This transformation is no small feat. It demands long-term thinking, strategic planning, and a willingness to learn from sectors that have already made significant strides in energy efficiency and the planning of decarbonisation. One such sector is heavy industry, where energy-intensive operations have driven innovation in sustainability for decades. There are lessons health estates can learn from industry.
Planning for real energy needs
Industrial organisations typically approach energy infrastructure with a whole-life cost mindset, grounded in operational realities such as resilience, cost, and security. The thought process for development focuses on critical success factors that relate to outputs from the end result, and not necessarily linked to budget or political cycles. In contrast, NHS briefs often prioritise full electrification, universal EV charging, and digitisation, ambitious goals that may not align with existing infrastructure.
In one hospital project, electrification and EV charging targets required 30MVA of electrical supply, but with only 7MVA of contracted supply, and the availability of a further 9MVA coming online in a realistic timeframe. Through early engineering intervention and reassessment of the brief the requirement was reduced to 14.5MW, enabling phased delivery which could be delivered in line with the build out programme.
Halving demand may sound simple, but the eventual strategy required a critical analysis of almost every aspect of the planned new hospital. Everything from the fabric performance, the availability of ‘spare’ land, more costly capital infrastructure (which lowered energy requirements and operational cost), the local area and demographic, distribution systems all had to be analysed. This mirrors industrial practice, where energy-intensive operations demand precise planning and phased implementation. The lesson here is clear: strategic energy planning must be grounded in realistic assessments of requirements and infrastructure capability, and flexibility must be built into project delivery to accommodate evolving energy landscapes.
Modular, standardised and digital delivery
Modular construction is standard in industrial and pharmaceutical environments, where speed, compliance, and cost control are paramount. These sectors have long embraced kit-of-parts thinking, enabling faster deployment of facilities that remain consistent and reduce waste. For the NHS, this isn’t just about construction methods — it’s about delivering care sooner, with less disruption and lower emissions.
At Manchester Airport, our team applied the kit-of-parts approach to support the expansion of Terminal 2 and the addition of 12 new gates. Working alongside contractor Mace, the team focused on minimising disruption to passengers and operations by using modular, standardised components. This approach enabled the team to reduce the number of components used to build each node from over 5,000 to 67. It is also estimated to have produced fewer CO₂ emissions compared with traditional methods. This solution has proved transformative, especially for projects where minimal disruption is paramount.
We also applied these principles with the Environment Agency, upgrading depots across England to support flood response and environmental protection. Modular construction, offsite fabrication, and low-carbon materials were prioritised, reducing embodied carbon and accelerating delivery.
Key innovations included:
- Standardised design templates adaptable to local conditions.
- Offsite manufacturing to minimise disruption.
- Sustainable drainage systems and biodiversity enhancements.
- Digital tools such as Building Information Modelling (BIM), which enabled real-time collaboration and reduced errors — lessons directly applicable to NHS estate programmes.
The result is faster, greener, and more resilient infrastructure — exactly what NHS estates need.
The same approach is already proving its value in healthcare. At the Grange University Hospital in Wales, 50—55 per cent of the facility was constructed off-site, saving 42 weeks on the programme and reducing emissions. For existing hospitals, modular, phased approaches are the only way to upgrade without disrupting patient care.
Water and energy integration
In heavy industry, the integration of water and energy systems is a cornerstone of efficiency. With evolving regulations and climate challenges, industries must prioritise water management, treatment and reuse as part of a holistic water resilience plan.
This includes treating water only to the quality required for each process, avoiding unnecessary energy use and CO₂ emissions. By adopting modular, adaptable systems, and planning water needs through mass and energy balances, industry and healthcare alike can reduce operational cost and environmental impact.
At a petrochemical site in Ravenna, Italy, WSP supported the design of a water treatment plant that optimised water use for cooling and steam generation. The site now captures CO₂ at source and stores it in depleted gas fields in the Adriatic Sea, transforming legacy infrastructure into future-ready assets which minimise environmental impact. Moreover, the site’s system used soft and demineralised water tailored to operational needs, which avoided unnecessary purification, thus helping to reduce energy use.
This kind of systems thinking where water, energy, and emissions are considered holistically, through a sustainable development lens, is highly applicable to healthcare estates. Hospitals rely heavily on water for sterilisation, HVAC systems, and cooling, yet these systems are often designed and operated in silos. By integrating water and energy planning, healthcare estates can unlock efficiencies, reduce operational costs, avoid planning and environmental risks — all while addressing water and nutrient neutrality, and significantly lowering their carbon footprint. Moreover, such integration supports resilience, ensuring that critical systems remain functional during disruptions or peak demand periods.
Tailored solutions for complex estates
Faced with a mix of 80-year-old and modern buildings, Royal United Hospitals Bath NHS Foundation Trust needed a strategy that balanced heritage preservation with Net Zero ambitions.
We conducted a comprehensive energy audit, optimised existing systems, and introduced on-site renewables. Fossil fuel systems were phased out in favour of electrification, with minimal disruption to patient care. This systems thinking approach allowed for the phase out of fossil fuels to occur whilst minimising the requirements of the upgraded electrical capacity.
Every NHS estate is different, and success depends on tailoring solutions to the site. Industrial projects often begin with a detailed interrogation of the client’s brief to ensure proposed solutions are technically feasible and operationally aligned. NHS projects can benefit hugely from the same discipline.
In one hospital project, assumptions about the necessary volume of EV charging for ambulances and staff were examined, leading to a 10% reduction in energy requirements. Analysis of local demographics revealed that most staff charged their vehicles at home, making universal on-site charging unnecessary. Responsibility for ambulance charging was transferred to the ambulance trust, dividing the costs.
This pragmatic approach is common in industrial strategies as the contractual boundaries and success criteria are viewed differently than in the public sector.
Smart energy and resilient hospitals
Heavy energy users in industry routinely adjust operations to avoid peak tariffs, saving millions annually. These strategies enhance resilience and support national energy stability.
NHS estates, which require round-the-clock energy, can adopt similar approaches.
Battery systems charged overnight on low tariffs can power facilities during the day, flattening energy profiles and easing grid pressure. Microgrids, combining solar PV, battery storage, and backup generators, offer continuity of care during outages and enable participation in demand-side response programmes.
In short, smart energy management means hospitals save costs while keeping the lights on — no matter what. They may even be able to unlock additional revenue streams by smartly utilising their own assets.
Alder Hey Children’s Hospital in Liverpool, one of Europe’s busiest children’s hospitals, exemplifies sustainable design. It now generates 60% of its energy on site through solar and heat pumps, while creating a ‘health park’ that boosts both wellbeing and sustainability.
With Lexica now part of WSP, NHS clients get the full journey: strategy, planning, and delivery under one roof. That means insights don’t just sit on paper, they become efficient, decarbonised hospitals.
Industrial decarbonisation increasingly relies on digital tools to model energy use, forecast emissions, and optimise design. WSP’s LCPro and Carb0nise platforms enable project teams to evaluate the environmental impact of materials and construction methods in real time.
The same tools are now being adapted for NHS projects, giving Trusts a real-time picture of carbon impact, and helping them make better decisions, faster. Digital workflows mean the NHS can cut carbon without cutting corners.
Our Healthcare Beyond Carbon whitepaper compared nine global healthcare systems, from Sweden’s electrified hospitals to South Africa’s green retrofits. The study revealed diverse approaches tailored to local contexts. For the UK, the big takeaways are passive design, low-carbon materials, and community-based care.
Australia’s New Women’s and Children’s Hospital (nWCH), currently under development in Adelaide, offers a great example of how healthcare infrastructure can be designed for a Net Zero future, and the learnings we can take from work across the world. It will be Australia’s first all-electric hospital, built to serve future generations.
This move reflects a growing international trend toward electrification in healthcare, supported by increasingly renewable energy grids. In South Australia, renewables already supply over 60% of the state’s energy needs, making electrification both feasible and environmentally responsible.
This year, the UK has seen solar power generation surge, and with record approvals for new renewable energy generation capacity a clear signal that this trend will continue. For the NHS, it is a true reflection of the every-growing possibility that electrification of healthcare facilities is possible.
A blueprint for change
The NHS stands at a pivotal moment in its decarbonisation journey. By learning from heavy industry, healthcare estates can adopt proven strategies that balance ambition with feasibility. From modular design and microgrid solutions, to strategic planning and digital tools, the lessons are clear, and increasingly urgent.
Integrating these insights into everyday practice will not only support the NHS’s Net Zero goals but also ensure that its infrastructure is resilient, efficient, and fit for the future.