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Hospital Healthcare Europe

Sustainable construction in healthcare

David Moon
1 January, 2008  

Two UK hospital rebuilds demonstrate how the healthcare sector is giving a lead in waste reduction: Middlesex’s Hillingdon Hospital, and North Bristol NHS Trust’s Southmead project. Dr David Moon, from the UK’s WRAP, reports.

David Moon
Construction
Programme
Manager for
Procurement
Waste & Resources Action Programme (WRAP)
Banbury, UK

The construction industry is responsible for the consumption of 400 million tonnes of material resources every year and is the UK’s largest source of waste, contributing one-third of the UK’s annual total. The healthcare sector in particular is an arena in which a clear opportunity exists to deliver greater resource efficiency.
There is considerable scope for the healthcare sector to set a benchmark of sustainability for the wider construction industry to follow. The last government Budget revealed that capital expenditure in healthcare on IT and buildings would be raised significantly over the next 10 years from £2.2bn to £5.5bn per annum. This means that approximately one-third of all hospital estate and all GP surgeries are due for replacement or refurbishment. The market for capital investment is therefore likely to remain buoyant over the next few years as the level of capital expenditure is increased, presenting significant opportunities for clients and delivery teams to prioritise energy, materials and water efficiency
throughout the project process.

Why act on waste?
There are significant policy drivers for the construction industry to make a change to its current level of wastage. The waste strategy from the UK’s Department for Environment, Food and Rural Affairs and the government’s draft sustainable construction strategy both include a target to halve waste to landfill by 2012. With landfill tax on non-inert waste set to double to £48/tonne in the next three years there is a clear business case for organisations to improve their performance. WRAP (Waste & Resources Action Programme) is a public-funded body tasked with supporting construction clients and their delivery teams in reducing waste, increasing recycling, using the recovered materials and thereby achieving best value.
Action at the planning stage of a construction project is key in driving the efficient use of materials and waste through the later stages. In particular, clients should set minimum requirements for reused and recycled content and request that contractors forecast and set their own targets for waste
reduction and recovery as part of their Site Waste Management Plan (SWMP).

A “green” exemplar
The £200m redevelopment project at Middlesex’s Hillingdon Hospital, part of the Hillingdon Hospital NHS Trust, is setting high standards for sustainable procurement. The design philosophy for Hillingdon dictates that sustainability must underlie all aspects of design, specification and operation. With WRAP’s help, a good practice standard of 20% reused and recycled content has been set to ensure that contractors seek out good practice product options within their supply chain. To help implement this minimum requirement, WRAP provided model wording for procurement documentation and evidence on the ease and cost-effectiveness of the mainstream ‘quick win’ product substitutions that would enable the project team to meet Hillingdon’s standard.

Practical help and assistance
WRAP has a series of tools and resources to assist contractors in making client and policy requirements a reality. These include a recycled product guide (searchable online or available for downloading) that sets out the recycled content of commonly used construction products across 35 product categories. Typically, products are mainstream, high-volume and both cost competitive and of similar quality to equivalent products containing less recycled material. WRAP also provides model procurement wording, case studies and a recycled content toolkit. This enables design teams and contractors to quantify the baseline content of their project with minimum effort and identify the top five to 10 ‘quick win’ product substitutions. The toolkit also supports reporting on performance to clients.
Achieving targets for waste reduction, recycling and use of recycled content is not only cost neutral or cost saving but will incur impressive benefits for the environment. These include reducing the quantities of waste going to landfill and overall life-cycle environmental impact, and increasing the market demand for materials that contractors want to recycle.

A step further
At North Bristol NHS Trust’s Southmead redevelopment project, the opportunity presented by the project planning stage to drive materials efficiency is being wholeheartedly embraced. A minimum requirement for 20% recycled content has been set in the Trust’s ‘invitation to participate in competitive dialogue’ documents based on research commissioned by WRAP on the cost-competitive prices of recycled products in the local area.
Southmead is also setting an environmental benchmark by acting on the potential existing at the tendering stage to encourage good practice on site. Minimising the amount of waste sent to landfill is an important means by which clients and their project teams can improve their impact on the environment. The benefits of effective site practices are impressive; Taylor Woodrow for example has saved 3% of build costs by reducing and recycling waste on live sites. In achieving this end, the Trust is expecting bidders to demonstrate a low transfer of waste to landfill through a detailed strategy for implementing an SWMP.
Trust deputy director Tricia Down explains: “We are committed to achieving a sustainable design, constr uction and operational solution for our hospital, and in order to deliver this we have had to ensure that we set out specific expectations in these areas for our bidders. Setting these requirements for recycled content and the use of a SWMP within our ‘invitation to participate…’ documents shows bidders that we are serious about sustainability. We expect robust responses from contractors, demonstrating how they intend to meet the challenges.”
WRAP project manager for procurement Jim Wiltshire comments: “The requirements being set at Southmead and Hillingdon represent a level of engagement that positions these developments at the forefront of sustainable practice.
“At WRAP we are on hand to help leading organisations and delivery teams across the healthcare sector looking to become more sustainable. Awareness of the challenges that the construction industry faces with regards to waste is slowly but surely being raised. As more clients begin prioritising and driving ‘green’ construction we should witness a change to current waste statistics. There are opportunities for clients to demonstrate corporate responsibility across the £100bn construction sector, and following the lead of the healthcare sector to date is a great place to start!”