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Decarbonising healthcare buildings: your guide to sustainable retrofit solutions

Here are our top tips from the Supply Chain Sustainability School’s latest webinar on decarbonisation through retrofitting.

The panel

David Emery, Consultant, The School
Alice Lovatt, Environmental Sustainability Manager, Sanctuary Care
Jon Hodgkins, Director, Care Valuation Services, Christie & Co

Understanding retrofit in healthcare

Retrofitting refers to upgrading or modifying existing buildings to improve energy efficiency, accessibility, safety, and the overall quality of care environments.

Given that over 40% of emissions in the UK originate from the built environment, and with many healthcare buildings expected to still be in use by 2050, retrofitting is critical for achieving national net-zero targets.

Jon Hodgkins, a RICS registered valuer for Christie & Co, a specialist adviser for buying and selling businesses, outlined the key drivers for retrofitting in care homes:

  • Reducing operational costs: Energy-efficient upgrades could significantly cut heating and lighting expenses, leading to a measurable impact on operational budgets.
  • Enhancing care quality: Improvements in heating, lighting, and air quality could enhance patient comfort and staff productivity.
  • Meeting regulatory standards: Regulations now require buildings to meet minimum Energy Performance Certificate (EPC) ratings, with stricter guidelines set for future years.

The business case for decarbonising healthcare facilities

Energy-efficient buildings not only benefit the environment but also positively impact a facility’s market value, noted Jon. For example, care homes with higher EPC ratings (B or above) can see reduced operational costs, averaging a 14% per square meter saving compared to lower-rated properties.

Additionally, improvements in energy efficiency are linked to increased property values, making retrofitting a sound financial decision.

Decarbonising healthcare buildings is not just about reducing emissions; it’s about transforming the care environment to deliver better outcomes for patients, staff, and communities.

Barrie Davison
The bank’s National Sector Head for Healthcare

“Retrofitting offers a unique opportunity for healthcare organisations to achieve sustainability goals while potentially enhancing the operational and economic performance of their facilities. With over 40% of UK emissions tied to the built environment, the healthcare sector has a pivotal role in leading the charge toward net-zero targets,” he says.

Steps to start your decarbonisation journey

Sanctuary Care manages a diverse portfolio of over 120,000 homes across England and Scotland, including social and affordable housing, student accommodation, supported and retirement living, new-build homes, and 110 care homes.

They have over 4,600 residents in their care homes, employing over 7,000 people. Alice Lovatt laid out how the business has taken a structured approach to retrofitting since 2020, summarised here:

Identifying environmental leads: Assigning sustainability champions within the organisation ensures accountability and drives initiatives forward.

Assessing current building performance: A baseline assessment of energy use (Scope 1 and 2 emissions – energy/transport) and EPC ratings helps identify areas with the greatest potential for improvement.

Understanding long-term regulatory requirements: Futureproofing buildings to comply with upcoming regulations, plus Care Quality Commission requirements, avoids costly adjustments later. “There has been a lot of horizon-scanning,” Alice notes.

Retrofit strategies for healthcare settings

Alice shared Sanctuary’s rationale for investment, particularly in care homes that can be “24/7 huge guzzlers of energy,” from energy savings and costs, and customer health and wellbeing, through to CQC environmental statements in the Single Assessment Framework. Here’s a summary:

Fabric-first approach: Prioritise upgrades to the building’s thermal envelope—insulating walls, roofs, and windows. This minimises energy loss, creating a solid foundation for subsequent improvements.

Decarbonising heating: Heating demands in healthcare facilities are high, necessitating careful consideration of options like heat pumps, district heating, or electric panel heaters powered by renewable energy sources. Sanctuary Care, for instance, is piloting smart heating controls in some homes to optimise heat usage.

Lighting and equipment upgrades: LED lighting, energy-efficient appliances, and smart control systems reduce energy consumption while lowering operational costs.

Renewable energy integration: Adding solar panels or wind energy systems where feasible reduces reliance on fossil fuels and supports a facility’s green energy targets.

Ensuring safety and accessibility: Retrofitting should also improve safety measures, including fire systems and accessible layouts, contributing to a safe and welcoming environment for all.

“This isn’t just about the now,” notes Alice. “If you’re going to sell your buildings; if you’re wanting to attract and retain talent; or attract a different clientele in terms of the next generation coming in, the efficiencies you are likely to get alongside the sustainability credentials from retrofitting your buildings could have a massive impact on future-proofing your operations and your business.”

Building stakeholder support

Successful retrofitting requires buy-in from all stakeholders, including staff, patients, and their families. Clear communication about the benefits—lower costs, improved comfort, and a healthier environment—can foster engagement across regions and generations.

“Consider whole costs and get the full picture,” Alice says, “from capital and admin costs through to ancillary costs, surveys, and inflation. There could be scaffolding, for example, or assessing for failed insulation in cavity walls or asbestos. What might the costs look like in three to four years after inflation?”

Healthcare organisations should also consider partnerships with experienced contractors familiar with patient-centred environments to ensure seamless project execution.

Moving forward: Monitoring and maintenance

Continuous monitoring and regular maintenance are essential to sustain the benefits of retrofits. Energy performance metrics should be routinely assessed, with adjustments made to optimise efficiency.

Facilities may also explore advanced energy management systems to maintain and enhance building performance over time.

Getting fit for the future

“By adopting measures like improving insulation, integrating renewable energy, and optimising heating systems, we could significantly lower operational costs, meet stringent regulatory requirements, and create healthier, more comfortable spaces for all,” notes Barrie.

“The business case for retrofitting healthcare buildings has never been clearer. Energy-efficient upgrades not only reduce costs but also boost property value and align with the evolving expectations of patients and stakeholders.

“Initiatives like our collaboration with The School equip organisations with the skills and knowledge needed to undertake this transformation.

“As we celebrate the first anniversary of this programme, we’re seeing strong demand and tangible benefits across the sector. Retrofitting is more than an investment in sustainability; it’s an investment in the future of healthcare — creating facilities that are resilient, efficient, and ready to meet the challenges of tomorrow.”

Our partner the Supply Chain Sustainability School (UK) offers learning and support in the form of training, events, networking, e-learning modules, tailored assessment and a library of online resources.

For retrofit-specific learning: Supply Chain Sustainability School

For more information on making your business premises more energy efficient, visit: Retrofit

This material is published by NatWest Group plc (“NatWest Group”), for information purposes only and should not be regarded as providing any specific advice. Recipients should make their own independent evaluation of this information and no action should be taken, solely relying on it. This material should not be reproduced or disclosed without our consent. It is not intended for distribution in any jurisdiction in which this would be prohibited. Whilst this information is believed to be reliable, it has not been independently verified by NatWest Group and NatWest Group makes no representation or warranty (express or implied) of any kind, as regards the accuracy or completeness of this information, nor does it accept any responsibility or liability for any loss or damage arising in any way from any use made of or reliance placed on, this information. Unless otherwise stated, any views, forecasts, or estimates are solely those of NatWest Group, as of this date and are subject to change without notice. Copyright © NatWest Group. All rights reserved.

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