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NHS Sustainability Roadshow Manchester

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NHS Sustainability Roadshow Manchester

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NHS Sustainability Roadshow Manchester

  1. 1. #DAYFORACTION WELCOME #dayforaction
  2. 2. Refill partnership with City to Sea
  3. 3. Chance to win a water station worth £2000 and installed!
  4. 4. Deadline March 14th Ceremony May 16th- Leeds
  5. 5. #DAYFORACTION Session 1: Top down & Bottom up approaches to embedding sustainability #dayforaction
  6. 6. Greater Manchester and Sustainability Making a difference in health and social care
  7. 7. • In 2016, Greater Manchester took control of its health and social care system. • At the same time we launched our five-year plan to improve health and social care, called Taking Charge • It involves NHS, councils, voluntary, community & social enterprise, Healthwatch, other public services • • • • • • • • • • . Taking Charge
  8. 8. • • More children reaching a good level of social and emotional development - ready for school • Fewer people dying from: cancer, heart and lung disease • Supporting people to stay well and live at home for as long as possible • Ensuring we contribute in a leading way to a ‘sustainable’ system • • • • • • . A Reminder of Our Aims – by 2021
  9. 9. GMHSCP Partnership Opportunities • • • | 9 GMHSCP Partnership Opportunities Carbon Neutrality (2038) Environmental Plan GM Spatial Framework Industrial Strategy Clean Air Plan Air Quality Strategy Transport Strategy and Made to Move
  10. 10. Health Benefits of Action • • Cleaner Air • Warmer Homes • Healthier Eating • Active Travel • Green Space and Biodiversity • Community Cohesiveness • Healthier, Sustainable Economies • Resilient communities and health/social care system •| 10
  11. 11. Locality • Carbon Literacy Training • Plastic & paper reduction • Recyclable stationary • Advocacy • Social Value Strategy
  12. 12. Greater Manchester – Advocacy
  13. 13. Phil Korbel • • Co Founder/Director Carbon Literacy Project • Board Member, G Mcr Low Carbon Hub •
  14. 14. Just think • • how different it would be if… • everyone ‘got it’ • thought low carbon • acted low carbon • how much more effective would your existing SD measures be? •
  15. 15. Carbon Literacy is • • a day’s-worth of adaptable, relevant, action-based learning-and-doing on climate change that you deliver • the foundation for upping your game on climate change • is not about polar bears • about health • •
  16. 16. Meanwhile, in Greater Manchester • • •
  17. 17. •      • Carbon neutral by 2038, 15% annual reductions from now on •
  18. 18. The bosses agreed • • tackling climate change is part of the job • is rarely a high priority • why? • “…because I won’t get fired if I don’t…” • What gets measured gets done •
  19. 19. What leeway does ‘Devo Manc’ offer? • • align with the GMCA plan • standing agenda item • Providers Board action group • what gets measured gets done • embed in funding contracts?? • spread best practice nationally •
  20. 20. • www.carbonliteracy.com @Carbon_Literacy #CarbonLit phil@carbonliteracy.com •
  21. 21. Sustainability Solutions 14th February 2019 Paul Broadberry Manchester Sustainability Solutions | CIS10315 Rev. A
  22. 22. Single-use device remanufacturing Overview - Safety & Efficacy Sustainability Solutions | CIS10315 Rev. A
  23. 23. Dedicated to your sustainability goals § Remanufactured devices are backed by Stryker’s comprehensive quality system § All devices are individually tested to ensure the highest quality § Patient Care sustainability § Maximise savings through case support, business reviews, education and utilising Stryker’s entire remanufacturing program § Leverage partnership to provide purchasing power and price containment Financial sustainability § Purchasing and collection processes designed to minimise waste § Alignment to prioritize the reuse of remanufactured devices Environmental sustainability Sustainability Solutions | CIS10315 Rev. A
  24. 24. Sustainability Solutions | CIS10315 Rev. A
  25. 25. ‘Single-use’ devices (SUDs) § Most SUDs cannot be reused § The‘single use’label is determined by the manufacturer, not the regulatory body: • Perceived limitation of liability • Reduced scrutiny by regulatory body • Increased sales and profits § Specialised technology and knowledge allows manufacturers to remanufacture certain SUDs DVT HARMONIC SCALPEL Sustainability Solutions | CIS10315 Rev. A
  26. 26. § OEM devices are studied to identify critical quality attributes and establish performance specifications § Multiple Considerations: • Analysis of the product • Materials characterisation • Chemical compatibility • Generation of intermediate level product description, including engineering drawings • Analysis of clinical application to produce a specification § Reverse engineering Sustainability Solutions | CIS10315 Rev. A
  27. 27. § Complex medical devices must often be disassembled • Enables thorough cleaning • Allows replacement of components worn out during original use • Increases yield § Replacement components are designed and sourced based on OEM specifications • Validated as equivalent to new Remanufacturing requires disassembly to facilitate cleaning Disassembly and replacement components Sustainability Solutions | CIS10315 Rev. A
  28. 28. § Receiving and Sorting • All orders are ticketed to ensure order content integrity and traceability • Gross rejects, heavily soiled items, and unapproved products are removed • Devices are identified according to OEM convention § § Device Marking/Tracking • All devices are indelibly marked with Unique Device Identifiers via pad printing, bar coding, laser etching, etc. • Allows traceability for cycle counts, reject reconciliation, and potential post-market field actions Identification and traceability Sustainability Solutions | CIS10315 Rev. A
  29. 29. § Accepted devices undergo comprehensive cleaning that incorporates prolonged soaking, cleaning and rinsing in pH-neutral enzymatic cleansers and sanitisers that are compatible with all device materials § § Residual levels of organic materials, such as protein, hemoglobin and total organic carbon are quantified and compared with acceptable standards § Decontamination and cleaning Sustainability Solutions | CIS10315 Rev. A
  30. 30. § Performance is compared to baseline catheters § § Testing performed in house and/or by third party Material strength and performance testing Tensile Strength Tensile Strength FatigueFatigue Joint Seal Testing Joint Seal Testing Introduction & Withdrawal Introduction & Withdrawal Torsion / Deflection Torsion / Deflection Bending / Buckling Bending / Buckling Sustainability Solutions | CIS10315 Rev. A
  31. 31. § DEPCTS (Diagnostic EP Catheter Test System) § § Complete electrical profile testing including isolation and continuity • Isolation test • Captures internal and/or minor insulation breakdowns that can result in cross-talk or noise on the electrogram signals • • Continuity test • Closely mimics actual clinical use • Verifies that the signal from each electrode is consistent and unbroken • • Both tests are performed during active deflections of the test catheter Electrical integrity testing Sustainability Solutions | CIS10315 Rev. A
  32. 32. § Requirements • Package variation (i.e. lot to lot) • Storage • Human interaction (i.e. shipping) § § Validation Steps • Validation Plan • Material/Design Qualification • Performance Qualification • Product Qualification § § Testing • Shock/Drop Test, Vibration Test, Seal/Package Strength, Ship Test • ISO 11607, ASTM D4169, ASTM F-1140-00, ASTM F1980-02 • Accelerated Aging (thermodynamic temperature coefficient) Packaging and shelf life testing Sustainability Solutions | CIS10315 Rev. A
  33. 33. § Conventional Release • Biological Indicators • 72 hour quarantine § § Sterilisation validation: • AAMI/ANSI/ISO 11135 • EN550 • Annual Revalidation • SAL of 10-6 • EO Residuals: ISO 10993-7; TIR 19 • Not an irritant to patients or clinicians Sterilisation Sustainability Solutions | CIS10315 Rev. A
  34. 34. 37 Sustainability Solutions Remanufacturing services portfolio Sustainability Solutions | CIS10315 Rev. A
  35. 35. Remanufacturing in the EP / cath lab • Diagnostic ultrasound catheters (3D mapping catheters) • Electrophysiology catheters • Electrophysiology interface cables • Catheter introducer sheaths EP catheters Diagnostic ultrasound catheters Catheter introducer sheaths EP cables Stryker Corporation or its affiliates own, use, or have applied for the following trademarks or service marks: Stryker. All other trademarks are trademarks of their respective owners or holders. Sustainability Solutions | CIS10315 Rev. A
  36. 36. • Laparoscopic devices (trocars and directed energy – bipolar and ultrasonic) • • Arthroscopic devices (shavers and wands) • • Orthopedic devices (bits / blades / burs and external fixation devices) § Trocars Harmonic scalpels Sealer / dividers Stryker Corporation or its affiliates own, use, or have applied for the following trademarks or service marks: Stryker. All other trademarks are trademarks of their respective owners or holders. Remanufacturing in theatre Sustainability Solutions | CIS10315 Rev. A
  37. 37. Regulatory Activities Sustainability Solutions | CIS10315 Rev. A
  38. 38. Safety evidence § Reprocessors have been regulated since 2000 § Millions of SUDs have been reprocessed with no evidence of increased infection rates. § No deaths have been attributed to reprocessed devices in the FDA’s Manufacturer and User Facility Device Experience (MAUDE) database. 2008 GAO report: Of the 320,000+ adverse events filed with FDA between 2000 and 2006, only 65 adverse events “actually involved or were suspected to involve a reprocessed SUD and that the reprocessed SUD was one of several possible causal factors in the adverse event. In reviewing these 65 reports, FDA found that the types of adverse events reported to be associated with the use of reprocessed SUDs were the same types of events that were reported for new devices.” 2008 Government Accountability Office (GAO) report: noted the findings of FDA’s Medical Product Safety Network (MedSun) Program and confirmed that “none of the representatives of MedSun hospitals who participated in the FDA focus groups reported being aware of any infections related to the use of reprocessed SUDs.” Established record Sustainability Solutions | CIS10315 Rev. A
  39. 39. Protecting your patients § Remanufacturing of single-use devices is regulated by governmental authorities § Remanufactures must obtain premarket clearance and comply with the same medical device regulations as original equipment manufacturers § Premarket clearance is intended to validate that: • The remanufacturing is able to clean and sterilise the device • Functional performance of the remanufactured device is equivalent to the predicate device § NO BATCH TESTING – every device is fully function tested Regulatory oversight Sustainability Solutions § FDA QSR compliant § 105+ premarket clearances for reprocessing § ISO 13485 certified Sustainability Solutions | CIS10315 Rev. A
  40. 40. Regulatory § MHRA issued remanufacturing guidance document § § BSI is Stryker’s notified body § § EU Council’s and Parliament’s Committees on ENVI endorsed remanufacturing agreement § § Stryker Sustainability received CE mark for select vascular devices Market activities Regulations Sustainability Solutions | CIS10315 Rev. A
  41. 41. The Stryker difference Financial & environmental sustainability Sustainability Solutions | CIS10315 Rev. A
  42. 42. Remanufacturing: making a difference In 2017, our single-use medical device remanufacturing programs helped our U.S. customers: $326 million in supply costs 13.4M lbs. of waste from landfills Save Divert Sustainability Solutions | CIS10315 Rev. A
  43. 43. 3_89 Effective remanufacturing prices will be determined as a 10-45% discount from OEM prices, depending on Market Share commitment. • Hospitals/GPOs will provide usage data, including pricing. List price can be used as a starting point when actuals are not available. • • Each individual system may have variations with OEM prices and annual volumes. Tier 1 Less Than 10% Market Share Tier 2 10% Market Share Tier 3 20% Market Share Tier 4 30% Market Share Tier 5 40% Market Share Tier 6 50% Market Share 10% 15% 21% 28% 36% 45% % Market Share of Customer Spend (Please state if discount or actual price is being offered) Pricing and contracting plan
  44. 44. Current Annualized Expenditures Total Remanufactured Spend at 30% Adjusted OEM Spend Total Adjusted Spend Total Adjusted Savings Total Adjusted % Savings £ 1,227,293 £ 143,152 £ 905,743 £ 1,048,894 £ 178,399 15% 14% 86% Total KG Collected Rate Total Waste Savings 10,000 £ 0.20 £ 2,000 Total Savings Remanufacturing Savings + Waste Savings £ 180,399 Customer Spend & Remanufacturing Savings Summary of Total Annualized Savings Waste Savings 3_89 Savings Opportunities: 1. Sustainability devices 2. 3. OEM price erosion 4. 5. Waste diversion 6. 7. Totals Savings analysis 1 2 3 1 2 4 4
  45. 45. Case study Sustainability Solutions | CIS10315 Rev. A
  46. 46. Collections process Establish account Collection materials supplied Set up & training Collections Shipment Inspection, tally and reporting Sealer / dividers Harmonic scalpels Trocars
  47. 47. Dedicated to your sustainability goals § Remanufactured devices are backed by Stryker’s comprehensive quality system § All devices are individually tested to ensure the highest quality § Patient Care sustainability § Maximise savings through case support, business reviews, education and utilising Stryker’s entire remanufacturing program § Leverage partnership to provide purchasing power and price containment Financial sustainability § Purchasing and collection processes designed to minimise waste § Alignment to prioritize the reuse of remanufactured devices Environmental sustainability Sustainability Solutions | CIS10315 Rev. A
  48. 48. Questions? Thank you! Sustainability Solutions | CIS10315 Rev. A
  49. 49. 52 References: Anderson, L. (2013, April). Clinical business strategies. Retrieved from: www.hpnonline.com Ferguson, M. & Toktay, B. (2007, July). Effects of competition on recovery strategies. Retrieved from: www.insead.edu NuRep. (2015, April 23). Are repless models the answer to PPI cost management? Retrieved from: www.nurep.com Scott, B. (2016, April 22). Savings war: The pros and cons of SUD reprocessing growth. Retrieved from: www.dotmed.com White, B. (2016, May 4). Single-use device Options – Promoting Cost Savings and Infection Prevention. Retrieved from: www.medicaldealer.com
  50. 50. © 2015 JRP Solutions Ltd The information in this document is the property of JRP Solutions Ltd and may not be copied or communicated to a third party, or used for any purpose other than that for which it is supplied without the express written consent of JRP Solutions Ltd. This information is given in good faith based upon the latest information available to JRP Solutions Ltd, no warranty or representation is given concerning such information, which must not be taken as establishing any contractual or other commitment binding upon JRP Solutions Ltd or any of its subsidiary or associated companies. Saving Energy Through Staff Engagement George Richards 14th February 2019
  51. 51. Discussion Framework • Introductions • Who are JRP? – What do we do? – Who do we work with? • Energy Training – Why do it? – Levels of training – eLearning – Costs • Any questions? • •
  52. 52. Why do it? ü NHS annual energy spend of approximately £544m ü Increased consumption due to more energy hungry technology ü Pressure on to deliver savings ü Little capital available to invest in energy saving projects ü Inefficient building stock ü Effecting behavioural change is low cost and delivers immediate benefits ü A 5% - 10% reduction in energy use would realise a £30 - £60m annual saving ü We all have a moral duty to change what we do and prevent waste wherever possible as we face ‘A Climate Emergency’
  53. 53. Energy Awareness Training Harness the inherent knowledge of your staff – they know your business better than any consultant! JRP provide five levels of training from Level 1 General Energy Awareness to Level 4 Embedding Energy Culture Change ensuring it is always relevant, engaging and practical
  54. 54. Making it relevant Level 1 – General Energy Awareness Training ü Face to face or eLearning modules ü Fundamental principles of energy – what it is, where it comes from, what it costs, security of supply, environmental impacts ü The impacts of inaction in the home and workplace ü Can be bespoke for larger organisations ü EUSR approved
  55. 55. Energy – the big picture • • • • • • • • Provides a universal understanding of what energy is, where it comes from and why CO2 emissions are so harmful to the planet
  56. 56. Energy at home Looks at how energy is used within a typical home and provides some useful tips to help reduce energy consumption and reduce energy bills at home
  57. 57. Energy at Work Every day £000’s of energy is wasted at work with lights, heating & cooling and equipment being left on when it’s not actually needed. This module looks at simple ways in which energy consumption can be reduced to help make the workplace more sustainable and save the NHS significant amounts of money.
  58. 58. Energy Awareness via eLearning https://jrpsolutions.learnupon.com/users/sign_in
  59. 59. Making it relevant to the NHS • Relevant to all staff – clinical, medical and support • Builds universal understanding of energy and CO2 through modules • Adds personal value by relating energy to the home environment • Relates to NHS priorities and values e.g. improved patient comfort • Can be used for Induction Training, Team Talks or as a complete course • Very affordable @ £3k per annum with unlimited usage in each Trust •
  60. 60. © 2015 JRP Solutions Ltd The information in this document is the property of JRP Solutions Ltd and may not be copied or communicated to a third party, or used for any purpose other than that for which it is supplied without the express written consent of JRP Solutions Ltd. This information is given in good faith based upon the latest information available to JRP Solutions Ltd, no warranty or representation is given concerning such information, which must not be taken as establishing any contractual or other commitment binding upon JRP Solutions Ltd or any of its subsidiary or associated companies. Any Questions? Contact: George Richards e: george.richards@jrpsolutions.com m: 07870 394601
  61. 61. Thank you
  62. 62. Nerys Simmons Manchester University NHS Foundation Trust Embedding Reuse
  63. 63. Why have a reuse system? • £100s disposing of unwanted items • £1000s procuring same items • Match up the 2 üAvoid waste üReduce carbon footprint from procurement üSave ££££££
  64. 64. In figures Since February 2016 we have…. • Registered 1252 colleagues as users • Reused 3558 items over 861 transactions • Saved estimated £175k in procurement costs • Avoided 25 tonnes of waste
  65. 65. Things to consider • Know your stakeholders • Know your own resources • Know your audience • Keep it fair • Keep it in focus •
  66. 66. Know your stakeholders • Procurement and budget holders • Health and Safety, Infection Prevention, Fire Safety • Medical Engineering, Informatics • • Capital Works/Property and Estates •
  67. 67. Know your own resources • Time, transport, storage • Be clear on everyone’s responsibilities • Accept there are limitations
  68. 68. Know your audience • What do people want? • What items have restrictions on procurement • Use popular items to promote the system
  69. 69. Keep it fair • Everything for reuse goes through Warp It • Everyone has an equal chance to claim • Users are expected to give as well as receive
  70. 70. Keep it in focus • Case studies in staff newsletter • Sign-up at events • Criteria for Green Impact award • •
  71. 71. Thank you Nerys Simmons Waste and Sustainability Officer Nerys.simmons@mft.nhs.uk 0161 276 6349
  72. 72. #DAYFORACTION Refreshment Break #dayforaction
  73. 73. #DAYFORACTION Session 2: Injecting finance into the NHS and creating savings #dayforaction
  74. 74. Reducing waste in every way NHS Sustainability Roadshow Manchester 14th February 2019
  75. 75. Introductions MJ Rose - Business Development Manager Kerry Jones – Sales Director www.forwardwaste.co.uk
  76. 76. The importance of segregation… The way we handle waste has to change! Volume of wastes going to UK landfill - In 2016, 15.7 million tonnes of municipal waste was sent to landfill. Of this, 7.7 million tonnes was biodegradable municipal waste. Around 10 million tonnes of food and drink was wasted in the food chain in 2015 - around 60 per cent of this is avoidable. The problem with plastic… 8.3 billion tonnes of virgin plastic created to date 9% recycled 12% incinerated 79% accumulated in landfills If this trend continues, roughly 12 billion tonnes will be landfilled by 2050 www.forwardwaste.co.uk
  77. 77. The waste hierarchy… www.forwardwaste.co.uk
  78. 78. Where can your general waste go? www.forwardwaste.co.uk EfW General waste incinerated to produce energy, with incineration temperatures reaching over 850 degrees celsius Reduction in greenhouse gas emissions between 32% - 41% compared with sending to landfill Local EfW facility generates enough electricity for 50,000 homes 23% of renewable energy comes from energy from waste – equivalent to 726,000 tonnes of oil
  79. 79. Where can your food waste go? www.forwardwaste.co.uk Anaerobic Digestion Uses microorganisms to break down food waste in an enclosed system, without oxygen As it breaks down, methane is produced which is collected and converted to biogas Biogas used to generate electricity, heat or transport fuels Also creates a nutrient-rich fertiliser for use in agriculture
  80. 80. The importance of segregation… Higher chance of achieving zero to landfill Valuable, recyclable materials recovered at source with lower disposal charges, or rebates achieved Full traceability of waste destinations www.forwardwaste.co.uk
  81. 81. Efficient waste management in the NHS www.forwardwaste.co.uk or… BEDS? BINS? Simple Choices…
  82. 82. Case study – the problem NHS hospital trust 13 tonnes of unsegregated waste produced per month general waste and cardboard all in together! Increased container collections per annum, leading to a high carbon footprint Health & Safety concerns and disruption to site through high container frequency www.forwardwaste.co.uk
  83. 83. Case study – the solution General waste collected from around the hospital Residual general waste loaded into portable compactor www.forwardwaste.co.uk Waste taken for onward recycling. Cardboard segregated at source and baled. Collected every 2 months with rebate achieved. Compactor emptied once a month.
  84. 84. Case study – the outcome Reduction in general waste by 50% Collection frequency's reduced from 2 visits PCM to only 1 PCM – 50% reduction! Cardboard waste generating income Carbon footprint reduction in general waste movement. Baler hire costs covered by rebate. www.forwardwaste.co.uk
  85. 85. What should be happening… Elimination Minimisation Diversion Waste Management Risk Reduction Legal Compliance Cost Control Environmental Consultancy Removal and Disposal www.forwardwaste.co.uk
  86. 86. Any questions?
  87. 87. Thank you for your time. mj.rose@forwardwaste.co.uk kerry.jones@forwardwaste.co.uk www.forwardwaste.co.uk
  88. 88. In It Together: Creating a Whole Trust Approach
  89. 89. Introduction •2.4 million patient contacts •+- 15,000 staff •A 900-year history •Almost £1.5 billion annual turnover •6,659 babies born •+- 5,000 tonnes of waste p.a. •Awarded TWM contract in 2014 •Close working relationship •Education & communication •Innovations & initiatives • •
  90. 90. About us Partnership Approach •Recycling & Resource Management company - contract lead •Dedicated staffing – team of 35 on site •Sustainability Director & Team • • • • • • Head of Health & Sustainability Contract Manager Key Coordinator Supervisors Waste/ Obsolete Porters Guy’s and St Thomas’ sites Trust Waste Manager Logistics Assistant Sustainability Team
  91. 91. About us Initiatives •SAVE - savings of up to £150,000 p.a. •Waste data from Byweigh mini-weighbridge •Senior Management buy in & SAVE Champions •Support for events and sustainability activities •Staff induction education • • • • • • •
  92. 92. About us Mini-weighbridge system •Identifies and weighs every bin - ward/ department level tracking •Bespoke software and tagging system •Performance and cost - real-time, to pin-point problem areas •Staffing and efficiency benefits •
  93. 93. About us Reuse and Food recycling •Reuse •Trust signed up to Warp-it in November 2017 •12 months savings of £76,000 •Initial Roll Out - Ward Clerks and Procurement Buyers •Procurement decisions for purchase are prompted to use StockDoc •Food waste •Tonnage from 1 tonne to 14 tonnes per month •Training of Food Service Assistants
  94. 94. About us Single – use packaging •Installed August 2018 at St Thomas’ •4,000 bottles refilled since being introduced •Machine also to be installed at Guy’s and in community sites •
  95. 95. About us Single – use packaging – market reactions •Customer enquiries and questions •Commitment and leadership o Unilever – 100% plastic packaging fully recyclable, compostable, reusable by 2025. Increase recycled content in packaging to 25% by 2025 o Costa – 500million single- use coffee cups recycled in the UK
  96. 96. About us Inspiring action and useful resources •Leading by example •Spread the word enthusiastically •Resources out there: •https://www.ellenmacarthurfoundation.org / •https://skyoceanrescue.com/ •https://thesra.org/ •https://lessplastic.co.uk/ •https:// www.flipsnack.com/Bywaters/new-flipbook-fti01qafh.html • • •
  97. 97. The Right People
  98. 98. The Right People
  99. 99. Sustainability
  100. 100. Ed van Reenen 07818560650 e.vanreenen@bywaters.co.uk
  101. 101. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Securing funding to deliver cost-saving energy efficient technologies Thursday 14th February 2019 Liam Gillard, Salix Finance
  102. 102. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Overview of Salix Finance Independent, not-for-profit company working in partnership with the Public Sector since 2004 Salix provides interest-free funding to accelerate investment in energy efficient technologies National profile working in England, Scotland and Wales Funded by the Department for Business, Energy and Industrial Strategy (BEIS), the Department of Education, the Welsh Government and the Scottish Government
  103. 103. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Salix focus
  104. 104. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Funding model Funding committed following successful application Project delivery and installation (interim payments available) Salix loan paid out on completion Financial and carbon savings achieved Repayments made back to Salix (10 equal instalments over 5 years)
  105. 105. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Our achievements *calculated using emissions factors published by government for carbon foot printing client pilot schemes Salix funding allocated £930,000 energy saving per annum 6,000* tonnes CO2 per annum £3.4m19 500 client projects committed tCO2e* annual saving 766k*2301 Salix funded projects £692m energy saving per annum £158m client projects committed 16,656 Clients supported 2004 2018
  106. 106. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Technologies supported Salix funding can support over 100 energy efficiency technologies Boiler replacements Building energy management systems Combined heat and power Heat recovery Heat networks Heating and hot water upgrades Building fabric insulation LED lighting upgrades Street lighting Solar PV
  107. 107. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Salix Finance and the NHS Funding criteria – 5 year loan payback (no technical payback anymore), costs less than £172 to save tCO2e over lifetime of the project Funding can be used to improve existing equipment or to install equipment to achieve higher standards in new build developments Funding can be secured over multiple years to support Sustainable Development Management Plans and long term estate strategies (including EPCs) NHSI approve of Salix’s Invest to Save model
  108. 108. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR £70.5m 100,000 £19.5m 63 236 £567.5m Salix working within the NHS *Calculated using emission factors published by government for carbon footprinting 63 227 TOTAL TRUST ENERGY SPEND 2017/18 £567.5m TOTAL SALIX LOAN VALUE ESTIMATED ANNUAL tCO2e* TOTAL ANNUAL SAVINGS £71m 100,000 £19.5m
  109. 109. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Top Salix NHS clients Imperial College Healthcare NHS Trust East Kent University Hospitals NHS Foundation Trust Wrightington, Wigan and Leigh NHS Foundation Trust Frimley Health NHS Foundation Trust George Eliot Hospital NHS Trust Northern Devon Healthcare NHS Trust University Hospitals of Morecambe Bay NHS Foundation Trust Lewisham and Greenwich NHS Trust North West Anglia NHS Foundation Trust Northampton General Hospital NHS Trust
  110. 110. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Salix project knowledge slides Sharing of knowledge between clients Before and after project delivery Supporting comments Lessons learnt Supplier information Contact details NHS knowledge slides Gaining internal approval
  111. 111. • • BEFORE • 3 x 4.5MW LTHW boilers • Annual energy spend of £407,000 gas and £1.6m electricity at Whiston Hospital • Whiston Heating System is maintained by Vinci Facilities. The heating demand from Whiston hospital is approx. 3,728Kw in the coldest months of the year. Project Knowledge – CHP and Heat Recovery by St Helens & Knowsley NHS Trust AFTER • CHP providing 1.28MW of electricity and 1403kW of Low Temperature Hot Water • FluAce direct contact gas condensing economiser fitted to current boilers to recover ~20% of the energy currently in the flu gas • • • • • • Project completion date – October 2018 • Project value £2,108,365 • 8,986,157 kWh annual electricity saving (51%) • £713,258/year savings • Payback 2.96 years • 1,638 tCO2 saved per year • • •
  112. 112. Supporting Comments: Project Knowledge – CHP and Heat Recovery by St Helens & Knowsley NHS Trust • Proposed savings derived from a)Use of expected kwh reductions from initial feasibility study ‘plugged’ into Trust invoicing monitoring spreadsheet, and b) Pre and post consumption (kwh) figures and cost per kwh also plugged into the SALIX compliance tool to test payback <5years. • • Electricity costs of 9.16 p/kWh and gas costs of 1.80 p/kWh at Whiston Hospital • • Clark Energy, Cogenco and Centrica put in a bid in our tender for the installation and maintenance of the CHP and Flue-Ace heat recovery unit. Centrica was the chosen supplier. • • Advice/lessons learned: • Consider whether your site has an A and B electrical supply, which is usual in modern hospitals. If this is the case you may have to consider the electrical demand of one of these supplies, rather than total site demand, when sizing the CHP. • Ensure you have a good log of constant temperature hot water return data and primary heating loop temps prior to the project. • Be patient from initial SALIX approval through to feasibility to actual completion….. 3 years, we are however a PFI trust so were held up with Deed of Variation and Funder approval. • SALIX had equal patience with our delays……Thank you. •
  113. 113. Measurement of Savings: Project Knowledge – CHP and Heat Recovery by St Helens & Knowsley NHS Trust • The savings for December and January are greater than the expected savings amount. This is because the expected savings calculation took into account unforeseen downtime, scheduled downtime, Scheduled maintenance, and peak summer intervals over the course of the year. • There aren’t any aspects of the savings calculation we would approach differently after considering post verification results. • Graph 2 – Metered consumptio n to Jan 19 • • Savings have been monitored on this project using manual mains meter readings, STARK smart meter readings, utilities bills and the Web portal supplied by the CHP contractor which details Gas used as well as electrical and thermal energy generated. • • • Graph 1 – Metered consumption to Oct 18
  114. 114. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Salix case studies
  115. 115. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Supporting project delivery FeasibilityFeasibility Internal Consultation Internal Consultation ProcurementProcurement MobilisationMobilisation InstallationInstallation Business case checks Meet with finance department Offer reservation of funding for Trust Board Workshops and calls with other Trusts for advice Interim Payments Phase works over financial years
  116. 116. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Summary 100% interest free funding available for NHS Trusts and Foundation Trusts – no maximum loan amount Cost neutral - loan repaid through savings Supporting long-term funding plans, Sustainable Development Management Plans and estates strategies Helping the NHS achieve energy and carbon reduction targets Reduce energy bills at your Trust
  117. 117. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR Thank you liam.gillard@salixfinance.co.uk 0203 714 5655
  118. 118. #DAYFORACTION Lunch #dayforaction
  119. 119. #DAYFORACTION Session 3: Sustainability in action #dayforaction
  120. 120. Powering Performance: Helping major energy users in the healthcare sector to improve energy efficiency and operational performance through onsite generationTony Orton Centrica Business Solutions Thursday 14th February 2019
  121. 121. Centrica Business Solutions The energy landscape is evolving Powering business advantage 124124Centrica Business Solutions CENTRALISED ENERGY MICROGRIDS RENEWABLES STORAGE DISTRIBUTED GENERATION DEMAND SIDE RESPONSE Centralised energy supply is giving way to distributed technology, providing businesses with smart, secure and affordable solutions to the energy challenges they face.
  122. 122. Centrica Business Solutions Energy supply Wholesal e energy Energy insight Energy optimisation Energy solutions Centrica Business Solutions has been created to develop new thinking, new technologies and new ways of working to help our healthcare customers We assist organisations to improve their operational efficiency, ensure site resilience and unlock new sources of value with energy insight, optimisation and technical solutions. 125Centrica Business Solutions 2022 annual revenue target £1bn >2k Enterprise customers £700m Investment to 2020
  123. 123. Centrica Business Solutions The rising cost of non-commodity charges 126 Capacity market subsidy A subsidy to encourage flexible generation to meet peak demand. Contract for difference Subsidies for large scale low carbon generators, to replace the closing renewables obligation. Feed-in tariffs A subsidy for small scale renewable generators, e.g. solar panels. Transmission network charges Paid to National Grid to cover build and maintenance costs of Britain’s high voltage network. Distribution network charges Paid to regional networks to cover the cost of transporting energy from National Grid to customer meters. Renewables obligation Subsidies for large scale low carbon generators, e.g. wind farms. Balancing Services Charge Paid to National Grid for their work ensuring supply and demand are always equal. Supplier costs Debt costs, operating expenses and profit. Wholesale energy costs Energy purchased on the wholesale market plus the cost of any ‘imbalance’ caused by changes to our forecast consumption. 42% 19% 14% 8% 5% 4% 3% 2% 2% Note: British Gas forecast 2018 costs for sample customer
  124. 124. Centrica Business Solutions Tracking the continuing rise of non-commodity costs in the UK 127 Environmental Levies Balancing Services Transmission Network Charges Distribution Network Charges Wholesale Energy Costs 31% 57% 64% Non-Commodity cost as % of total
  125. 125. Centrica Business Solutions 128 21 3 Panoramic Power’s non-invasive, self-powered wireless sensors can be installed quickly and easily, with little or no disruption or downtime to your operations. Enabling access to energy data and analytics through a single platform. Sensor installation Easily attach the non-invasive self-powered sensors to the outgoing electrical wire. Each individual sensor will start tracking the energy usage of the device, equipment or process. Analysis and action Capturing energy data in a single platform provides a powerful interface to monitor, measure, report, and understand energy consumption from multi-site level to individual device level. Monitoring and data Data is continuously received from the sensors and wirelessly transmitted to the analytics platform via cloud technology, all in real-time. Panoramic Power Energy insights
  126. 126. Centrica Business Solutions 129 Cloud based analytics platform for understanding your consumption
  127. 127. Centrica Business Solutions 130 Energy Insights Device level visibility and energy insights 14bn global data points across 53k sensors and in 30 countries Demand Side Response Additional revenues from existing assets Europe’s #1 Demand Side Response provider with c. 5GW under management globally Battery Storage Additional revenue Patented battery optimisation driving industry leading returns Roosecote 49MW and Gateshead 3MW battery developed, 18MW battery live this week in Belgium Combined Heat and Power 25% increase in energy efficiency UK’s largest CHP provider, with over 3k units in market Integrated Solutions Platform Solar 100% renewable generation 150MW of solar power managed globally with 6.5k solar panels in the UK Delivering an integrated approach
  128. 128. Centrica Business Solutions Optimising the value of onsite generation 131 Connection and supply e.g. Bord Gáis, British Gas and Direct Energy Wholesale market trading Energy insight Operations and maintenance Power generation e.g. back up- generator Automated Demand Side Response Combined heat and power (CHP) Energy efficiency e.g. solar panels, LED lighting, heating, ventilation and air-conditioning (HVAC) Battery storage
  129. 129. Centrica Business Solutions 132 Combined Heat and Power Solar PV Battery storage charge Battery storage discharge Grid import An illustrative Distributed Energy strategy
  130. 130. Centrica Business Solutions CHP helps hospital cut carbon emissions to the equivalent of removing 1,000 cars Customer objective • Offer healthcare services for three million • Make cost effective energy decisions • Produce sustainable energy The solution Centrica Business Solutions installed a brand new Combined Heat & Power (CHP) unit that: • Reduced electricity consumption • Cut energy spending • Slashed energy-related concerns • Created healthcare investment opportunities University Hospitals of the North Midlands (UHNM) 133 “We chose Centrica Business Solutions because their product offered the best fit for our needs. It offered the best savings in consumption, cost and carbon over the 15 year life of the installation. I would definitely recommend them for CHP installation and maintenance.” Charlie Cox Energy Manager University Hospitals of the North Midlands, NHS Trust £500 K 2,000 20 CHP unit saves £500,000 annually Carbon emissions cut by 2,000 tonnes Carbon cuts same as hiring 20 nurses
  131. 131. Centrica Business Solutions 24 Thank you If you have any questions please contact us: Tony Orton Distributed Energy Sales Manager Centrica Business Solutions Email: Tony.Orton@centrica.com Centrica Business Solutions Email: CentricaBusinessSolutions@centrica.com Website: www.centricabusinesssolutions.com Twitter: @CentricaSoln_UK
  132. 132. “Sustainable Solutions for a Circular Economy”
  133. 133. IntroductionTo Sterimelt and a Sustainable Recycling Solution for Clinical ‘SterilisationWrap’ • Burton Queen’s Hospital • Sterilisation Wrap • Legal and Compliance • Sterimelt • Benefits to Health care industry • BBC News – NHS News - Awards - Social Media • Ongoing Solutions, Projects and Opportunities • Questions and Comments • October 2018 www.tcg.ltd136 Today’s Presentation Agenda
  134. 134. October 2018 www.tcg.ltd137 Where would you rather see your NHS money being spent..?? BEDS BINSOR
  135. 135. October, 2018 www.tcg.ltd 138 Burton NHS FoundationTrust
  136. 136. SterilisationTheatreWrap Typical operating room featuring “Wrap” • Clinical “Wrap” is a non-woven polypropylene sterile wrap that is used to maintain the sterility of instruments and equipment and can also be used as bed sheets, drapes and covers in the operating theatre. • “Over 4 Million Operations are performed across the NHS in England each year”- Natalie Roddis, Waste and Sustainability Officer- NHS Burton • WHO estimates, 75-90% of waste from healthcare facilities is non-hazardous. • Queen’s Hospital Burton produces about 16 tonnes of “Sterilisation wrap”-previously sent for incineration at very high cost. • Merged with the Royal Derby NHS in August 2018 to become University Hospitals Of Derby And Burton NHS FoundationTrust. October 2018 www.tcg.ltd139
  137. 137. October 2018 www.tcg.ltd140 Legal and Compliance Independent EmissionsTest Environment Agency & Natural ResourcesWales Independent Lab Report
  138. 138. October 2018 www.tcg.ltd141 Ø Reduction inVolume by 80 to 85% Ø Operator Free for Other Duties During Densification Process Ø Diverts From Landfill and/or Incineration - Sustainable Ø 100% Compliant Recycling Process – Circular Economy Ø Current Revenue Stream from PP Ø Processed Blocks Re-Manufactured–Circular Economy Ø Ø ”Savings from disposal costs for the UK of Circa £12,750,000 should Sterimelt be implemented across the NHS.The revenue created for the UK could reach £6,500,000”- Natalie Roddis, Waste and Sustainability Officer- NHS Burton Ø Save on disposal costs Ø Earn Revenue for tonnages recycled Ø
  139. 139. The Simple Sterimelt Process
  140. 140. October 2018 www.tcg.ltd143 BenefitsToThe Healthcare Industry
  141. 141. October 2018 www.tcg.ltd144 BBCWales – NHS – Awards – Social Media
  142. 142. TCG Ltd- Further Projects, Solutions and Opportunities……. • Single Use Disposable PatientTransfer Sheets • Successfully processed PTS supplied by M.I.P. UK Ltd (Formerly Cromptons) • Significant opportunity to recycle yet more “single use disposable” products. October 2018 www.tcg.ltd145 • Disposable Curtain Recycling – Innovate UK • Ongoing trials of volume reduction and recycling of disposable curtains • Significant opportunity to recycle yet more “single use disposable” products.
  143. 143. www.tcg.ltd “World First Sustainable Healthcare Innovation” ThankYou ForYourTime And Attention --Any Questions….???
  144. 144. Delivering Energy Savings through ‘Low Cost’ Interventions Presented by: Darren Jones BSc (Hons), C.Eng. FCIBSE LCC LCEA Manchester NHS Sustainability Day Roadshow – 14th February 2019 www.lowCO2.eu
  145. 145. An overview 1. Hospital Energy Efficiency; the Drivers & Barriers 2. BMS Optimisation 3. Operating Theatre Optimisation - Case Studies 4. Lighting Upgrades & Controls 5. Steam and Condensate Systems 6. Chiller Upgrades & Optimisation 7. Summary - Technological Improvements 8. Summary - Non Technical Opportunities 9. 10.
  146. 146. Ø Ø Economic: Electricity and other energy prices are rising, NHS Trusts are currently in financial deficit. Ø Political: Global, European and National Targets. Climate Change Act, Carbon Reduction Targets. Ø Environmental: Reducing energy waste reduces GHG emissions and accompanying environmental impacts. Ø Social: Energy efficiency has health benefits, both in the home and at work. Fuel poverty impacts on the whole health economy. Ø Hospital Energy Efficiency – The Drivers
  147. 147. Common barriers include: Ø Financial Restrictions Ø Economic Uncertainty and Risk Ø Information and Skill Gaps Ø Poor Commissioning Ø Poor Maintenance Ø Sub-optimum Engineering Design Hospital Energy Efficiency – The Barriers
  148. 148. Ø Avoid a wide range of set temperatures. Adopt a heating schedule policy. Ø Ensuring a dead band of at least 3 C (+/-1.5ºC) is factored into○◦ BMS strategies will help to prevent simultaneous heating and cooling taking place. Ø Ø Reviewing temperature and pressure sensor calibration on a frequent basis will help maintain optimum control efficiency. What you see on the BMS, is often not the reality… • Quick Win – BMS Control Set-point Optimisation
  149. 149. Recommendation – Repair Fresh Air Actuator Issue – Faulty Actuator Annual Energy Saving – 30,000kWh Annual Cost Saving – £1,350 Implementation Cost – £350 Payback Period – 3 Months Damper Actuators
  150. 150. Recommendation – Replace Fresh Air Actuator Issue – Actuator Removed Annual Energy Saving – 190,000kWh Annual Cost Saving – £9,500 Implementation Cost – £500 Payback Period – Under 1 Month Damper Actuators
  151. 151. Ø The cooling and heating control valves on many AHUs ‘let-by’, which isn’t always evident from the BMS head-end. Ø A more invasive inspection of plant will identify this type of issue. Replacing or repairing control valves on AHUs will prevent losses across the system. AHU Heating/Cooling Emitters
  152. 152. Ø Chiller Flow Temperatures – 5 Degrees C. too low!! Ø 1 Degree C. increase equates to a 3% performance improvement… Ø Ø Ø Ø Ø Quick Win – Control Set-point Optimisation Office Building Sever Room
  153. 153. Simultaneous Heating and Cooling
  154. 154. Simultaneous Heating and Cooling
  155. 155. Thermal Wheels - Heat/Coolth Reclaim Can reduce plant running costs by up to 50%
  156. 156. Recommendation – Clean Coil Face (Jet or Steam) Issue – Soiled Coil Face Annual Energy Saving – 300,000kWh Annual Cost Saving – £15,000 Implementation Cost – £500 Payback Period – Under 1 Month Heating/Cooling - Soiled Coil Faces
  157. 157. Filter Media What impact does dirty filter media have on energy consumption?
  158. 158. Variable Speed Drives - Interlocked with BMS Ø Chiller Compressor Control Ø Chiller Condensing Fan Control Ø Chilled Water Circuits Ø Condensing Water Circuits Ø Heating Water Pump Control Ø Ventilation Fan speed control
  159. 159. Ø We have proved that by improving the air supply in one theatre alone, a Trust could save in the region of £5,000 a year. Ø Ø If this figure was extended to all the Trusts in England, it could mean a saving of more than £10m and a reduction in carbon emissions of 80,000 tonnes a year! Operating Theatre Optimisation
  160. 160. Operating Theatre Optimisation Mile End Hospital
  161. 161. Rec. No. Complexity (1 = Simple, 3 = Complex) Relates To: Recommendation Est. Cost (£) CO2 Emissions Reductions (Tonnes) Annual Energy Saving (kWh) Annual Saving (£) Simple Payback Period (Months) 1 2 All Theatres Consider reducing Air Change Rate in line with HTM requirement in order to reduce energy. £600 14.27 26,718 £2,671 3 2 1 All Theatres Consider removing the HEPA filters to reduce system pressure. £100 5.7 10,512 £1,051 1 3 3 All Theatres Consideration should be given to replacing supply fans with high efficiency units in order to reduce power drawn by the systems. £5,000 3.88 7,183 £718 84 4 2 All Theatres It is recommended that the time schedules for the Theatre unit are changed in line with occupancy hours. £600 6.44 11,913 £1,190 6 5 3 Cooling Plant Consideration should be given to installing variable speed drives (VSDs) and controlling pumps based on demand, and the adoption of a 2-way valve system on the chiller plant. £6,300 13 23,875 £2,387 32 6 2 Heating Plant A review of installation of a software interlock, and the adoption of time schedule to prevent the unnecessary operation of heating pumps during low demand. £600 6.2 11,466 £1,147 6 7 2 All Theatres Consideration could be given to reducing the temperature set-point. £600 16.3 88,595 £2,658 3 8 2 All Theatres It is recommended that the existing VSDs on the Theatre unit are utilised by modulating the fan speed in accordance with system demand. £600 11.3 21,000 £2,100 3 Totals* £14,400 77 201,262 £13,922 12 *Savings are not considered cumulative, totals shown for representation purposes only. Summary of Recommendations – Mile End Hospital
  162. 162. Recommendation 1 Consider Reducing Air Change Rates Room Room Size (m²) Total Flow Rate (m³/h) Air Change Rate (per hour) Recommended Air Changes (per hour) Achievement of Design Values (%) Theatre & Scrub 188.2 3178.8 16.9 15 113 Anaesthetic 61.0 1746.0 28.6 15 191 Prep 44.5 648.0 14.6 10 146 Air Flow Results Ø The Theatre & Scrub AHU is running at 3,178.8 m³/h vs. the required duty of 2,813 m³/h, the volume can therefore be reduced by 13%. The Anaesthetic & Prep AHU is running at 2,394 m³/h vs. the required duty of 1,357.98 m³/h, a 44% reduction is therefore possible. Ø Ø This initiative can be achieved through modification of the operating frequency on the Variable Speed Drive (VSD). Ø Ø Following the fan laws, this equates to a reduction in energy of 34% and 82.4% respectively.
  163. 163. Recommendation 2 Consider removing the HEPA filters from the AHUs ØThe AHUs serving the theatres at Mile End were found to contain HEPA filters. As HEPA filters are only a requirement for ultra clean theatres, it is recommended that consideration be given to their removal from the system. Ø ØOwing to the high pressure drops developed by HEPA filters, the reduction in energy has been calculated to be 1.2kW, equating to a £1,051 saving per annum.
  164. 164. Recommendation 7 Consider reducing temperature set-point The existing controls for the Air Handling Units are controlled to a set-point of 25˚C; this is considered high. It is recommended that this set-point be reviewed and adjusted to nearer 21˚C. Reducing the temperature by 4˚C would reduce the energy consumption by approximately 27%. Supply Air Temperature (Heating Coil) = 25.00 0 C Total Air Volume = 0.88 m3 /s Daily Running Hours = 24.00 hr UK Geographical Location = Month Total Degree Days (K.day) No. of Days in Month Mean Deviation (∆T) from Base Temp (15.5) (0 C) Operational Hours Load Factor Average Fresh Air Temp (0 C) Supply Air Temp Required (0 C) Mean Heating Coil Uplift (0C) Mean Monthly kWhr Jan 340 31 10.97 1.00 4.53 25.00 20.47 16,473.56 Feb 309 28 11.04 1.00 4.46 25.00 20.54 14,930.23 Mar 261 31 8.42 1.00 7.08 25.00 17.92 14,421.41 Apr 197 30 6.57 1.00 8.93 25.00 16.07 12,515.41 May 111 31 3.58 1.00 11.92 25.00 13.08 10,526.34 Jun 49 30 1.63 1.00 13.87 25.00 11.13 8,668.11 Jul 20 31 0.65 1.00 14.85 25.00 10.15 8,168.38 Aug 23 31 0.74 1.00 14.76 25.00 10.24 8,240.81 Sep 53 30 1.77 1.00 13.73 25.00 11.27 8,777.14 Oct 128 31 4.13 1.00 11.37 25.00 13.63 10,968.96 Nov 234 30 7.80 1.00 7.70 25.00 17.30 13,473.34 Dec 308 31 9.94 1.00 5.56 25.00 19.44 15,644.65 Totals 2,033 365 142,808.34 Boiler Efficiency = 75.00 % Gas Tariff = 3.00 p/kW Annual Input kWhr = 190,411.12 kWhr Annual Heating Cost = £5,712.33 Thames Valley - Heathrow Supply Air Temperature (Heating Coil) = 25.00 0 C Total Air Volume = 0.67 m3 /s Daily Running Hours = 24.00 hr UK Geographical Location = Month Total Degree Days (K.day) No. of Days in Month Mean Deviation (∆T) from Base Temp (15.5) (0 C) Operational Hours Load Factor Average Fresh Air Temp (0 C) Supply Air Temp Required (0 C) Mean Heating Coil Uplift (0C) Mean Monthly kWhr Jan 340 31 10.97 1.00 4.53 25.00 20.47 12,406.48 Feb 309 28 11.04 1.00 4.46 25.00 20.54 11,244.17 Mar 261 31 8.42 1.00 7.08 25.00 17.92 10,860.97 Apr 197 30 6.57 1.00 8.93 25.00 16.07 9,425.54 May 111 31 3.58 1.00 11.92 25.00 13.08 7,927.54 Jun 49 30 1.63 1.00 13.87 25.00 11.13 6,528.08 Jul 20 31 0.65 1.00 14.85 25.00 10.15 6,151.72 Aug 23 31 0.74 1.00 14.76 25.00 10.24 6,206.27 Sep 53 30 1.77 1.00 13.73 25.00 11.27 6,610.19 Oct 128 31 4.13 1.00 11.37 25.00 13.63 8,260.88 Nov 234 30 7.80 1.00 7.70 25.00 17.30 10,146.97 Dec 308 31 9.94 1.00 5.56 25.00 19.44 11,782.21 Totals 2,033 365 107,551.02 Boiler Efficiency = 75.00 % Gas Tariff = 3.00 p/kW Annual Input kWhr = 143,401.36 kWhr Annual Heating Cost = £4,302.04 Thames Valley - Heathrow 24 Hours at 25˚C = Annual heating cost of £10,014.37
  165. 165. Recommendation 7 Consider reducing temperature set-point Supply Air Temperature (Heating Coil) = 21.00 0 C Total Air Volume = 0.88 m3 /s Daily Running Hours = 24.00 hr UK Geographical Location = Month Total Degree Days (K.day) No. of Days in Month Mean Deviation (∆T) from Base Temp (15.5) (0 C) Operational Hours Load Factor Average Fresh Air Temp (0 C) Supply Air Temp Required (0 C) Mean Heating Coil Uplift (0C) Mean Monthly kWhr Jan 340 31 10.97 1.00 4.53 21.00 16.47 13,254.50 Feb 309 28 11.04 1.00 4.46 21.00 16.54 12,022.69 Mar 261 31 8.42 1.00 7.08 21.00 13.92 11,202.35 Apr 197 30 6.57 1.00 8.93 21.00 12.07 9,400.19 May 111 31 3.58 1.00 11.92 21.00 9.08 7,307.28 Jun 49 30 1.63 1.00 13.87 21.00 7.13 5,552.89 Jul 20 31 0.65 1.00 14.85 21.00 6.15 4,949.31 Aug 23 31 0.74 1.00 14.76 21.00 6.24 5,021.74 Sep 53 30 1.77 1.00 13.73 21.00 7.27 5,661.92 Oct 128 31 4.13 1.00 11.37 21.00 9.63 7,749.90 Nov 234 30 7.80 1.00 7.70 21.00 13.30 10,358.12 Dec 308 31 9.94 1.00 5.56 21.00 15.44 12,425.59 Totals 2,033 365 104,906.48 Boiler Efficiency = 75.00 % Gas Tariff = 3.00 p/kW Annual Input kWhr = 139,875.31 kWhr Annual Heating Cost = £4,196.26 Thames Valley - Heathrow 24 Hours at 21˚C = Annual heating cost of £7,356.52 Supply Air Temperature (Heating Coil) = 21.00 0 C Total Air Volume = 0.67 m3 /s Daily Running Hours = 24.00 hr UK Geographical Location = Month Total Degree Days (K.day) No. of Days in Month Mean Deviation (∆T) from Base Temp (15.5) (0 C) Operational Hours Load Factor Average Fresh Air Temp (0 C) Supply Air Temp Required (0 C) Mean Heating Coil Uplift (0C) Mean Monthly kWhr Jan 340 31 10.97 1.00 4.53 21.00 16.47 9,982.15 Feb 309 28 11.04 1.00 4.46 21.00 16.54 9,054.46 Mar 261 31 8.42 1.00 7.08 21.00 13.92 8,436.65 Apr 197 30 6.57 1.00 8.93 21.00 12.07 7,079.42 May 111 31 3.58 1.00 11.92 21.00 9.08 5,503.22 Jun 49 30 1.63 1.00 13.87 21.00 7.13 4,181.96 Jul 20 31 0.65 1.00 14.85 21.00 6.15 3,727.40 Aug 23 31 0.74 1.00 14.76 21.00 6.24 3,781.95 Sep 53 30 1.77 1.00 13.73 21.00 7.27 4,264.07 Oct 128 31 4.13 1.00 11.37 21.00 9.63 5,836.56 Nov 234 30 7.80 1.00 7.70 21.00 13.30 7,800.85 Dec 308 31 9.94 1.00 5.56 21.00 15.44 9,357.89 Totals 2,033 365 79,006.58 Boiler Efficiency = 75.00 % Gas Tariff = 3.00 p/kW Annual Input kWhr = 105,342.11 kWhr Annual Heating Cost = £3,160.26 Thames Valley - Heathrow Ø This initiative can be achieved by a simple adjustment on the BMS.
  166. 166. Operating Theatre Optimisation Newham University Hospital
  167. 167. Rec. No. Complexity (1 = Simple, 3 = Complex) Relates To: Recommendation Est. Cost (£) CO2 Emissions Reductions (Tonnes) Annual Energy Saving (kWh) Annual Saving (£) Simple Payback Period (Months) 1 2 Theatre 3 Consider reducing Air Change Rate in line with HTM requirement in order to reduce energy. £300 7 12,973 £1,297 3 2 1 Theatre 1 It is recommended that the run around coil pump system be reinstated in order to reduce load on the boilers. £1,000 25.6 138,842 £4,165 3 3 3 All Theatres Consideration should be given to replacing supply fans with high efficiency units in order to reduce power drawn by the systems. £29,000 34 61,854 £6,186 56 4 1 Theatre 2 Consider replacing air seals around openings in order to reduce air leakage. £150 0.2 328 £33 56 5 1 Theatre 4/5 Consideration should be given to repairing the thermal wheel in order to reduce load on heating and cooling. £3,000 55 297,518 £8,925 4 6 2 All Theatres Consider adjusting the frost coil set-point in order to reduce heating load which could be recovered through use of the run around coil. £1,000 210 1,141,658 £34,250 1 7 2 All Theatres Consideration could be given to introducing PIR control so that energy can be reduced during periods of inactivity. £1,000 11 20,617 £2,062 6 Totals* £35,450 342.2 1,673,790 £56,918 8 *Savings are not considered cumulative, totals shown for representation purposes only. Summary of Recommendations – Newham University Hospital
  168. 168. Recommendation 2 Consider reinstating the run around pump system The run around coil recovery system is capable of recovering around 50% of the heating/cooling energy. With the pumps out of order, the heating coil is operating at a higher demand than would be expected. Through the use of simulation software, we can calculate that the heating energy used is 277,683.67kWh. By repairing the run around coil pump we can assume that this figure will be reduced by 50%; this equates to a £4,165 saving per annum. Supply Air Temperature (Heating Coil) = 21.00 0 C Total Air Volume = 3.50 m3 /s Daily Running Hours = 14.00 hr UK Geographical Location = Month Total Degree Days (K.day) No. of Days in Month Mean Deviation (∆T) from Base Temp (15.5) (0 C) Operational Hours Load Factor Average Fresh Air Temp (0 C) Supply Air Temp Required (0 C) Mean Heating Coil Uplift (0C) Mean Monthly kWhr Jan 340 31 10.97 1.20 5.44 21.00 15.56 28,953.66 Feb 309 28 11.04 1.25 5.58 21.00 15.42 25,916.39 Mar 261 31 8.42 1.21 8.57 21.00 12.43 23,129.43 Apr 197 30 6.57 1.19 10.63 21.00 10.37 18,673.78 May 111 31 3.58 1.16 13.83 21.00 7.17 13,341.76 Jun 49 30 1.63 1.13 15.67 21.00 5.33 9,598.00 Jul 20 31 0.65 1.12 16.63 21.00 4.37 8,131.59 Aug 23 31 0.74 1.11 16.38 21.00 4.62 8,596.78 Sep 53 30 1.77 1.13 15.51 21.00 5.49 9,886.12 Oct 128 31 4.13 1.14 12.96 21.00 8.04 14,960.63 Nov 234 30 7.80 1.15 8.86 21.00 12.14 21,861.11 Dec 308 31 9.94 1.34 7.45 21.00 13.55 25,213.50 Totals 2,033 365 208,262.75 Boiler Efficiency = 75.00 % Gas Tariff = 3.00 p/kW Annual Input kWhr = 277,683.67 kWhr Annual Heating Cost = £8,330.51 Thames Valley - Heathrow
  169. 169. Recommendation 5 Consider repairing the thermal wheel At the time of inspection, the wheel serving Theatre 4/5 had failed and was therefore not rotating. Repairing the thermal will provide savings equating to a £8,925 per annum.
  170. 170. Recommendation 5 Consider repairing the thermal wheel The thermal wheel is capable of recovering around 75% of the heating energy. Through the use of simulation software, we can calculate that the heating energy used is 396,690.96kWh. By repairing the thermal we can assume that this figure will be reduced by 75%; this equates to a £8,925 saving per annum. Supply Air Temperature (Heating Coil) = 21.00 0 C Total Air Volume = 5.00 m3 /s Daily Running Hours = 14.00 hr UK Geographical Location = Month Total Degree Days (K.day) No. of Days in Month Mean Deviation (∆T) from Base Temp (15.5) (0 C) Operational Hours Load Factor Average Fresh Air Temp (0 C) Supply Air Temp Required (0 C) Mean Heating Coil Uplift (0C) Mean Monthly kWhr Jan 340 31 10.97 1.20 5.44 21.00 15.56 41,362.37 Feb 309 28 11.04 1.25 5.58 21.00 15.42 37,023.42 Mar 261 31 8.42 1.21 8.57 21.00 12.43 33,042.05 Apr 197 30 6.57 1.19 10.63 21.00 10.37 26,676.83 May 111 31 3.58 1.16 13.83 21.00 7.17 19,059.65 Jun 49 30 1.63 1.13 15.67 21.00 5.33 13,711.43 Jul 20 31 0.65 1.12 16.63 21.00 4.37 11,616.55 Aug 23 31 0.74 1.11 16.38 21.00 4.62 12,281.12 Sep 53 30 1.77 1.13 15.51 21.00 5.49 14,123.03 Oct 128 31 4.13 1.14 12.96 21.00 8.04 21,372.33 Nov 234 30 7.80 1.15 8.86 21.00 12.14 31,230.15 Dec 308 31 9.94 1.34 7.45 21.00 13.55 36,019.29 Totals 2,033 365 297,518.22 Boiler Efficiency = 75.00 % Gas Tariff = 3.00 p/kW Annual Input kWhr = 396,690.96 kWhr Annual Heating Cost = £11,900.73 Thames Valley - Heathrow
  171. 171. Operating Theatre Optimisation Whipps Cross University Hospital
  172. 172. *Savings are not considered cumulative, totals shown for representation purposes only. Rec. No. Complexity (1 = Simple, 3 = Complex) Relates To: Recommendation Est. Cost (£) CO2 Emissions Reductions (Tonnes) Annual Energy Saving (kWh) Annual Saving (£) Simple Payback Period (Months) 1 2 All Theatres Consider installing occupancy detection in order to control ventilation on demand. 20,000 53 114,395 11,439 21 2 1 Theatres 5 - 8 Consider reviewing filter specification in order to reduce system pressure and associated fan power requirement. 50 11 23,060 2,306 1 3 2 Theatres 5 & 6 Consider reducing the extract ventilation rate to the HTM03-01 standard so that fan power is reduced. 500 5 10,353 1,035 6 4 3 Theatres 3 & 4 Consider installing an energy recovery device to theatre 3 & 4 in order to reduce the heating requirement. 12,000 30 160,717 4,822 30 5 3 Theatres 3 & 4 Consider replacing the plant serving theatre 3 & 4 with a packaged AHU in order to greatly improve system efficiency. - - - - - 6 3 All Theatres Consider replacing fans with high efficiency units in order to reduce power draw. 22,000 23 48,697 4,870 54 7 1 Theatres 5 – 8 Consider improving thermal insulation on pipework in order to reduce system losses. 1,000 2 13,140 395 30 8 1 Boiler Plant Review boiler room insulation and pumps in order to increase system efficiency. 4,500 12 56,502 1,971 27 9 2 All Theatres Consider reinstating automatic control in order to avoid excessive energy use. 40,000 146 665,844 25,980 18 Totals* £100,050 282 1,092,708 52,818 23 Summary of Recommendations - Whipps Cross University Hospital
  173. 173. Recommendation 4 Consider Installation of an Energy Recovery Device A run around coil system normally consists of two coils that are connected to each other via a pumped circuit of water. The water absorbs heat from the exhaust air coil and dissipates it through the supply air coil.
  174. 174. Recommendation 4 Consider Installation of an Energy Recovery Device There is currently no heat recovery device installed within the system serving theatres 3&4. A run-around-coil energy recovery system is typically capable of recovering around 50% of the heating/cooling energy from the extracted air, which is then transferred to the supply air. Installing a RAC will provide savings of 50%; this equates to a £4,821 per annum. Supply Air Temperature (Heating Coil) = 21.00 0 C Total Air Volume = 1.92 m3 /s Daily Running Hours = 24.00 hr UK Geographical Location = Month Total Degree Days (K.day) No. of Days in Month Mean Deviation (∆T) from Base Temp (15.5) (0 C) Operational Hours Load Factor Average Fresh Air Temp (0 C) Supply Air Temp Required (0 C) Mean Heating Coil Uplift (0C) Mean Monthly kWhr Jan 351 31 11.32 1.00 4.18 21.00 16.82 29,433.12 Feb 327 28 11.68 1.00 3.82 21.00 17.18 27,153.75 Mar 283 31 9.13 1.00 6.37 21.00 14.63 25,600.86 Apr 218 30 7.27 1.00 8.23 21.00 12.77 21,625.23 May 135 31 4.35 1.00 11.15 21.00 9.85 17,236.40 Jun 68 30 2.27 1.00 13.23 21.00 7.77 13,158.03 Jul 32 31 1.03 1.00 14.47 21.00 6.53 11,426.77 Aug 38 31 1.23 1.00 14.27 21.00 6.73 11,776.75 Sep 75 30 2.50 1.00 13.00 21.00 8.00 13,547.52 Oct 158 31 5.10 1.00 10.40 21.00 10.60 18,548.81 Nov 254 30 8.47 1.00 7.03 21.00 13.97 23,657.36 Dec 324 31 10.45 1.00 5.05 21.00 15.95 27,910.71 Totals 2,263 365 241,075.31 Boiler Efficiency = 75.00 % Gas Tariff = 3.00 p/kW Annual Input kWhr = 321,433.75 kWhr Annual Heating Cost = £9,643.01 South Eastern - Gatwick
  175. 175. Recommendation 6 Consider changing fans to high efficiency direct drive There are multiple options for a direct drive replacement but as shown in the example below, removing the existing fan (1) from the AHU, then enlarging the opening (2) would allow for a new plenum wall to be installed (3), which would then facilitate the installation of a plug fan (4). The new direct drive fan in this example has an absorbed power of 1.7kW at the same volume and pressure as the original, this represents a 43% reduction.
  176. 176. Lighting upgrades & Controls Provide advice on energy efficient lighting upgrades: Ø LED Ø Induction lamps Ø Integrated sensor systems with light reflectors for optimum output Ø Retro fit or upgrade from T12 & T8 to T5 • Provide advice on lighting system controls and their efficiency: Ø Dimmable control systems Ø PIR sensors Ø Photocells • Our approach is to undertake a lighting survey using calibrated Lux meters to determine current lighting levels, which are then compared against healthcare requirements in accordance with the relevant CIBSE Lighting Guide. • •
  177. 177. Steam and Condensate Systems Ø Steam raising plant optimisation – pressure regimes and boiler setback/sequencing Ø Ø Suitability of steam traps and associated components Ø Ø Reduction of thermal losses – pipework insulation review utilising infrared thermography Ø Ø Water treatment – TDS levels Ø Ø Heat & condensate recovery – boiler blow down, flue gas economisers Ø Ø System zoning – minimisation of live circuits and utilising motorised valves Ø Ø Steam metering and monitoring Ø Ø Condensate pump optimisation – demand control on VSDs Ø Ø Oxygen trim – burner optimisation Ø Ø Feed pump modulation
  178. 178. Chiller Upgrades & Optimisation Ø Review and improve chiller controls Ø Ø Establish opportunities for condenser coil heat reclaim Ø Ø Investigate opportunities for liquid pressure amplification (LPA) Ø Ø Investigate opportunities for condensing fan optimisation Ø Ø Review opportunities to retro-fit chiller, free-cooling circuits • • •
  179. 179. Quick Win – Free Cooling Opportunity
  180. 180. Ø 7 Temperatures Ø 2 Pressures Ø 1 Power Input Evaluating chiller performance & the Scope for Optimisation
  181. 181. Advantages of this method: Ø No need to install flow meters Ø Ø Easy to use Ø Ø Analysis within 30 minutes, without reliance on pre-installed device Ø Ø Better field accuracy at much lower cost than traditional method Ø Evaluating chiller performance & the Scope for Optimisation - Recommissioning
  182. 182. Performance evaluation Ø COP (+/- 5 %) Ø Ø Capacity (+/- 7%) Ø Ø Power input Ø Super-heat Ø Ø Sub-cool Ø Ø Evaporator performance Ø Condenser performance Evaluating chiller performance and the Scope for Optimisation Operational evaluation Ø Correct charge Ø Ø Optimisation of expansion device Ø Ø Compressor defects Ø Ø Stability or instability
  183. 183. Summary - Technological Improvements Ø BMS Optimisation Ø HVAC Optimisation Ø Air Handling Unit Optimisation Ø Effective control of Variable Speed Drives Ø Improved Lighting and Lighting Controls Ø Re-commissioning – no building is fully commissioned
  184. 184. Summary - Non Technical Opportunities Ø Behavioural Change Programme Ø Monitor Energy and Water Consumption Trends Ø Invoice Validation Ø CHP QA Ø Review of Energy Tariffs
  185. 185. Thank you for listening… Any Questions Please?
  186. 186. #DAYFORACTION Conference close #dayforaction

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