Energy Efficiency

, Volume 9, Issue 1, pp 27–48 | Cite as

Applicability, potential and limitations of staff-centred energy conservation initiatives in English hospitals

  • Paula Morgenstern
  • Rokia Raslan
  • Gesche Huebner
Original Article


Increasing energy costs and climate change legislation have prompted efforts to reduce energy consumption in UK hospitals. In addition to technological conservation strategies focussing on buildings and building services, staff-centred initiatives such as energy awareness campaigns are increasingly being considered by National Health Service (NHS) trusts due to their potential cost-effectiveness. However, hospitals are complex buildings with unique energy requirements, and it is unclear to what extent these requirements are influenced by clinical staff. This paper combines a review of staff-centred energy conservation initiatives in organisations in general and in hospitals in particular with the results of a survey-based study among NHS energy managers (N = 70). The study findings highlight that staff-centred energy conservation initiatives are currently of interest to a majority of NHS trusts in England and may become an increasingly important part of carbon reduction strategies in hospitals in the future. Policy assumptions regarding their savings potential, however, appear to be undifferentiated, and it seems advisable to relate behavioural efforts more closely to the physical context of the respective hospital building and its service infrastructure as well as the health care processes relevant to different departments.


Hospitals Energy managers Energy behaviours NHS Organisational energy use Energy awareness 


  1. Abrahamse, W., & Steg, L. (2013). Social influence approaches to encourage resource conservation: a meta-analysis. Global Environmental Change, 23(6), 1773–1785.CrossRefGoogle Scholar
  2. Abrahamse, W., Steg, L., Vlek, C., & Rothengatter, T. (2005). A review of intervention studies aimed at household energy conservation. Journal of Environmental Psychology, 25(3), 273–291.CrossRefGoogle Scholar
  3. Aune, M., Berker, T., & Bye, R. (2008). The missing link which was already there: building operators and energy management in non-residential buildings. Facilities, 27(1), 44–55.Google Scholar
  4. Azar, E., & Menassa, C. C. (2014). A comprehensive framework to quantify energy savings potential from improved operations of commercial building stocks. Energy Policy, 67, 459–472.CrossRefGoogle Scholar
  5. Baird, G. (2010). Sustainable buildings in practice: What the users think. London: Routledge.Google Scholar
  6. Balaras, C. A., Dascalaki, E., & Gaglia, A. (2007). HVAC and indoor thermal conditions in hospital operating rooms. Energy and Buildings, 39(4), 454–470.CrossRefGoogle Scholar
  7. Banks, N., Redgrove, Z., Gunn, M., Mullen, J., Ryle, J., Fawcett, T., Ristic, L., & Bird, S. (2012). What are the factors influencing energy behaviours and decision-making in the non-domestic sector? London: Centre for Sustainable Energy (CSE), Environmental Change Institute (ECI).Google Scholar
  8. Barts Health NHS Trust. (2013). Changing energy behaviours in the NHS: Operation TLC. Accessed 10 Nov 2013.
  9. Benke, G., Leutgöb, K., Varga, M., Kolpek, M., & Greisberger, H. (2009). Das energieeffiziente Krankenhaus. Realistische Ansatzpunkte und Maßnahmenidentifikation (in German). Wien: Bundesministerium für Verkehr, Innovation und Technologie. Accessed 05 May 2013.Google Scholar
  10. Bordass, B., Leaman, A., & Ruyssevelt, P. (2001). Assessing building performance in use: conclusions and implications. Building Research and Information, 29(2), 144–157.CrossRefGoogle Scholar
  11. Brayford, L. (2004). Carbon/energy management in healthcare. Best practice advice for the NHS in England on meeting the mandatory carbon/energy targets. Leeds: NHS Estates.Google Scholar
  12. Building Research Energy Conservation Support Unit (BRECSU). (1992). Energy efficiency in hospitals by good housekeeping. Health Estate Journal, 48(8), 4–6.Google Scholar
  13. Building Research Energy Conservation Support Unit (BRECSU). (1995). Energy savings in NHS hospitals. Good Practise Case Study, 202, 1–6.Google Scholar
  14. Carbon Trust. (2008). Introducing NHS carbon management. Tech. rep. London: Carbon Trust.Google Scholar
  15. Carbon Trust. (2010). Hospitals. Healthy budgets through energy efficiency. Guide CTV024. London: Carbon Trust.Google Scholar
  16. Carrico, A. R., & Riemer, M. (2011). Motivating energy conservation in the workplace: an evaluation of the use of group-level feedback and peer education. Journal of Environmental Psychology, 31(1), 1–13.CrossRefGoogle Scholar
  17. Cox, A., Higgins, T., Gloster, R., Foley, B., & Darnton, A. (2012). The impact of workplace initiatives on low carbon behaviours. Scottish Government Social Research. London: Crown.Google Scholar
  18. Creswell, J. W., & Plano Clark, V. L. (2011). Designing and conducting mixed method research (2nd ed.). London: SAGE.Google Scholar
  19. Department of Energy and Climate Change (DECC). (2011). The carbon plan: Delivering our low carbon future. London: Crown.Google Scholar
  20. Department of Health (DoH). (2006a). EnCO2de- making energy work in healthcare. Environment and sustainability. London: The Stationery Office.Google Scholar
  21. Department of Health (DoH). (2006b). Statistics on energy performance and carbon and CO2 emissions, NHS England, 1999/00 to 2004/05 (with prediction to 2009/10). London: The Stationary Office.Google Scholar
  22. Diez, K., & Lennerts, K. (2010). Benchmarking im Krankenhaus – Schwerpunkte Energie und Instandhaltung (in German). In Facility Management Messe und Kongress (pp. 377–385). Frankfurt (Main).,d.cGU. Accessed 21 Jan 2013
  23. Dillman, D. A., Smyth, J. D., & Christian, L. M. (2008). Internet, mail, and mixed-mode surveys: The tailored design method. New York: John Wiley & Sons.Google Scholar
  24. Emmerson, C., Frayne, C., & Goodman, A. (2000). Pressures in UK Healthcare: Challenges for the NHS. The Institute for Fiscal Studies. Accessed 05 Oct 2014.
  25. Fan, W., & Yan, Z. (2010). Factors affecting response rates of the web survey: a systematic review. Computers in Human Behavior, 26(2), 132–139.CrossRefGoogle Scholar
  26. Gray, S. M. (2011). Sustainable healthcare, health knowledge.
  27. Jeffries, I., & Rowlands-Rees, T. (2013). Energy efficiency trends annual report 2012/2013. Essential insight for consumers and suppliers of non-domestic energy-efficiency., EEVS Bloomberg New Energy Finance. Accessed 10 Nov 2014.
  28. Jensen, A. H., & Petersen, P.M. (2011). Energy efficiency in hospitals and laboratories. In Energy efficiency first: The foundation of a low-carbon society: ECEEE 2011 Summer Study. Conference proceedings, 6-11 June 2011, Belambra Presquile de Giens, France.Google Scholar
  29. Jones, C. S. (2001). Towards benchmarking in British acute hospitals. Health Services Management Research, 14(2), 125–138.CrossRefGoogle Scholar
  30. Junnila, S. (2007). The potential effect of end-users on energy conservation in office buildings. Facilities, 25(7), 329–339.CrossRefGoogle Scholar
  31. Kattenstein, T., Unger, H., & Wagner, H. (2002). Handlungskonzepte zur Optimierung des Energiebedarfs und der Energieversorgung der Ruhr-Universität Bochum. Abschlussbericht zum Vorhaben: IV A4-20600298 Optimierung der bestehenden wirtschaftlichen Energieversorgung der Ruhr-Universität Bochum (in German). Ruhr-Universität: Lehrstuhl für Energiesysteme und Energiewirtschaft.Google Scholar
  32. Leaman, A. J. (2000). Usability in buildings: the Cinderella subject. Building Research and Information, 28(4), 296–300.Google Scholar
  33. Littleford, C. (2013). Energy use by individual office workers: Psychological and contextual influences on behaviour. PhD, Loughborough University.Google Scholar
  34. Lo, S. H., Peters, G.-J. Y., & Kok, G. (2012). A review of determinants of and interventions for proenvironmental behaviors in organizations. Journal of Applied Social Psychology, 42(12), 2933–2967.CrossRefGoogle Scholar
  35. Lomas, K., Giridharan, R., Short, C., & Fair, A. (2012). Resilience of ‘Nightingale’ hospital wards in a changing climate. Building Services Engineering Research and Technology, 33(1), 81–103.CrossRefGoogle Scholar
  36. Matthies, E., Kastner, I., Klesse, A., & Wagner, H.-J. (2011). High reduction potentials for energy user behavior in public buildings: how much can psychology-based interventions achieve? Journal of Environmental Studies and Sciences, 1(3), 241–255.CrossRefGoogle Scholar
  37. McClelland, L., & Cook, S. W. (1980). Energy-conservation in university buildings - encouraging and evaluating reductions in occupants electricity use. Evaluation Review, 4(1), 119–133.CrossRefGoogle Scholar
  38. McGuire, A. (1987). The measurement of hospital efficiency. Social Science & Medicine, 24(9), 719–724.CrossRefGoogle Scholar
  39. Murtagh, N., Nati, M., Headley, W. R., Gatersleben, B., Gluhak, A., AliImran, M., & Uzzell, D. (2013). Individual energy use and feedback in an office setting: a field trial. Energy Policy, 62, 717–728.CrossRefGoogle Scholar
  40. NHS England. (2013). Putting patients first. The NHS England business plan for 2013/14 - 2015/16. Accessed 04 Aug 2014.
  41. NHS Jobs. (2014). Working in the NHS. Accessed 21 Nov 2014.
  42. NHS Sustainable Development Unit (NHS SDU). (2010). Save money by saving carbon. Decision making in the NHS using marginal abatement cost curves. Cambridge: NHS Sustainable Development Unit.Google Scholar
  43. NHS Sustainable Development Unit (NHS SDU). (2013). Carbon footprint update for NHS in England 2012. Cambridge: NHS Sustainable Development Unit. Accessed 04 Aug 2014.Google Scholar
  44. NHS Sustainable Development Unit (NHS SDU). (2014). Case studies. [online] Accessed 05 Mar 2014.
  45. Nye, M., & Hargreaves, T. (2010). Exploring the social dynamics of proenvironmental behavior change. Journal of Industrial Ecology, 14(1), 137–149.Google Scholar
  46. Osbaldiston, R., & Schott, J. P. (2011). Environmental sustainability and behavioral science: meta-analysis of proenvironmental behavior experiments. Environment and Behavior, 44(2), 257–299.CrossRefGoogle Scholar
  47. Pencheon, D., Cointet, S., Brown, J., Howley, J., Tennison, I., Greensmith, H., & Wright, S. (2009). Saving carbon, improving health. NHS carbon reduction strategy for England. Cambridge: NHS Sustainable Development Unit.Google Scholar
  48. Saunders, M., Lewis, P., & Thornhill, A. (2012). Research methods for business students (6th ed.). Harlow: Pearson.Google Scholar
  49. Schahn, J. (2007). Projekt Energiemanagment am Psycholgischen Institut der Universiät Heidelberg: Ein erfolgreicher Fehlschlag. [in German]. Umweltpsychologie, 11(2), 138–163.Google Scholar
  50. Schonlau, M., Fricker, R. D., & Elliott, M. N. (2002). Conducting research surveys via e-mail and the web. Santa Monica: RAND Corporation.Google Scholar
  51. Short, C. A., Lomas, K. J., Giridharan, R., & Fair, A. J. (2012). Building resilience to overheating into 1960’s UK hospital buildings within the constraint of the national carbon reduction target: adaptive strategies. Building and Environment, 55, 73–95.CrossRefGoogle Scholar
  52. Siero, F. W., Bakker, A. B., Dekker, G. B., & Van Den Burg, M. T. C. (1996). Changing organizational energy consumption behaviour through comparative feedback. Journal of Environmental Psychology, 16(3), 235–246.CrossRefGoogle Scholar
  53. Silvermann, D. (2011). Interpreting qualitative data: Methods for analysing talk, text and interaction. London: Sage.Google Scholar
  54. Socolow, R. H. (1978). Saving energy in the home: Princeton's experiments at Twin Rivers. Cambridge: Ballinger Pub. Co.Google Scholar
  55. Staats, H., van Leeuwen, E., & Wit, A. (2000). A longitudinal study of informational interventions to save energy in an office building. Journal of Applied Behavior Analysis, 33(1), 101–104.CrossRefGoogle Scholar
  56. Tippköter, R., & Schüwer, D. (2003). Leitfaden Energieeffizienz für Krankenhäuser (in German). NRW, Germany: Energie Agentur.Google Scholar
  57. Tudor, T. L., Barr, S. W., & Gilg, A. W. (2008). A novel conceptual framework for examining environmental behavior in large organizations: a case study of the Cornwall National Health Service (NHS) in the United Kingdom. Environment and Behavior, 40(3), 426–450.CrossRefGoogle Scholar
  58. Ziebik, A., & Hoinka, K. (2013). Energy systems of complex buildings. London: Springer.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Paula Morgenstern
    • 1
  • Rokia Raslan
    • 2
  • Gesche Huebner
    • 3
  1. 1.UCL Energy InstituteUniversity College LondonLondonUK
  2. 2.UCL Institute of Environmental Design and EngineeringUniversity College LondonLondonUK
  3. 3.UCL Energy InstituteUniversity College LondonLondonUK

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