The ‘silent crisis’ of hospitals’ energy security

Nigel Thomas, National Specification and Projects Sales manager at ABB, discusses the importance of hospitals and other healthcare facilities having the most resilient possible power infrastructure and – where existing systems are not optimal – upgrading them to minimise interruption to clinical activity in the event of disruptive incidents such as ‘blackouts’ and ‘brownouts’. He explores the benefits of ‘robust, digital-ready, and low-maintenance’ energy solutions.

As they attempt to decarbonise and electrify their operations, hospitals across the UK and the rest of the world are facing an underreported crisis: energy insecurity. Ageing infrastructure, the shift away from fossil fuels, extreme weather events, cyberattacks, and surging demand for power-hungry medical technology, are individually formidable. Together, they are creating a perfect storm for the healthcare sector which calls for decisive action.

For a modern hospital, continuous power is a matter of life and death. With an average energy intensity of approximately 74 kWh per square foot, hospitals consume up to 2.5 or 3 times more energy per square metre than commercial buildings. This is because on top of the usual lighting and heating, ventilation and air conditioning (HVAC) systems, critical equipment such as ventilators, dialysis machines, and infusion pumps, and diagnostic imaging, also rely on uninterrupted electricity.

High cost of power outage for hospitals

According to ABB’s recent report, The Future of Healthcare is open, every minute of a hospital power outage can already cost upwards of US $7,900. The biggest costs of electrical downtime, however, are deteriorating patient outcomes. When those start to falter, lives hang in the balance. The logic is clear: hospitals must urgently upgrade their resilience. This means they must reinforce their supply, safeguard their back-ups, improve monitoring, and build in the agility to evolve with changing patient needs. At ABB, we believe a key part of hospitals’ resilience lies in the adoption of open protocol platforms. These are intelligent, digitally secure, and vendor-agnostic systems that can adapt to uncertainty without disruption. In times of crisis, open protocol energy reliability could save lives.

Current NHS England guidance for Emergency Preparedness, Resilience and Response (EPRR) makes business continuity expectations clear. Based on The Civil Contingencies Act (2004), the framework requires NHS bodies to demonstrate that they can deal with disruptive incidents while maintaining their services. However, recent real-world events reveal a more fragile reality. In January 2025, Storm Eowyn caused a power failure at Forth Valley Royal Hospital in Larbert in Scotland. Although no patients were harmed, the hospital was forced to rely on its emergency battery reserves for around 70 minutes after the back-up generator failed to engage immediately. Investigations are ongoing, but the incident showed existential vulnerabilities to extreme weather conditions, even in nations with high-quality healthcare infrastructure.

Blackout’s impact

Likewise, a blackout at the Queen Alexandra Hospital in Portsmouth in late 2024 forced staff to cancel procedures and close the Emergency Department to new admissions. The incident even disrupted phone lines, and left patients and staff unable to call in either direction. It has been reported that door malfunctions meant staff were effectively ‘locked in’ the building overnight. These are just some of the many power incidents, minor and major, that the NHS has commented on directly. Many more are not reported on.

Elsewhere, Europe’s largest blackout in decades — affecting Spain, Portugal, and parts of France — left hospitals without internal communications and out-of-order lifts. For healthcare staff, the power outage meant routine procedures quickly came to a halt as they shifted their focus to urgent medical needs.

Hospitals turned to generators to maintain open Emergency Departments, and could perform only the most time-sensitive surgeries. Dialysis treatments were delayed, leading to shortened sessions in some cases. Across the two countries, healthcare workers were especially concerned about the risk to vaccines, which need continuous refrigeration. In Portugal, some clinics successfully transported their vaccine supplies to a nearby hospital; however, it remains unclear whether all primary care facilities nationwide were able to do the same.

Fortunately, the power in both countries was restored later in the evening, but these regional events highlight the interdependencies of digital, mechanical, and human systems in hospital infrastructure, and how they are ultimately underpinned by the health of their power systems. If power is unstable, hospitals can no longer function with the precision and speed required by today’s clinical expectations.

From design to daily operation, hospitals operate under unique constraints. Each ward or facility is an ecosystem of diverse and energy-intensive systems. A study published in Energy and Buildings in 2021 showed that hospitals of various sizes could consume between ~3,900,000 kWh (small), ~6,500,000 kWh (medium), and ~11,200,000 kWh (large) per year.¹

During the COVID pandemic, these numbers skyrocketed due to the increased use of specialised infection control apparatus — specifically negative pressure (NP) treatment rooms and xenon pulsed ultraviolet (XP-UV) equipment. Diagnostic imaging equipment like MRIs or CT scanners draws vast amounts of power per session. Factor in sterilisation facilities, robotic-assisted surgeries, and a future of AI-powered diagnostics, and the scale of the challenge comes into focus.

Not a complete story

Hospital energy use is often talked about in terms of kWh-per-bed: dividing the total energy use straightforwardly by the number of occupants. This figure does not tell a complete story; it does not show us which technologies are drawing the most power, and which would need the most support from back-up systems like circuit breakers and uninterruptible power supply in the event of a crisis.

Separate from the specialised equipment already mentioned, HVAC alone can account for up to 50% of a hospital’s total energy demand. The importance of patient comfort, from a temperature perspective, is the first thing we tend to think of. However, it goes beyond room-to-room climatic control: HVAC systems help to control the spread of infections by keeping a regular flow of fresh air, thereby containing airborne pathogens. Further studies have shown that faulty HVAC systems are linked to outbreaks.²

The electrification of hospital transport is another growing source of power demand, and a risk that needs to be managed. A Freedom of Information request in 2021 revealed that around half (51%) of NHS Trusts had installed electric vehicle charging infrastructure on their sites for staff, patients, and the wider community to use. A further 43% were either planning to install charging facilities on site within the next five years, or were in early stage planning around how best to integrate such capabilities.

As we approach that five-year mark, we’ve seen many hospitals stick to their word. The government also pledged a £63 m EV investment package in July 2025, £8 m of which is set aside for 62 NHS Trusts and around 224 sites. The consequences of charger downtime for this future fleet of electrified ambulances are clear: slower emergency response, smaller catchment areas, and loss of public trust. Safeguards to providing this power must be in place.

Pledging to manage volatility

Environmental impacts are no less pressing. According to ABB, the global healthcare sector, if considered a nation, would be the world’s fifth-largest emitter of greenhouse gases. The NHS, as the largest public sector emitter in the UK, has committed to delivering Net Zero carbon patient care by 2045. Innovation cannot, however, come at the expense of reliability. The energy transition is adding further volatility to the grid. Renewable sources like wind and solar must be integrated to enable this transition, but they are intermittent by nature, and healthcare facilities need ways to safeguard against ‘brownouts’ — temporary reductions in voltage which cause appliances to falter rather than completely switch off. Meeting Net Zero imperatives must not undercut the constancy on which effective healthcare relies.

The UK Government’s clean energy company, Great British Energy, laid out its first major initiative in March 2025: a £180 m spend on installing rooftop solar panels on approximately 200 NHS sites, including hospitals, and 200 schools across England. The National Grid’s Great Grid Upgrade, which aims to completely transform the grid to better deal with more renewable power from offshore wind and other sources, is also underway. Energy intermittency aside, this introduces the possibility of more blackouts due to tinkering and maintenance work. All of these changes will require hospitals to become smarter, more connected, and more prepared. That begins with foundational systems being made future-ready.

Historically, hospital electrical and building management systems (BMS) have been proprietary and fragmented. Multiple vendors, siloed data, and hardware locked to unique platforms, have limited the ability of estate managers to respond to changing requirements.

Open protocol systems solve that problem. Instead of locking a facility into a single vendor’s technology, they establish a shared ‘language’ that enables diverse systems to communicate and collaborate. Lighting control, HVAC, access management, back-up systems, and building analytics, can all be managed through a unified interface, regardless of brand or age.

In turn, this gives hospitals the power to choose the best technology for each use case, without concern for compatibility or future upgrades. It simplifies retrofitting, and encourages innovation, and — most importantly — it improves clinical resilience while reducing operational and environmental costs.

Royal Preston Hospital

For example, Royal Preston Hospital in Lancashire has installed ABB Cylon across its sprawling estate, which serves over 1.2 million patients a year. It gradually replaced legacy BMS infrastructure with a unified, open control system. This controls ventilation, boiler plants and heating systems, and lets operators carefully manage lighting and temperature by zone. Occupancy sensors also reduce energy waste in empty rooms. These simple changes have profound cumulative effects on both carbon footprint and cost.

Connected Energy and Asset Management (EAM) platforms allow continuous digital monitoring of transformer systems, UPS performance, and power distribution. By remotely identifying temperature and vibration anomalies as well as electrical faults, these platforms enable predictive maintenance via real-time data available via the cloud.

Helsinki University Hospital

A good illustration of this was when Helsinki University Hospital (HUS), one of Europe’s most advanced healthcare institutions, recently adopted ABB’s transformer-sensing and asset monitoring solution to reduce shutdowns and physical inspection requirements. When integration is seamless across systems, hospitals are no longer left vulnerable to bottlenecks or single points of failure. This is the model that must now be scaled across the UK and internationally.

Keeping uninterruptible power healthy

The backbone of any hospital’s resilience plan is 
its emergency power system, but as recent events 
have shown, not all back-up systems are fit for purpose. UPS systems are supposed to provide a seamless automatic switch in the case of an outage, acting as an instant bridge between an appliance and backup generators or batteries, but they must also be reliable themselves.

Highly modular and energy-efficient UPS systems, such as the MegaFlex DPA, are built on independent modules with redundant components. They ensure continuous operation even if individual units inside the wider system require maintenance or suffer faults. In Estonia, ABB recently supported Haapsalu and Narva hospitals in implementing new DPA UPS infrastructure, delivering back-up systems within 12 weeks that were tested for safety and operability in Switzerland prior to deployment. These facilities now enjoy significantly improved energy security for their critical surgical systems, which can now operate without interruption during outages.

In Santiago, Chile, ABB deployed a full suite of advanced circuit breakers and power monitoring tools — S750DR SMCBs, Emax 2, and Tmax XT smart breakers — to safeguard every level of power distribution at Felix Bulnes Hospital. The system’s real-time monitoring capabilities allow Facilities managers to anticipate issues well before they can cause downtime. Equally important is the space-saving design, which has helped the hospital reduce its electrical room footprint by 25%, and free up vital capacity elsewhere.

Getting ahead of cyber threats

Digital transformation and ‘smart’ hospital systems bring tremendous quality-of-life value to patients and staff, but they also increase risk. In particular, the rise of ransomware has made healthcare one of the top global targets for cyber criminals. While cyberattacks in recent times have focused on digital theft — such as the organised raid of sensitive patient data from the Synnovis blood pathology laboratory in London in June 2024, energy management systems, if poorly secured, could become critical points of vulnerability.

Secure-by-design software is therefore essential. ABB’s KNX Data Secure protocol encrypts data transmission across building automation components. Meanwhile, cloud-based solutions like ABB Ability are regularly updated to counter new threats. These are fixes that wouldn’t be possible or timely enough to stop attacks in traditional on-premises architectures.

In the UK, where many hospital systems run on legacy or mixed-generation infrastructure, the move to hybrid models is especially important. Partial migration to cloud platforms can yield the benefits of security, scalability, and compliance, without needing the wholesale replacement of existing assets, which could also come with upskilling costs and potential data corruption issues during transferral.

In early 2024, the UK Government’s own scenario planning revealed unsettling gaps in our energy resilience strategy. In the event of a national grid outage lasting 48-72 hours, even hospitals may not be protected from initial cuts. Only upon implementing emergency energy codes, possibly days later, would selected priority facilities begin to be shielded from rolling blackouts. Such admissions raise clear questions. If facilities face realistic risk of multi-hour blackouts, how confident can we be in the adequacy of current back-up and continuity systems? The Government’s response has focused on long-term planning, but as Storm Eowyn proved, weather extremes and ageing grid infrastructure are already testing hospital resilience at the local level, today.

The World Health Organization (WHO) frames this issue in unequivocal terms: without reliable electricity, healthcare services cannot be called universal. Many low- and middle-income countries still operate with severe electricity insecurity butut even high-income nations must address their dependency risks, whether those emerge from cyber vulnerabilities, extreme weather, or resource shortages. In every case, the benefits of robust, digital-ready, and low-maintenance energy solutions, are now too great to ignore.

Future-proofing starts now

In our increasingly electrified and digitalised 
world, it is untenable that hospitals — society’s most 
critical infrastructure, should remain exposed to unpredictable but preventable energy disruptions. Whether it’s through cloud-integrated monitoring, 
modular UPS resilience, or simply the smarter use of building controls, the same principle applies: better connectivity equals better care.

At ABB, we advocate for a shift in how we design, renovate, and manage healthcare environments. Tight budgets and staffing shortages are realities, but resilience need not be expensive when enabled by smart technologies capable of integrating with existing systems.

Open protocol platforms provide hospitals with the tools to choose their future. They can retrofit smartly, scale responsibly, and lead in safety, sustainability, and performance. As energy security moves steadily higher up the public agenda, and as digitalisation becomes the norm rather than the frontier, healthcare facilities will only succeed by partnering with experts who understand the full scope of these challenges.

Resilient hospitals are not built overnight, but with the right foundational technologies and partnerships, they can be ready to weather whatever storms may come. Hospitals are centres of hope, care, and dignity. Ensuring the systems that power them do not falter or fail should be our highest priority.

References

1 Squire M, Munsamy M, Lin G, Telukdarie A, Igusa T. Modeling hospital energy and economic costs for COVID-19 infection control interventions. Energy Build 2021; 26: 242:110948. https://tinyurl.com/694rwjh7

2 Wu HT, Li QS, Dai RC, Liu S, Wu L, Mao W et al. Effects of air-conditioning systems in the public areas of hospitals: A scoping review. Epidemiol Infect 2021: 27:149.