Lorraine Brayford argues that sustainability should be a priority in healthcare design and recognises those already working to deliver sustainable healthcare buildings for the future

There is no escaping the need for the NHS to build a sustainable estate.

Legislation such as the Building Regulations 2006 and the energy white paper have prioritised the environment.

These policy drivers, considered alongside the chancellor's announcement of£20bn extra capital expenditurefor the NHS by 2011, mean the motivation and the resources to build a sustainable estate already exist.

What we need now is more positive action. I believe there are several key areas that those looking to deliver sustainable healthcare buildings must take into account:

  • biodiversity and outdoor spaces;

  • accessibility and transport implications;

  • use of local employment and suppliers;

  • natural light and ventilation and renewable energy sources;

  • energy efficiency and reduced carbon emissions;

  • whole-life costing and best value;

  • making best use of material resources and minimising waste.

Cutting out waste

Of these, waste and the management of material resources presents us with a major opportunity to be more efficient, and there are a number of high-profile exemplars that are already showing the healthcare sector and the wider construction industry how to take effective action.

By treating waste as a resource and mandating good practice through procurement requirements, these organisations are setting a benchmark for sustainable development and delivering buildings with give and not just take.

Construction and demolition waste amounts to 120 million tonnes per year, a third of theUK'sannual waste total. 20 million tonnes of this figure goes unused into landfill, but with landfill tax for non-inert materials set to rise to£48 per tonne by 2010, disposing of this waste is becoming increasingly costly.

With this in mind, there is a strong business case for more trusts to follow the examples set at Bristol Southmead and Hillingdon and use the resources of organisations such as the Waste and Resources Action Programme to mandate the more efficient use of materials.

Reducing and recovering more waste not only saves money, it also enables trusts to reap the reputational benefits associated with meeting legislative requirements and policy targets.

Leading the way

TheNorth Bristoltrust's Southmead Hospital redevelopment project is a striking example of this. With WRAP's help, a minimum requirement has been set that 20 per cent of the building materials must come from recycled materials. A requirement for the use of a site waste management plan has also been implemented to encourage good waste management on site.

Following this lead, a similar requirement has been incorporated into the tender documentation at the Hillingdon Hospital redevelopment project.

At the Department of Health, we are committed to encouraging more trusts to follow in the footsteps of these sustainable exemplars. This will improve the environmental impact of the NHS's wider estate and allow trusts to reap the benefits associated with good practice.

For this reason, we are working with WRAP on our design development protocol, to provide clear guidance for those trusts looking to encourage better use of water, materials and waste during the development process.

We hope this document will help motivate greater engagement in sustainable construction from the wider NHS estate and prevent a legacy of costly inefficiency.

Most importantly, we want more trusts to use the expertise of WRAP, Envirowise and other organisations to dispel the myth that going green costs more or requires excessive effort.