) CO2 Emissions
Reductions
(Tonnes)
Annual Energy
Saving (kWh)
Annual
Saving (£)
Simple Payback
Period
(Months)
1 2 All
Theatres
Consider reducing Air Change Rate in line with
HTM requirement in order to reduce energy.
£600 14.27 26,718 £2,671 3
2 1 All
Theatres
Consider removing the HEPA filters to reduce
system pressure.
£100 5.7 10,512 £1,051 1
3 3 All
Theatres
Consideration should be given to replacing
supply fans with high efficiency units in order to
reduce power drawn by the systems.
£5,000 3.88 7,183 £718 84
4 2 All
Theatres
It is recommended that the time schedules for
the Theatre unit are changed in line with
occupancy hours.
£600 6.44 11,913 £1,190 6
5 3 Cooling
Plant
Consideration should be given to installing
variable speed drives (VSDs) and controlling
pumps based on demand, and the adoption of a
2-way valve system on the chiller plant.
£6,300 13 23,875 £2,387 32
6 2 Heating
Plant
A review of installation of a software interlock,
and the adoption of time schedule to prevent the
unnecessary operation of heating pumps during
low demand.
£600 6.2 11,466 £1,147 6
7 2 All
Theatres
Consideration could be given to reducing the
temperature set-point.
£600 16.3 88,595 £2,658 3
8 2 All
Theatres
It is recommended that the existing VSDs on the
Theatre unit are utilised by modulating the fan
speed in accordance with system demand.
£600 11.3 21,000 £2,100 3
Totals* £14,400 77 201,262 £13,922 12
*Savings are not considered cumulative, totals shown for representation purposes only.
Summary of Recommendations – Mile End Hospital

165. Recommendation 1
Consider Reducing Air Change Rates
Room Room Size (m²) Total Flow Rate
(m³/h)
Air Change Rate
(per hour)
Recommended Air
Changes
(per hour)
Achievement of
Design Values (%)
Theatre & Scrub 188.2 3178.8 16.9 15 113
Anaesthetic 61.0 1746.0 28.6 15 191
Prep 44.5 648.0 14.6 10 146
Air Flow Results
Ø The Theatre & Scrub AHU is running at 3,178.8 m³/h vs. the required duty of 2,813 m³/h, the volume can
therefore be reduced by 13%. The Anaesthetic & Prep AHU is running at 2,394 m³/h vs. the required duty
of 1,357.98 m³/h, a 44% reduction is therefore possible.
Ø
Ø This initiative can be achieved through modification of the operating frequency on the Variable Speed Drive
(VSD).
Ø
Ø Following the fan laws, this equates to a reduction in energy of 34% and 82.4% respectively.

166. Recommendation 2
Consider removing the HEPA filters from the AHUs
ØThe AHUs serving the theatres at Mile End were found to contain
HEPA filters. As HEPA filters are only a requirement for ultra
clean theatres, it is recommended that consideration be given to
their removal from the system.
Ø
ØOwing to the high pressure drops developed by HEPA filters, the
reduction in energy has been calculated to be 1.2kW, equating to
a £1,051 saving per annum.

167. Recommendation 7
Consider reducing temperature set-point
The existing controls for the Air Handling Units are controlled to a set-point of 25˚C; this is considered high. It is
recommended that this set-point be reviewed and adjusted to nearer 21˚C. Reducing the temperature by 4˚C
would reduce the energy consumption by approximately 27%.
Supply Air Temperature (Heating Coil) = 25.00 0
C
Total Air Volume = 0.88 m3
/s
Daily Running Hours = 24.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.00 4.53 25.00 20.47 16,473.56
Feb 309 28 11.04 1.00 4.46 25.00 20.54 14,930.23
Mar 261 31 8.42 1.00 7.08 25.00 17.92 14,421.41
Apr 197 30 6.57 1.00 8.93 25.00 16.07 12,515.41
May 111 31 3.58 1.00 11.92 25.00 13.08 10,526.34
Jun 49 30 1.63 1.00 13.87 25.00 11.13 8,668.11
Jul 20 31 0.65 1.00 14.85 25.00 10.15 8,168.38
Aug 23 31 0.74 1.00 14.76 25.00 10.24 8,240.81
Sep 53 30 1.77 1.00 13.73 25.00 11.27 8,777.14
Oct 128 31 4.13 1.00 11.37 25.00 13.63 10,968.96
Nov 234 30 7.80 1.00 7.70 25.00 17.30 13,473.34
Dec 308 31 9.94 1.00 5.56 25.00 19.44 15,644.65
Totals 2,033 365 142,808.34
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 190,411.12 kWhr
Annual Heating Cost = £5,712.33
Thames Valley - Heathrow
Supply Air Temperature (Heating Coil) = 25.00 0
C
Total Air Volume = 0.67 m3
/s
Daily Running Hours = 24.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.00 4.53 25.00 20.47 12,406.48
Feb 309 28 11.04 1.00 4.46 25.00 20.54 11,244.17
Mar 261 31 8.42 1.00 7.08 25.00 17.92 10,860.97
Apr 197 30 6.57 1.00 8.93 25.00 16.07 9,425.54
May 111 31 3.58 1.00 11.92 25.00 13.08 7,927.54
Jun 49 30 1.63 1.00 13.87 25.00 11.13 6,528.08
Jul 20 31 0.65 1.00 14.85 25.00 10.15 6,151.72
Aug 23 31 0.74 1.00 14.76 25.00 10.24 6,206.27
Sep 53 30 1.77 1.00 13.73 25.00 11.27 6,610.19
Oct 128 31 4.13 1.00 11.37 25.00 13.63 8,260.88
Nov 234 30 7.80 1.00 7.70 25.00 17.30 10,146.97
Dec 308 31 9.94 1.00 5.56 25.00 19.44 11,782.21
Totals 2,033 365 107,551.02
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 143,401.36 kWhr
Annual Heating Cost = £4,302.04
Thames Valley - Heathrow
24 Hours at 25˚C = Annual heating cost of £10,014.37

168. Recommendation 7
Consider reducing temperature set-point
Supply Air Temperature (Heating Coil) = 21.00 0
C
Total Air Volume = 0.88 m3
/s
Daily Running Hours = 24.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.00 4.53 21.00 16.47 13,254.50
Feb 309 28 11.04 1.00 4.46 21.00 16.54 12,022.69
Mar 261 31 8.42 1.00 7.08 21.00 13.92 11,202.35
Apr 197 30 6.57 1.00 8.93 21.00 12.07 9,400.19
May 111 31 3.58 1.00 11.92 21.00 9.08 7,307.28
Jun 49 30 1.63 1.00 13.87 21.00 7.13 5,552.89
Jul 20 31 0.65 1.00 14.85 21.00 6.15 4,949.31
Aug 23 31 0.74 1.00 14.76 21.00 6.24 5,021.74
Sep 53 30 1.77 1.00 13.73 21.00 7.27 5,661.92
Oct 128 31 4.13 1.00 11.37 21.00 9.63 7,749.90
Nov 234 30 7.80 1.00 7.70 21.00 13.30 10,358.12
Dec 308 31 9.94 1.00 5.56 21.00 15.44 12,425.59
Totals 2,033 365 104,906.48
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 139,875.31 kWhr
Annual Heating Cost = £4,196.26
Thames Valley - Heathrow
24 Hours at 21˚C = Annual heating cost of £7,356.52
Supply Air Temperature (Heating Coil) = 21.00 0
C
Total Air Volume = 0.67 m3
/s
Daily Running Hours = 24.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.00 4.53 21.00 16.47 9,982.15
Feb 309 28 11.04 1.00 4.46 21.00 16.54 9,054.46
Mar 261 31 8.42 1.00 7.08 21.00 13.92 8,436.65
Apr 197 30 6.57 1.00 8.93 21.00 12.07 7,079.42
May 111 31 3.58 1.00 11.92 21.00 9.08 5,503.22
Jun 49 30 1.63 1.00 13.87 21.00 7.13 4,181.96
Jul 20 31 0.65 1.00 14.85 21.00 6.15 3,727.40
Aug 23 31 0.74 1.00 14.76 21.00 6.24 3,781.95
Sep 53 30 1.77 1.00 13.73 21.00 7.27 4,264.07
Oct 128 31 4.13 1.00 11.37 21.00 9.63 5,836.56
Nov 234 30 7.80 1.00 7.70 21.00 13.30 7,800.85
Dec 308 31 9.94 1.00 5.56 21.00 15.44 9,357.89
Totals 2,033 365 79,006.58
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 105,342.11 kWhr
Annual Heating Cost = £3,160.26
Thames Valley - Heathrow
Ø This initiative can be achieved by a simple adjustment on the BMS.

169. Operating Theatre Optimisation
Newham University Hospital

170. Rec.
No.
Complexity (1
= Simple,
3 = Complex)
Relates
To:
Recommendation Est. Cost (£) CO2 Emissions
Reductions
(Tonnes)
Annual Energy
Saving (kWh)
Annual
Saving (£)
Simple Payback
Period
(Months)
1 2 Theatre 3 Consider reducing Air Change Rate in line with
HTM requirement in order to reduce energy.
£300 7 12,973 £1,297 3
2 1 Theatre 1 It is recommended that the run around coil
pump system be reinstated in order to reduce
load on the boilers.
£1,000 25.6 138,842 £4,165 3
3 3 All
Theatres
Consideration should be given to replacing
supply fans with high efficiency units in order to
reduce power drawn by the systems.
£29,000 34 61,854 £6,186 56
4 1 Theatre 2 Consider replacing air seals around openings in
order to reduce air leakage.
£150 0.2 328 £33 56
5 1 Theatre
4/5
Consideration should be given to repairing the
thermal wheel in order to reduce load on heating
and cooling.
£3,000 55 297,518 £8,925 4
6 2 All
Theatres
Consider adjusting the frost coil set-point in
order to reduce heating load which could be
recovered through use of the run around coil.
£1,000 210 1,141,658 £34,250 1
7 2 All
Theatres
Consideration could be given to introducing PIR
control so that energy can be reduced during
periods of inactivity.
£1,000 11 20,617 £2,062 6
Totals* £35,450 342.2 1,673,790 £56,918 8
*Savings are not considered cumulative, totals shown for representation purposes only.
Summary of Recommendations – Newham University Hospital

171. Recommendation 2
Consider reinstating the run around pump system
The run around coil recovery system is capable of recovering around 50% of the heating/cooling energy. With the
pumps out of order, the heating coil is operating at a higher demand than would be expected. Through the use of
simulation software, we can calculate that the heating energy used is 277,683.67kWh. By repairing the run around
coil pump we can assume that this figure will be reduced by 50%; this equates to a £4,165 saving per annum.
Supply Air Temperature (Heating Coil) = 21.00 0
C
Total Air Volume = 3.50 m3
/s
Daily Running Hours = 14.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.20 5.44 21.00 15.56 28,953.66
Feb 309 28 11.04 1.25 5.58 21.00 15.42 25,916.39
Mar 261 31 8.42 1.21 8.57 21.00 12.43 23,129.43
Apr 197 30 6.57 1.19 10.63 21.00 10.37 18,673.78
May 111 31 3.58 1.16 13.83 21.00 7.17 13,341.76
Jun 49 30 1.63 1.13 15.67 21.00 5.33 9,598.00
Jul 20 31 0.65 1.12 16.63 21.00 4.37 8,131.59
Aug 23 31 0.74 1.11 16.38 21.00 4.62 8,596.78
Sep 53 30 1.77 1.13 15.51 21.00 5.49 9,886.12
Oct 128 31 4.13 1.14 12.96 21.00 8.04 14,960.63
Nov 234 30 7.80 1.15 8.86 21.00 12.14 21,861.11
Dec 308 31 9.94 1.34 7.45 21.00 13.55 25,213.50
Totals 2,033 365 208,262.75
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 277,683.67 kWhr
Annual Heating Cost = £8,330.51
Thames Valley - Heathrow

172. Recommendation 5
Consider repairing the thermal wheel
At the time of inspection, the wheel serving Theatre 4/5 had failed and was therefore not rotating.
Repairing the thermal will provide savings equating to a £8,925 per annum.

173. Recommendation 5
Consider repairing the thermal wheel
The thermal wheel is capable of recovering around 75% of the heating energy. Through the use of simulation
software, we can calculate that the heating energy used is 396,690.96kWh. By repairing the thermal we can
assume that this figure will be reduced by 75%; this equates to a £8,925 saving per annum.
Supply Air Temperature (Heating Coil) = 21.00 0
C
Total Air Volume = 5.00 m3
/s
Daily Running Hours = 14.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.20 5.44 21.00 15.56 41,362.37
Feb 309 28 11.04 1.25 5.58 21.00 15.42 37,023.42
Mar 261 31 8.42 1.21 8.57 21.00 12.43 33,042.05
Apr 197 30 6.57 1.19 10.63 21.00 10.37 26,676.83
May 111 31 3.58 1.16 13.83 21.00 7.17 19,059.65
Jun 49 30 1.63 1.13 15.67 21.00 5.33 13,711.43
Jul 20 31 0.65 1.12 16.63 21.00 4.37 11,616.55
Aug 23 31 0.74 1.11 16.38 21.00 4.62 12,281.12
Sep 53 30 1.77 1.13 15.51 21.00 5.49 14,123.03
Oct 128 31 4.13 1.14 12.96 21.00 8.04 21,372.33
Nov 234 30 7.80 1.15 8.86 21.00 12.14 31,230.15
Dec 308 31 9.94 1.34 7.45 21.00 13.55 36,019.29
Totals 2,033 365 297,518.22
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 396,690.96 kWhr
Annual Heating Cost = £11,900.73
Thames Valley - Heathrow

174. Operating Theatre Optimisation
Whipps Cross University Hospital

175. *Savings are not considered cumulative, totals shown for representation purposes only.
Rec.
No.
Complexity
(1 = Simple,
3 = Complex)
Relates To: Recommendation Est. Cost (£) CO2 Emissions
Reductions (Tonnes)
Annual Energy Saving
(kWh)
Annual Saving (£) Simple Payback
Period (Months)
1 2 All Theatres Consider installing occupancy detection in order to control
ventilation on demand.
20,000 53 114,395 11,439 21
2 1 Theatres 5 - 8 Consider reviewing filter specification in order to reduce
system pressure and associated fan power requirement.
50 11 23,060 2,306 1
3 2 Theatres 5 & 6 Consider reducing the extract ventilation rate to the HTM03-01
standard so that fan power is reduced.
500 5 10,353 1,035 6
4 3 Theatres 3 & 4 Consider installing an energy recovery device to theatre 3 & 4
in order to reduce the heating requirement.
12,000 30 160,717 4,822 30
5 3 Theatres 3 & 4 Consider replacing the plant serving theatre 3 & 4 with a
packaged AHU in order to greatly improve system efficiency.
- - - - -
6 3 All Theatres Consider replacing fans with high efficiency units in order to
reduce power draw.
22,000 23 48,697 4,870 54
7 1 Theatres 5 – 8 Consider improving thermal insulation on pipework in order to
reduce system losses.
1,000 2 13,140 395 30
8 1 Boiler Plant Review boiler room insulation and pumps in order to increase
system efficiency.
4,500 12 56,502 1,971 27
9 2 All Theatres Consider reinstating automatic control in order to avoid
excessive energy use.
40,000 146 665,844 25,980 18
Totals* £100,050 282 1,092,708 52,818 23
Summary of Recommendations - Whipps Cross University Hospital

176. Recommendation 4
Consider Installation of an Energy Recovery Device
A run around coil system normally consists of two coils that are connected to each other via
a pumped circuit of water. The water absorbs heat from the exhaust air coil and dissipates it
through the supply air coil.

177. Recommendation 4
Consider Installation of an Energy Recovery Device
There is currently no heat recovery device installed within the system serving theatres 3&4. A run-around-coil energy recovery
system is typically capable of recovering around 50% of the heating/cooling energy from the extracted air, which is then
transferred to the supply air. Installing a RAC will provide savings of 50%; this equates to a £4,821 per annum.
Supply Air Temperature (Heating Coil) = 21.00 0
C
Total Air Volume = 1.92 m3
/s
Daily Running Hours = 24.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 351 31 11.32 1.00 4.18 21.00 16.82 29,433.12
Feb 327 28 11.68 1.00 3.82 21.00 17.18 27,153.75
Mar 283 31 9.13 1.00 6.37 21.00 14.63 25,600.86
Apr 218 30 7.27 1.00 8.23 21.00 12.77 21,625.23
May 135 31 4.35 1.00 11.15 21.00 9.85 17,236.40
Jun 68 30 2.27 1.00 13.23 21.00 7.77 13,158.03
Jul 32 31 1.03 1.00 14.47 21.00 6.53 11,426.77
Aug 38 31 1.23 1.00 14.27 21.00 6.73 11,776.75
Sep 75 30 2.50 1.00 13.00 21.00 8.00 13,547.52
Oct 158 31 5.10 1.00 10.40 21.00 10.60 18,548.81
Nov 254 30 8.47 1.00 7.03 21.00 13.97 23,657.36
Dec 324 31 10.45 1.00 5.05 21.00 15.95 27,910.71
Totals 2,263 365 241,075.31
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 321,433.75 kWhr
Annual Heating Cost = £9,643.01
South Eastern - Gatwick

178. Recommendation 6
Consider changing fans to high efficiency direct drive
There are multiple options for a direct drive replacement but as shown in the example below, removing the
existing fan (1) from the AHU, then enlarging the opening (2) would allow for a new plenum wall to be
installed (3), which would then facilitate the installation of a plug fan (4).
The new direct drive fan in this example has an absorbed power of 1.7kW at the same volume and
pressure as the original, this represents a 43% reduction.

179. Lighting upgrades & Controls
Provide advice on energy efficient lighting upgrades:
Ø LED
Ø Induction lamps
Ø Integrated sensor systems with light reflectors for optimum output
Ø Retro fit or upgrade from T12 & T8 to T5
•
Provide advice on lighting system controls and their efficiency:
Ø Dimmable control systems
Ø PIR sensors
Ø Photocells
•
Our approach is to undertake a lighting survey using calibrated Lux meters to determine current
lighting levels, which are then compared against healthcare requirements in accordance with the
relevant CIBSE Lighting Guide.
•
•

180. Steam and Condensate Systems
Ø Steam raising plant optimisation – pressure
regimes and boiler setback/sequencing
Ø
Ø Suitability of steam traps and associated
components
Ø
Ø Reduction of thermal losses – pipework insulation
review utilising infrared thermography
Ø
Ø Water treatment – TDS levels
Ø
Ø Heat & condensate recovery – boiler blow down,
flue gas economisers
Ø
Ø System zoning – minimisation of live circuits and
utilising motorised valves
Ø
Ø Steam metering and monitoring
Ø
Ø Condensate pump optimisation – demand control
on VSDs
Ø
Ø Oxygen trim – burner optimisation
Ø
Ø Feed pump modulation

181. Chiller Upgrades & Optimisation
Ø Review and improve chiller controls
Ø
Ø Establish opportunities for condenser coil heat reclaim
Ø
Ø Investigate opportunities for liquid pressure amplification (LPA)
Ø
Ø Investigate opportunities for condensing fan optimisation
Ø
Ø Review opportunities to retro-fit chiller, free-cooling circuits
•
•
•

182. Quick Win – Free Cooling Opportunity

183. Ø 7 Temperatures
Ø 2 Pressures
Ø 1 Power Input
Evaluating chiller performance & the Scope
for Optimisation

184. Advantages of this method:
Ø No need to install flow meters
Ø
Ø Easy to use
Ø
Ø Analysis within 30 minutes, without reliance on pre-installed
device
Ø
Ø Better field accuracy at much lower cost than traditional method
Ø
Evaluating chiller performance & the Scope
for Optimisation - Recommissioning

185. Performance evaluation
Ø COP (+/- 5 %)
Ø
Ø Capacity (+/- 7%)
Ø
Ø Power input
Ø Super-heat
Ø
Ø Sub-cool
Ø
Ø Evaporator performance
Ø Condenser performance
Evaluating chiller performance and the
Scope for Optimisation
Operational evaluation
Ø Correct charge
Ø
Ø Optimisation of expansion
device
Ø
Ø Compressor defects
Ø
Ø Stability or instability

186. Summary - Technological Improvements
Ø BMS Optimisation
Ø HVAC Optimisation
Ø Air Handling Unit Optimisation
Ø Effective control of Variable Speed Drives
Ø Improved Lighting and Lighting Controls
Ø Re-commissioning – no building is fully commissioned

187. Summary - Non Technical Opportunities
Ø Behavioural Change Programme
Ø Monitor Energy and Water Consumption Trends
Ø Invoice Validation
Ø CHP QA
Ø Review of Energy Tariffs

188. Thank you for listening…
Any Questions Please?

189. #DAYFORACTION
Conference close
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