Design and Delivery of Robust Hospital Environments in a Changing Climate (DeDeRHECC)

Lead Research Organisation: University of Cambridge
Department Name: Architecture

Abstract

The Department of Health (DH) and the NHS are particularly exercised by climate change. Whereas the occupants of other building types might consider raising their comfort temperature thresholds a little in summer and suspend the use of mechanical cooling, NHS patients' well being and safety may well be compromised by higher summer temperatures. In fact the DH and the NHS are hit by a double whammy, the pressure to reduce energy consumption, colliding with the pressure to protect their patients and staff from overheating, the dangers of which were manifest in recent years' summer heatwaves. Innovative low energy design strategies and techniques will be required both for new buildings and, most importantly, for the existing building stock, the 27,701,676 square metres of the NHS Retained Estate. However there are many barriers to the implementation of such innovative interventions in NHS buildings, patient safety being paramount. Worries include the inability to achieve stable temperature control and safe ventilation (the airborne transmission of pathogens is an emerging science as our colleague Dr.Cath Noakes freely admits), the proliferation in the use of medical equipment adding heat to hospital interiors and the mechanics of modern contractual arrangements which place private companies in charge of the Facilities Management of health buildings, which, unsurprisingly, given the penalties they face, are ultra-cautious about adopting change.This project, 'Design and delivery of Robust Hospital Environments in a Changing Climate' (DeDeRHECC), will investigate these conundra to come up with economical and practical low energy refurbishment strategies for existing hospitals. It will derive a closer definition of resilience in the context of an acute hospital and, most particularly, the criteria set for hospital environments for the various categories of space found in hospitals; non-clinical, patient rooms, diagnostic and treatment, even operating theatres. The team is sceptical that these all align into a cherent requirement and will review UK and US criteria. Using four sets of hospital sites drawn from the project's four participating major NHS Trusts, it will 'catalogue' basic hospital building types from this sizeable sample of NHS stock, identify those most frequently occurring, assess their current resilience to climate change and propose appropriate solutions or clusters of interventions for each 'type'. It will model these ideas so that relative energy savings can be quantified and their resilience to warming external temperatures determined. It will cost them. It will calculate the lifetime running costs and energy savings and assess Value for Money. It will also examine the procurement environment in which these innovative solutions need to be delivered, the protocols by which refurbishment projects are designed, approved and implemented. Their delivery will incur risks. The project will take innovative risk assessment tools for change, developed for engineering design, and apply them to these future large and medium scale construction projects. It will develop processes to make the integration of these innovative, low energy interventions into hospital refurbishment projects smoother and more familiar to those who will be delivering them. It will produce guidance and worked examples in text and web form and, most significantly, as a DVD film of participants discussing the challenges, their anxieties, the ideas and how to deliver them. Accompanying animations will communicate the strategies and communications vividly and quickly to very busy people.

Publications

10 25 50
 
Title Robust Hospital Environments in a Changing Climate 
Description Film to accompany the project, winner of the Global Sustainability Film Award at BAFTA 2013, the full length 30 minute version which includes other hospital types, most notably the remarkably resilient Nightingale wards, is available at www.sms.cam.ac.uk/media/1446036. 
Type Of Art Film/Video/Animation 
Year Produced 2013 
Impact Watched across China, India, S. Africa and S.America by Propellor TV and related broadcasters. 
URL http://sms.cam.ac.uk/media/1559781
 
Description DeDeRHECC builds on 20 years of research into natural ventilation and passive cooling of non-domestic buildings led by Short, more recently focused on hospitals: 'Design Strategy for low energy ventilation and cooling of health buildings', National Institute for Health Research (NIHR), Department of Health, Estates and Facilities Division Research and Development Fund 2007-09, (£265K) and NIHR funded 'Watford Acute Hospital: Public Sector Comparator', application of NIHR project findings to proposed 600 bed new hospital for W.Herts NHS Trust (£184K). This work provided a working knowledge of the physical environments associated with healthcare and enabled the construction of the DeDeRHECC project. It demonstrates that substantial energy savings are available through good design and re-engineering of the existing building stock before the application of active renewable energy technologies. It gathered evidence in the form of real temperature data over three years, calibrating computational models of the buildings selected used to predict future performance and from this diagnostic exercise it presents a series of re-engineering options for the most recurrent hospital types, costs them in detail, showing that re-engineering is cheaper, faster, safe and effective as opposed to wholesale demolition of the NHS Acute Estate. Since completion of the EPSRC project we have intensified collaborations with the Dept of Health and the NHS through firstly the implementation of the NHS Energy Efficiency Fund 2013-14, adjudicating the distribution of the £50 million Fund across NHS England with the Professor of Sustainable Engineering UoC, reporting to the Under-Secretary of State for Health and Lord Carter of Coles NHS Procurement, ongoing, the Executive Summary was published in February 2015 at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/407160/EEF.pdf. and writing the guidance on sustainability for the NHS as Health Technical Memorandum 07-02 with UoC Prof of Sustainable Engineering and the Centre for Sustainable Development, Health Technical Memorandum (HTM) 07-02, published in March 2015 at: https://www.gov.uk/government/publications/making-energy-work-in-healthcare-htm-07-02. This guidance is referred to worldwide and introduces concepts such as adaptive comfort and methodologies for achieving more natural healthcare environments directly from DeDeRHECC case studies. We have developed an Adaptation Plan for the while of the NHS England Acute Hospital Estate, 12Million sq.m.at a cost of £17Billion, 4-5 years of NHS Backlog Maintenance budget, and published this in Short's 2017 book The Recovery of Natural Environments in Architecture,Taylor and Francis, Routledge.
Exploitation Route - Findings cited in the National Climate Change Risk Assessment for the Built Environment Sector Jan. 2012 and DEFRA's 'Adapting to Climate Change: National Adaptation Programme 2013 p.146.
- As a consequence of DeDeRHECC involvement with the DH Short was appointed as the external member of the Department of Health Energy Efficiency Working Group in Jan. 2013, adjudicating the distribution of the £50 million Energy Efficiency Fund from Public Dividend Capital to 50+ Trusts in NHS England out of 360+ applications. The Director of the DH Estates & Facilities Policy Division, Peter Sellars, comments in a letter to Cambridge University: "This valuable research project ... demonstrated that the existing estate is capable of being sustainably improved to achieve levels of ventilation and cooling which will extend the estates functional suitability for the foreseeable future Cambridge University's research [is] at the heart of government policy on making the country resilient to climate change."

- Short was subsequently commissioned to administrate and monitor the scheme and report to Ministers in Sep 2014. Prof. Peter Guthrie and members of the Cambridge University Centre for Sustainable Development are assisting, two Interim Reports to Ministers delivered. Our message is that with Mitigation comes an Adaptation co-benefit. The Under-Secretary of State Dr. Dan Poulter is enthusiastic about early outcomes and, we understand from DH officials, is considering the deployment of more resources to extend the scheme.
- The research team is appointed as Trust Advisor for the new Watford General Hospital to the West Herts. NHS Trust funded by NIHR by Sir Neil McKay former Director of the East of England Strategic Health authority on the advice of DH Estates and Facilities Policy, having formerly been included in the PFI project team, a very revealing engagement in which the project managers explained that the team was de-barred from considering climate change effects on the emerging design. The former W. Herts Chief Exec. Prof. Jan Filokowski sat on the DeDeRHECC Sounding Panel, now at Gt. Ormond St.
- The research team is appointed as advisor to Skanska for its current Papworth Hospital proposals which the Treasury has very recently sanctioned. Skanska's Head of Environment Greg Hall-Chant sat on the DeDeRHECC Sounding Panel and writes that our work has influenced the design of the new Karolinska Hospital in Solna, intended to be an exemplary sustainable hospital.
Sectors Construction

Energy

Environment

Healthcare

Government

Democracy and Justice

URL http://impact.ref.ac.uk/CaseStudies/CaseStudy.aspx?Id=2340
 
Description DeDeRHECC builds on 20 years of research into natural ventilation and passive cooling of non-domestic buildings led by Short, more recently focused on hospitals: 'Design Strategy for low energy ventilation and cooling of health buildings', National Institute for Health Research (NIHR), Department of Health, Estates and Facilities Division Research and Development Fund 2007-09, (£265K) and NIHR funded 'Watford Acute Hospital: Public Sector Comparator', application of NIHR project findings to proposed 600 bed new hospital for W.Herts NHS Trust (£184K). This work provided a working knowledge of the physical environments associated with healthcare and enabled the construction of the DeDeRHECC project. It demonstrates that substantial energy savings are available through good design and re-engineering of the existing building stock before the application of active renewable energy technologies. It gathered evidence in the form of real temperature data over three years, calibrating computational models of the buildings selected used to predict future performance and from this diagnostic exercise it presents a series of re-engineering options for the most recurrent hospital types, costs them in detail, showing that re-engineering is cheaper, faster, safe and effective as opposed to wholesale demolition of the NHS Acute Estate.
First Year Of Impact 2011
Sector Communities and Social Services/Policy,Construction,Energy,Environment,Healthcare,Other
Impact Types Cultural

Societal

Economic

 
Description Defra UK Climate Change Risk Assessment
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact The work of the DeDeRHECC team was featured in the 'Built Environment' section of the report, including the presentation of data gathered during the monitoring exercise at one of our Partner Trust hospitals. The report can be viewed at: http://randd.defra.gov.uk/Document.aspx?Document=CCRAfortheBuiltEnvironmentSector.pdf. Target Audience: Research Council / Institute;Government Department;Local Government;Hospital / NHS Trust;General Public
URL http://randd.defra.gov.uk/Document.aspx?Document=CCRAfortheBuiltEnvironmentSector.pdf
 
Description Making energy work in healthcare (HTM 07-02 )
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
Impact The National Health Service (NHS) is responsible for the management of its publicly funded healthcare estate. This includes the provision of an efficient, safe and resilient estate that supports both clinical services and improves the experience that patients have of their care and treatment. It should be a public sector exemplar for the implementation of Climate Change adaptation and mitigation strategies. The NHS estate has an important contribution to make in reducing running costs and delivering savings for investment in frontline patient care. These must be undertaken to meet the challenges of funding the NHS in the future and will form part of the government's drive to increase the efficiency of the public sector estate in parallel with the dual challenges of an ageing population and Climate Change. A significant step change in the way this estate is managed has to be achieved. The opportunities for the NHS to achieve efficiency savings and reduced running costs in the estate are considerable. These efficiencies need to be driven by: • more efficient plus effective running and use of the estate; • improved efficiency, including value for money, in capital procurement and construction; • improved energy efficiency and associated carbon reduction. Building energy use (gas and electricity) is 18% of the NHS England carbon footprint at a metered energy cost of £636 million .This cost equates to approximately 9% of the total estates budget of £7bn. In 2013/14 the Department's NHS Energy Efficiency Fund (NHS EEF) of £49.3M was allocated to 117 energy efficiency projects across 48 NHS organisations in England. The Fund enabled the NHS to go further, faster in mitigating the effects of climate change, by improving energy efficiency, whilst retaining the resulting benefits within the NHS organisations for re-investment directly into frontline patient services. The lessons learnt from these energy efficiency projects are embedded in Encode 2015 as best practice guidance. The current NHS Estates Efficiency programme has the challenge of reducing the current estates budget as part of the contribution to help ensure the continued delivery of a sustainable NHS. Improving energy efficiency of the NHS estate will deliver a contribution to this important initiative whilst also assisting the NHS to meet the necessary reductions in carbon emissions of 34% compared to 1990 levels by 2020.
URL https://www.gov.uk/government/publications/making-energy-work-in-healthcare-htm-07-02
 
Description NHS Energy Efficiency Fund Final Report to Ministers
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
Impact Alan Short was appointed Academic Advisor to the £50m Energy Efficiency Fund (Improving Energy Efficiency in the NHS) in late 2012, subsequently appointed to monitor and report on scheme from Cambridge University, authoring Final Report to Ministers submitted October 2014, due for publication early December 2014 Awarding Body - DH, Name of Scheme - Energy Efficiency Fund
 
Description 'Robust Hospitals in a Changing Climate' 
Organisation Screenspace
Country Australia 
Sector Private 
PI Contribution The 10 minute version of the film of the project findings 'Robust Hospitals in a Changing Climate' funded by EPSRC won the tv/e Global Sustainability Film Award for Governance at BAFTA in Oct 2013, available at http://sms.cam.ac.uk/media/1559781. The Awards ceremony was screened on Propellor TV across China, India and Africa, the show was syndicated to other tv stations, in 2013 some 18 million people watched the programme. The full length 30 minute version which includes other hospital types, most notably the remarkably resilient Nightingale wards, is available at www.sms.cam.ac.uk/media/1446036.
Collaborator Contribution Screenspace produced and directed the film, featuring data collected by Cambridge and Loughborough, adaptation schemes by Cambridge, animations by Monika Koek of Liverpool University, former Cambridge Phd.
Impact As a consequence of DeDeRHECC involvement with the DH Short was appointed as the external member of the Department of Health Energy Efficiency Working Group in Jan. 2013, adjudicating the distribution of the £50 million Energy Efficiency Fund from Public Dividend Capital to 50+ Trusts in NHS England out of 360+ applications. The Director of the DH Estates & Facilities Policy Division, Peter Sellars, comments in a letter to Cambridge University: "This valuable research project ... demonstrated that the existing estate is capable of being sustainably improved to achieve levels of ventilation and cooling which will extend the estates functional suitability for the foreseeable future Cambridge University's research [is] at the heart of government policy on making the country resilient to climate change." - Short was subsequently commissioned to administrate and monitor the scheme and report to Ministers in Sep 2014. Prof. Peter Guthrie and members of the Cambridge University Centre for Sustainable Development are assisting, two Interim Reports to Ministers delivered. Our message is that with Mitigation comes an Adaptation co-benefit. The Under-Secretary of State Dr. Dan Poulter is enthusiastic about early outcomes and, we understand from DH officials, is considering the deployment of more resources to extend the scheme.
Start Year 2008
 
Description AHRC Antimicrobial Resistance Research Grant awarded to Short 2017, Excising Infection in Surgical Environments ExISE 
Organisation Institute Of Healthcare Engineering & Estate Management
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution This collaboration arose from invitation to join the Centre for Infectious Diseases Research Strategy Group at Cambridge University. Group very enthusiastic to bid into the AHRC's AMR call which we won with Short as PI, Co-Is Dr.Lydia Drumright Clinical Informatics, Prof. Andrew Woods Director BPI Institute for Multiphase Fluid Flow, Dr.Lucia Tantardini History of Art all of Cambridge, Dr.Karthryn Schoefert and Dr. Caitjan Gainty Medical Historains at Kings College London, with the Royal College of Surgeons, CIBSE, Mr. Frank Wells cardiac surgeon Papworth Hospital, Ms Ellie Edelman neurosurgeon Addenbrookes Hospital, David Pencheon NHS Sustainable Developemnt trust, Peter Sellars President of th Institute of Hospital Engineers and Facilities Managers IHEEM.
Collaborator Contribution The Royal College of Surgeons has nominated Research Fellows to join the project and offered its London headquarters for project meetings and follows the project in its Bulletin, canvassing its membership for views on operating theatre design and airborne infection risk; CIBSE offers access to its membership of Building Services Engineers; Mr. Frank Wells is a very prominent cardiac surgeon at Papworth Hospital with strong views on OT design as has Ms Ellie Edelman neurosurgeon Addenbrookes Hospital RCS Research Fellow; NHS Sustainable Development Unit will be critical in dissemination and impact across NHS and Vienna University Medical School through Prof Sonia Horn, Schoefert visit February 2018 to be followed by PI and Co-Is visit in June/July to hold joint seminar. .
Impact Paper in Royal College of Surgeons Bulletin which elicited a tremendous response from surgeons, two papers accepted for the Cultural Histories of Air and Illness Conference University of Warwick 8-9 June 2018: Short on 'J.S. Billings and the Conundrum of the Naturally Ventilated Hospital', Schoefert and Gainty ''Temperature, Humidity and Movement': the crisis of ventilation in early 20th century medicine', and ongoing collaborations with Vienna University's Medical School exploring the Habsburg tradition of aseptic Operating Theatre design organised by partner Pof Sonia Horn medical historian and Dr.Markus Swittalek. March 6-7th 2018 Short and Drumright joined NESTA meeting to discuss Surgical Equity and the founding of a Surgical Equity Prize with ongoing involvement.
Start Year 2017
 
Description AHRC Antimicrobial Resistance Research Grant awarded to Short 2017, Excising Infection in Surgical Environments ExISE 
Organisation Royal College of Surgeons of England
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution This collaboration arose from invitation to join the Centre for Infectious Diseases Research Strategy Group at Cambridge University. Group very enthusiastic to bid into the AHRC's AMR call which we won with Short as PI, Co-Is Dr.Lydia Drumright Clinical Informatics, Prof. Andrew Woods Director BPI Institute for Multiphase Fluid Flow, Dr.Lucia Tantardini History of Art all of Cambridge, Dr.Karthryn Schoefert and Dr. Caitjan Gainty Medical Historains at Kings College London, with the Royal College of Surgeons, CIBSE, Mr. Frank Wells cardiac surgeon Papworth Hospital, Ms Ellie Edelman neurosurgeon Addenbrookes Hospital, David Pencheon NHS Sustainable Developemnt trust, Peter Sellars President of th Institute of Hospital Engineers and Facilities Managers IHEEM.
Collaborator Contribution The Royal College of Surgeons has nominated Research Fellows to join the project and offered its London headquarters for project meetings and follows the project in its Bulletin, canvassing its membership for views on operating theatre design and airborne infection risk; CIBSE offers access to its membership of Building Services Engineers; Mr. Frank Wells is a very prominent cardiac surgeon at Papworth Hospital with strong views on OT design as has Ms Ellie Edelman neurosurgeon Addenbrookes Hospital RCS Research Fellow; NHS Sustainable Development Unit will be critical in dissemination and impact across NHS and Vienna University Medical School through Prof Sonia Horn, Schoefert visit February 2018 to be followed by PI and Co-Is visit in June/July to hold joint seminar. .
Impact Paper in Royal College of Surgeons Bulletin which elicited a tremendous response from surgeons, two papers accepted for the Cultural Histories of Air and Illness Conference University of Warwick 8-9 June 2018: Short on 'J.S. Billings and the Conundrum of the Naturally Ventilated Hospital', Schoefert and Gainty ''Temperature, Humidity and Movement': the crisis of ventilation in early 20th century medicine', and ongoing collaborations with Vienna University's Medical School exploring the Habsburg tradition of aseptic Operating Theatre design organised by partner Pof Sonia Horn medical historian and Dr.Markus Swittalek. March 6-7th 2018 Short and Drumright joined NESTA meeting to discuss Surgical Equity and the founding of a Surgical Equity Prize with ongoing involvement.
Start Year 2017
 
Description UK Department of Health Estates and Facilities Policy 
Organisation Department of Health Social Services and Public Safety (DHSSPS)
Country United Kingdom 
Sector Public 
PI Contribution Managed the NHS Energy Efficiency Fund 2013-14, monitored outcomes and authored Final Report to Ministers submitted Oct 2014 currently in editing for publication by Department of Health scheduled for early Dec 2014
Collaborator Contribution Department of Health provided £50Million Public Dividend Capital for distribution by competition amongst NHS organisations, provided Quickr coordinating website, political and editorial overview and administrative support
Impact NHS Energy Efficiency Fund 2013-14 Report
Start Year 2012
 
Description UK Department of Health Estates and Facilities Policy 
Organisation Department of Health Social Services and Public Safety (DHSSPS)
Country United Kingdom 
Sector Public 
PI Contribution Authoring of the new Health Technical Memorandum HTM 07-02 'Making energy work in healthcare', the guidance to the NHS on energy efficiency and sustainable design and re-design of its estate.
Collaborator Contribution DH provides stakeholder contacts and raw energy data for NHS organisations
Impact HTM 07-02 Redrafting the guidance on energy efficiency for the NHS with UoC Prof of Sustainable Engineering and the Centre for Sustainable Development, Health Technical Memorandum (HTM) 07-02, published in March 2015 at: https://www.gov.uk/government/publications/making-energy-work-in-healthcare-htm-07-02.
Start Year 2014
 
Description tv/e Global Sustainability Film Award 2013 at BAFTA for 'Robust Hospitals in a Changing Climate', full version at www.sms.cam.ac.uk/media/1446036, 10 minute version http://sms.cam.ac.uk/media/1559781 
Organisation University of Liverpool
Country United Kingdom 
Sector Academic/University 
PI Contribution The film of the DeDeRHECC findings on the resilience and potential for adaptation of the NHS Estate produced by Cinetecture won the tv/e Global Sustainability Film Award 2013 at BAFTA for 'Robust Hospitals in a Changing Climate', full version at www.sms.cam.ac.uk/media/1446036, 10 minute version http://sms.cam.ac.uk/media/1559781
Collaborator Contribution Adaptation and Resilience in the Context of Change (EPSRC-ARCC) project 'Design and Delivery of Robust Hospital Environments in a Changing Climate' (DeDeRHECC) EPSRC (£1.05 million) with matching £120K from NHS Trusts including £10K from the Dept. of Health (EPSRC £973k), 2009-14. Co-I's. Prof. John Clarkson, UoC Engineering Design Centre; Prof. K. Lomas, Loughborough University; Dr. Claudia Eckert, Open University; Dr. Cath. Noakes, Pathogen Control Research Centre, Dept. of Engineering, Leeds University in collaboration with the Department of Health Director of Estates and Facilities and the Chief Architect, all now incorporated into NHSi, and with IHEEM, the institute of Hospital Engineers and Estate Managers. The film has been viewed by healthcare practitioners all over the world from Toronto to Beijing and the we believe that the tv/e Award Ceremony was viewed live on Propellor TV by approximately 18 Million people.
Impact The film of the DeDeRHECC findings on the resilience and potential for adaptation of the NHS Estate produced by Cinetecture won the tv/e Global Sustainability Film Award 2013 at BAFTA for 'Robust Hospitals in a Changing Climate', full version at www.sms.cam.ac.uk/media/1446036, 10 minute version http://sms.cam.ac.uk/media/1559781
Start Year 2009
 
Description 'Geometry and Atmosphere' Press release 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact A press release, by the University of Cambridge Office of External Affairs and Communication. http://www.cam.ac.uk/research/news/theatres-of-war-public-spending-on-buildings-for-the-arts/

This press release summarised key findings from the research project and was widely disseminated, leading to requests for interviews and coverage in online/print publications.
Year(s) Of Engagement Activity 2012
URL http://www.cam.ac.uk/research/news/theatres-of-war-public-spending-on-buildings-for-the-arts/
 
Description 'Practical resilience to climate change' - Health Estates Journal 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact An article about the project in the Health Estates Journal, widely read by NHS estates staff, hospital designers and design consultants.

This article summarised the project aims and objectives plus key findings to date. The Health Estates Journal is widely read in the NHS and beyond, including hospital architects, M&E consultants.

A number of NHS organisations got in touch, we sent out copies of research papers in response
Year(s) Of Engagement Activity 2010
 
Description Adaptation Sub-Committee Press Release July 2014 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? Yes
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact A great deal of press interest and heightened awareness of the vulnerability of the NHS Estate and hospital estates in general. Invitations to represent BIS through Healthcare UK followed at international conferences and trade events: Brazil Week at the House of Commons and the MENA Healthcare Conference at Lancaster House.

Heightened awareness of the summer over-heating problem in the non-domestic building stock in England.
Year(s) Of Engagement Activity 2014
 
Description Advisor World Health Organisation 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Excellent discussions chaired by Bettina Menne and part facilitated by Sonia Roschnik Deputy Director of the NHS Sustainable Development Unit, Short presented findings of the DedeRHECC project on re-engineering hospitals of the relatively recent past for resilience to climate change and preceding NIHR/DH funded work on low energy newbuild hospital design. WHO planning to publish new guidance and indication Short's group may author this.

Ironically, closer working relationships with NHS and DH attendees from UK.
Year(s) Of Engagement Activity 2013
 
Description Article in the 'Architects' Journal' - 'Report highlights serious flaws - 9/2/10 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Article in the 'Architects' Journal', based on an interview with C Alan Short about the book 'Geometry and Atmosphere' and its critique of the Lottery funding mechanism and its consequences for capital arts projects.

This article highlighted key findings from the research and linked to the book and website film. The request to interview was the result of the Cambridge University Media Office press release.
Year(s) Of Engagement Activity 2012
 
Description Department of Health - NHS Energy Efficiency Fund (EEF): Working Group and Reporting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Alan Short was appointed to the ongoing Department of Health Energy Efficiency Working Group. Awarding Body - DH, Name of Scheme - Energy Efficiency. Subsequently implemented NHS Energy Efficiency Fund, distributing £50Million across 49 Trusts for 117 projects, wide variety of approaches with very significant differences in relative value for money, payback and energy and carbon saved.

Short's team subsequently appointed to author the guidance on energy efficiency for the NHS, the Health Technical Memorandum 07-02 Making Energy work in healthcare, due for publication late March/early April 2015.
Year(s) Of Engagement Activity 2012,2013,2014
 
Description Design and Delivery of Robust Hospital Climates in a Changing Climate 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Project website for DeDeRHECC: http://www-edc.eng.cam.ac.uk/robusthospitals/

As the project findings on the current summer over-heating problem in NHS hospitals and potential risk as the climate changed, in England, developed, the project seized the imagination of the press and concerned NHS organisations, the website as a repository of publications became an important point of reference.
Year(s) Of Engagement Activity 2009
 
Description Healthcare UK MENA Health conference 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Chaired UK Healthcare MENA conference at Lancaster House 15th October 2014, potential carbon reduction involvements in Dubai with private health provider, introduction to head of research at the Royal College of Surgeons.

Discussions on prospects for low carbon health buildings in hot arid climates.
Year(s) Of Engagement Activity 2014
 
Description Living with Environmental Change website 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? Yes
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Description of project and link to hospital video on front page http://www.lwec.org.uk/node/532. A description of the research and link to the project film, on the 'Living with Environmental Change' website.

Various national agencies contacted us, not least Prof. Virginia Murray of the National Patient Safety Agency, now at UN.
Year(s) Of Engagement Activity 2011
URL http://www.lwec.org.uk/node/532.
 
Description Meeting with Anthony Schembri, General Manager, Sydney SW Area Health Service 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Anthony Schembri is General Manager of the Sydney South West Area Health Service and requested to meet with Alan Short and Alistair Fair in Cambridge.

Anthony Schembri contacted the team to request a meeting during a UK visit in order to learn more about the potential for adaptation strategies that would render hospital buildings more resilient to the effects of climate change. Project findings were discussed and Mr Schembri was supplied with copies of research papers.

PhD researcher Pam Garthwaite invited to speak to management of the health provider at their headquarters in Sydney
Year(s) Of Engagement Activity 2010