The Hospital Energy Project – the heart of the hospital

We use about the same amount of power each
year as a town such as Witney. The Project reduces CO2 output in Oxfordshire
by 10,000 tonnes of carbon. Energy Centres are the heart of every hospital.
They provide all of the heating, hot water, cooling, everything that impacts on the patient
environment and patient care. To go forward and deliver effective patient care and services
in the future, we need a new heart of the hospital to enable us to deliver that service.
The current heating infrastructure has had a fantastic lifespan, well beyond what we
would economically expect it to be doing, but we are at the stage now where we do need
to replace it. We are getting constant leaks, constant breakdowns and many shutdowns to
do the repairs that have a complete operational effect on patient services. If we don’t
replace this equipment, I cannot get the boilers through next winter and I am praying that,
by next winter, we have the new systems up and running. The Carbon and Energy Fund is currently working
on behalf of the Department of Health and is currently working with over 40 Trusts throughout
the UK delivering energy centre and energy centre type projects. The NHS has suffered
from under-investment primarily in the infrastructure of the hospitals because most of the money
has gone into patient care. What hospitals typically have is back log maintenance and
money that needs to be invested into energy and energy generation. The Oxford University
Hospitals require £11 million spending on backlog maintenance over the next three years.
That would have been taken from the capital budget and away from patient care. By doing
this scheme it allows the hospital to use that investment elsewhere and allows their
energy infrastructure to be replaced almost immediately. Lighting at the John Radcliffe Hospital hasn’t
changed since 1974 and in that time nursing and the way we manage our patient care have
changed dramatically. We now undertake I.V. cannulation at the bedside and a whole range
of procedures that, not only didn’t necessarily happen in a ward environment, but weren’t
done by nurses. So, if we don’t replace the lighting, we are unable to do those things.
For us, having good lighting and good facilities such as this, is really important for our
patient care and for our staff as well so that they can deliver the care they want to
deliver. Good lighting is very important in a hospital.
If the lighting isn’t good enough in a room it will cause a re-scheduled visit if there
is a patient in that room or that patient being moved out of the room. On average, we
are looking at changing 62 lightbulbs a week and it equates to 3,200 lamps a year. We’ve
got a guy going round pretty much all week just changing light fittings. Now if he wasn’t
that, we could find a lot more proactive things that he could be doing to facilitate patient
care. The new lamps are a lot less maintenance. They are virtually maintenance free. They
last on average 3-5 years longer and they are almost completely sealed so there’s
no way for dust or anything to get inside them. The new fittings definitely mean that
clinical areas are cleaner. By replacing all these lights we are looking at 50% more efficiency
and in some case 90% more efficiency. The Linen Room service turns over 3 million
items of linen a year and about 4,000 new staff uniforms. The new lights are an awful
lot brighter. It is really important for the sewing assistants to have a good lighting
source as they are doing quite intricate work. They do alterations and repairs. Having the
new lights installed has made our jobs a little bit easier in terms of less disruptions as
less lights are going out. We haven’t actually had any lights that needed to be repaired
since they were installed. When my colleague came back off holiday, the first thing she
said when she came back in was that she should still be wearing her sunglasses as it was
noticeably brighter than before. CHP stands for combined heat and power. It
produces heat in the form of low temperature hot water like you would have in your domestic
heating system at home. It also produces electricity. It also produces some exhaust heat which could
be used to create heat steam or higher temperature hot water. In a hospital environment it provides
the hot water demand. Hospitals need a lot of hot water. They use huge amounts of hot
water. And it produces power. As we all know, hospitals use huge amounts of power for powering
MRI Scanners and lighting and all the kinds of equipment you’d expect to find in a hospital.
Combined heat and power reduces the overall carbon footprint of that heat and power requirement
for the hospital and it also produces lower cost electricity for the hospital which saves
them significant sums that can be re-cycled into clinical care. The Trust engaged the Carbon and Energy Fund
with Vital Energi on an energy performance contract and to handover of our CHP in November
2014. So we’ve been just over a year in operation in Cheltenham. During the first
operational year the Trust has saved just over £500,000 in operating and energy costs.
Like the rest of the NHS we’re under strict targets, but by using the CHP Phase 1 in Cheltenham
we have just about managed to reach our 2015 carbon reduction targets. CHP is green technology because it reduces
carbon emissions by taking heat and power from a single energy source. What’s key
in this is that the CHP is located very close the source in which the heat and power will
be used and that’s where it is different to taking power from the National Grid. With
a CHP, the generation is very local so the network losses are substantially less. This
CHP will generate in excess of 10,000 tonnes of carbon savings which equates to over one
third of the current carbon emissions from the sites. District heating is a really well established
technology. It really well known and deployed in the Scandinavian countries. To run a CHP
efficiently you must produce as much electricity as possible, but you also need to use all
the heat that it produces – or certainly a large proportion of the heat that it produces.
So, connecting two sites with a heat link, optimises the amount of heat load available
and hence the amount of electricity that’s produced and the value that can then be re-cycled
back into clinical care. The Hospital Energy Link is a link between
the JR and the Churchill Hospital. It is encompassing a pipe system for heat energy to the boilers
at the Churchill and an HV Cable that will take the excess electricity to the Churchill
site. An Energy Link can create a number of challenges
when installing. Minimising disruption along the energy link construction is very much
about breaking the work into small zones. This allows access and egress to be maintained
in all of the areas except where the working zone is taking place. And key to that is having
a very small working zone. So, typically 100 – 120 metres at a time. Maintaining access
for residents and for people using the area can often be very challenging and therefore
in that period of construction, we’ll look to create temporary car parks. We’ll look
to create temporary points of access to ensure that people can still access their property
or access local to their property and we’ll often assist with a bin service and a delivery
service to aid delivery drivers and the normal day to day issues that everyone will encounter. This project alone offers a guaranteed saving
for us of £460,000 a year that we can put to good use to improve patient care. Wards
run at about £1.2 million a year to run a ward. We will have about a third of a ward
or about 13 nurses that can be funded through this saving or that equates to running two
additional ICU beds a year. The project reduces C02 output in Oxfordshire
by 10,000 tonnes of carbon a year. If you take that and try and compare it to a domestic
property, is about equivalent to 4,000 properties, which is a phenomenal amount of energy which
is being displaced through clean and efficient technology. The NHS and all Trusts, such as ourselves,
rely on digital technology. We rely on scanning. We rely on computers, we rely on a range of
different diagnostic tools that we have used in the past and we are using even more now
and into the future. To provide the best care for our patients, we will need to use advanced
technology. As a result of that, we use vast amounts of power. In fact, we use the about
same power each year as a town such as Witney. So, for all NHS Trusts but particularly our
Trust, it is really important if we want to be a world class centre such as we aspire
to be that we have a great environment for our patients We have to be able to utilise
the technology that we have available and we have to have the infrastructure that supports
all of that and that’s why it is so important for us to undertake this power project.

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