Energy efficiency could cut NHS costs by £400m

With the growing influence of digital applications in building maintenance and demands on NHS budgets, the Building Engineering Services Association (BESA), has taken a look at the digital advancements and potential cost savings that could be on offer to the Healthcare industry.

The NHS could reduce its annual running costs by more than £400m if it adopted a series of energy saving measures, according to new research.

The ‘Securing Health Returns’ report produced by the Sustainable Development Unit (SDU) for NHS England and Public Health England analysed 35 sustainability measures that it said could also reduce annual carbon emissions by one million tonnes by the end of this decade.

18 of the measures considered are linked to energy saving with staff energy awareness and ‘behaviour change’ capable of reducing energy costs by £21.5m and high efficiency lighting (£7.2m).

Lowering set points on heating systems by 1 degC would cut £6.2m from the NHS energy bill and switching to Combined Heat and Power (CHP) would also save the NHS £26.4m a year, according to the report.

Lifecycle Costs

In addition to the savings identified in the ‘Securing Health Returns’ report, the complete lifecycle cost of a building also need to be managed as this ongoing expenditure has always dwarfed the initial construction cost. In too many cases the primary focus has been on the initial design and handover of projects with too little thought given to long-term performance. This can be effectively achieved by adopting a smarter maintenance regime as a way of making substantial cost savings, whilst still maintaining compliance.

SFG20 – the definitive standard for planned maintenance has been saving businesses money in a wide range of sectors for a number of years by optimising maintenance, avoiding over-spend, ensuring efficient running of plant and maintaining compliance. The good news for the health sector in the wake of the Carter Report is that a HTM (Health Technical Memorandum) module is now available, providing maintenance schedules aligned with the requirements of the HTMs.

Real Costs

The 10-80-10 rule where 10% of a building’s total cost is accounted for in construction; 10% in decommissioning at the end of its life; and the vast majority (80%) in its operational phase, certainly holds true for most buildings and emphasises the importance of focussing on ensuring building services function well throughout a building’s useful life – particularly in buildings with high occupant densities and long operating hours such as hospitals and other healthcare facilities.

In addition to maintaining compliance keeping occupants happy, healthy and productive has to be the main preoccupation of any building engineer because that is where the operational value lies. However, in too many cases a ‘performance gap’ opens up due to poor understanding of how the building was to be operated and used – often exacerbated by the use of inappropriate or over-complex systems.

Heating, ventilation, lighting and air conditioning are critical to providing the necessary conditions for occupants to thrive in their indoor environment and managers of commercial buildings have to rely on the best and most cost-effective methods for keeping their built assets functioning well.

Occupant discomfort is often linked to poor energy performance. If the heating and cooling is poorly balanced, people at one end of the office will have totally different conditions to those at the other.

This leads to some people opening windows to reduce overheating and others bringing in additional heating in a bid to warm up cold spots – the dissatisfaction of the occupants is only matched by the fury of the financial director on receiving the electricity bill.

As a result, the ‘business’ case for investment in maintaining essential services is becoming stronger with service and maintenance programmes playing an increasingly important role in helping FMs maintain comfort levels, identify areas requiring improvement; and meet energy efficiency goals. 

Best practice guidance produced by the Building Engineering Services Association (BESA) in its SFG20 maintenance specification is now widely adopted to that end. We are seeing more and more building owners – including increasing numbers in the public sector, including hospitals – adopting SFG20 as a tool to establish a cost-effective strategy that closely matches user requirements to investment in planned service and maintenance.

SFG20 is a dynamic online tool so makes best practice widely available and easy to access. As well as featuring over 500 core maintenance schedules, covering more than 60 equipment types, SFG20 also gives users the opportunity to customise maintenance schedules, including service times, frequency and criticality ratings. SFG20 is also aligned with rapidly emerging digital working methods and is constantly updated to capture evolving service and maintenance techniques.

Brian Dunne, PPM Manager, Estates Department Operations Office of St Georges Hospitals University NHS Foundation Trust said;

“SFG20 is saving a lot of time that we previously had to spend making contact with equipment manufacturers regarding routine maintenance. SFG20 has simplified the task of setting specifications for our maintenance contractors at the same time as making sure we’re following all correct procedures. I also like the fact it’s speedy, making essential information readily available.”   

And it isn’t just about efficiency savings -by adopting SFG20 and embedding its measures into their estate management processes many building users have recorded savings of up to 20% in their maintenance costs. Such savings can have a significant impact on balancing the books. According to the NHS Estates Review, an analysis published in March by Arcadis, the NHS spends of the £8.3billion in Estate costs in 2015, so even if you halved the average saving SFG20 could potentially have a significant impact on the bottom line of most NHS operations.

HTM Alignment

SFG20 is about to be expanded again to provide comprehensive support for healthcare facilities by incorporating a Healthcare Functional Set, developed in collaboration with the Institute of Healthcare Engineering and Estate Management (IHEEM), this new addition has aligned SFG20 with the requirements of the HTM’s.

The new HTM module will be launched at the Healthcare Estates Conference in Manchester this October and is designed specifically for hospitals, NHS trusts, dentists, vets and doctors’ surgeries. Schedules display how often tasks need to be carried out to avoid over or under maintaining assets and what skill set should be used to perform the tasks.

Further Developments

As well as incorporating a healthcare functional set, SFG20 is constantly developing to meet the needs of its subscribers and the building services industry.

SFG20 is helping smooth the way for the wider adoption of digital design methods, including Building Information Modelling (BIM), by helping building managers present information in a standard, usable format.  

Since April this year the government has required all public-sector work to be subject to the Level 2 BIM method of working, which demands that building information is developed in a collaborative 3D environment.

SFG20 has been adapted so it can now accept building design information imported directly from BIM software.  This means that ongoing maintenance costs can be based on the SFG20 standard from the point that initial CAD drawings are constructed, rather than later in the process or after project handover, which greatly improves the long-term performance of the building.

SFG20 is also regularly integrated with different software solutions. This can be done on an individual basis with subscribers taking raw data that is then loaded into their own software. However, a simpler solution is to use an SFG20 ‘Approved Provider’ who can automatically load SFG20 into the user’s preferred software solution such as a CAFM system, which many healthcare engineers and managers utilise.


These are exciting – and challenging – times for the facilities management industry and a huge amount is now achievable by combining traditional expertise with modern IT tools. Google, Apple and the like have the software and data management skills, but they need traditional engineering partners, supported by tools such as SFG20, to make it all work in buildings for the long-term benefit of end users.

Find out more about how SFG20 can help streamline your maintenance costs and improve the efficiency of buildings visit