State Lighting Solutions Help The Nhs Reduce Carbon Construction Essay

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Dwindling fossil fuel resources, forcing high utility costs are just an inconvenience factor. Bruntland (1987), highlighted the global issue that all energy users need to focus on and adjust energy consumption, to ensure the future of our planet for future generations.

This report explores climate change and the effect on the healthcare environment, focusing on one critical facet; lighting.

The relationship between light, design and function is inseparable within a healthcare setting. As light allows the core function of 'healing care' to be carried out, the observation of skin tone and texture via artificial light, forms an intrinsic part of the treatment cycle. Turrent (2007), whilst acknowledging the fact that designers and architects can, 'exert most influence to help combat global warming' when developing buildings, goes on to highlight the fact that users of facilities need to be educated to the way buildings are designed to function; using lights within a room where sufficient daylight is available is not best use of energy. With this in mind and technological developments over the past decade, can we now be in a position to not only light spaces effectively and efficiently, but also allow technology to carry out the control.

Ulrich (1992) has explored the relationship between natural light, engagement with an outside view and patient recovery rates, showing that this connection should be a high design priority as it can help promote in the convalescence of patients and thus the effectiveness of healthcare facilities.

Natural light and its integration is becoming harder to achieve with the current trend of 'super hospitals' being designed and constructed. These 'deep plan' behemoths struggle to get natural daylight into all departments, impacting on the patient environment. Intricate design features and cleaver technology assist in the delivery of this much-needed Holy Grail.

Legacy healthcare buildings offer a more challenging issue, as departments flex with service demand they are constrained by the physical boundaries already imposed upon them from the original designer. Knitting these spaces together are a network of circulation routes for patients, visitors, staff and contractors; corridors, waiting areas, café spaces all make up communal areas, used by all. Illuminating these spaces via daylight could involve major capital investments; as the spaces are already designated within the building, the selection of the correct light source and controls for the space could assist in reduction of energy and the enhancement of the environment. These areas will provide the main focus for this study within a legacy healthcare building.

Project Aim…

This research will aim to evaluate the effectiveness of a low energy light solution for installation within the healthcare environment. As healthcare facilities rarely close, the need to light, heat and power the facility is constant. This places a burden around all healthcare providers to ensure buildings are safely lit whilst balancing the increasing need to deliver the triple bottom line of sustainable healthcare.

Figure 1. Triple bottom line of Sustainable Healthcare.

Report Description

Section 2.1 sets out the issues of global energy issues, surrounding carbon emissions, climate change and the need for step change in how we use our fossil fuel resources ……

Section 2.2 outlines a brief history of electrical lighting since conception in the early 1800's. It goes on to explore the technologies to current day and the need for specific lighting within a healthcare environment.

Section 2.3 explores current guidance and technical requirements for lighting installations with respect to a healthcare facility……….

Section 3 details the research methodology employed for this piece of work……..

Section 4 forms the main body of the case study trials. A selected lighting installation was measured and upgraded with 'new technology' to examine if it was possible to retain or improve the patient environment whilst reducing the carbon emissions via energy reduction……..

Section 5 is where conclusions and final recommendations are pulled together….






2.1 Energy

2.1.1 Introduction

This section of the report will highlight the global position relating to energy issues and climate change, honing in on healthcare and the challenges that healthcare facilities face over the next four decades of carbon mitigation.

2.1.2 Global Energy...

Over the past century and a half the global demand for energy has been unrelenting; industrial revolution coupled with population growth has pushed the need to heat, light and power our World beyond the realms of sustainability. Figures from the International Energy Agency show this primal need for growth is set to ensure the energy market continues to swell by at least 60% by 2030. Along with this growth comes a hidden assassin, suspected to jeopardise the future of Earth as we know it; Climate Change.

Figure 1 World Primary Energy Demand REF

Carbon based fuels, also known as fossil fuels (coal, oil and gas), satisfy approximately 80% of the UK's current energy requirements. However, these fuels are non-renewable; once they are expended they cannot be replenished. As these resources are drained from deep within the Earth, new and alternative energy sources need to be developed and embraced. The time is fast approaching when there will be no more coal for our power stations and no more gas or oil to power generators, so until these alternative energy sources are developed and proven, energy usage must be curtailed as much as possible in normal daily applications.

When carbon based fuels are burned they release, amongst other gases, carbon dioxide (CO2) that has been stored within the fuel. This gas has been labelled as the biggest contributor to climate change via the 'greenhouse effect'. Many 'greenhouse gases' (GHG's), do occur naturally, such as water vapour, methane, nitrous oxide, and ozone. Others such as chlorofluro-carbons (CFC's), hydro-fluorocarbons (HCFCs), per-fluorocarbons (PFCs), and sulphur hexafluoride (SF6) result exclusively from human industrial processes. Nitrous oxide emissions occur during various agricultural and industrial processes, and when solid waste or carbon based fuels are burned. Methane is emitted when organic waste decomposes, whether in landfills or in connection with livestock farming. Methane emissions also occur during the production and transport of carbon based fuels.

This emission and build-up of green house gases, carbon included, in turn has seen the Earth become partially encapsulated with a 'thermal blanket'. This outer coating sits high within the atmosphere, allowing the sun's radiation through; but as can be seen below, part of the reflected radiation becomes trapped, radiating back towards the Earth. Thus creating the "greenhouse effect", forcing our climate to shift from the norm, this is where the term 'climate change' originates.

Figure 2 Radiation emitted from the sun being trapped by greenhouse gases. (

The call for the reduction of greenhouse gases, (GHG's), has now become a primary focus for all energy users. Energy prices are rising with demand and the world is becoming more 'carbon focused.' If we can reduce our energy consumption via the reduction in use of carbon-based fuels, we can cut down on the carbon emissions. These issues are generating greater pressure to find more renewable sources for energy generation, e.g. solar, wind, tidal, ground or air sourced heat derivatives. This in turn will cut down on the demand of carbon-based fuels and reduce the amount of GHG's being expelled into the atmosphere.

'Sustainable Development', became a global phrase in 1987 as an outcome of the Bruntland report. This report highlighted the 'common challenge' that the World faces in relation to environmental issues. Although in recent years this report has come under some scrutiny due to inaccuracies of forecasts published; the over-arching principle still remains intact, that;

"Sustainable Development seeks to meet the needs and aspirations of the present without compromising the ability to meet those for the future."

The report has been the foundation stone in later years of international work such as, The Montreal and Kyoto Protocols, Agenda 21 and our own, Securing the Future.

Figure 3. Milestones of sustainable development, 1972-2005.

Securing the Future (2005), REF outlines the UK's approach to sustainable development; this strategy outlines five guiding principles as shown in figure 4, and highlights immediate priorities in four areas:

Sustainable consumption and production

Climate change and energy

Natural resource protection

Environmental enhancement and sustainable communities

Sustainable development in business ensures minimal impact on the environment whilst delivering maximum benefit to employees and the local communities without jeopardising opportunities for future generations. Stern (2006), initially found that the costs of inaction, against climate change far outweighed the costs of action, but in April 2008 Stern admitted that, "...he had badly underestimated the degree of damages and risks of climate change", in his groundbreaking 2006 report. REF

Figure 4 Guiding principles in the UK Government's sustainable development strategy: 'Securing the Future'

By November 2008, the UK government had passed the Climate Change Act. This Act sets legally binding targets for reducing emissions by at least 80% of 1990 levels by 2050 and has two main aims:

To improve carbon management, helping transition towards a low-carbon economy in the UK.

To demonstrate to the World that the UK is committed to reduce emissions.

After an initial target reduction of 12.5% from the 1990 levels over the period 2008-2012, the government increased the target to 60% reduction. This is a daunting task, which faces energy users the length and breadth of the UK and falls in line with the Climate Change Act required reduction by 2050.

All sectors of the economy are required to assist the drive to meet this target, including the NHS. As the largest public sector agency in the UK, the NHS is expected to reduce its net emissions by at least 600,000 tons of carbon by 2050.

2.1.3 NHS Energy

The NHS is Europe's largest employer and the largest public sector contributor to climate change in the UK. Figures published by the Sustainable Development Unit (SDU) in relation to the NHS carbon footprint, shows that the NHS has increased its carbon footprint from 1990 to 2010 by 40%; this equates to a footprint of 21 million tonnes of CO2e (carbon dioxide equivalent).

We can see from the graph in figure 5 that the trend of Carbon emissions since 1990 shows the rise in carbon output over the threshold of 1990 baseline emissions. Also projected on the graph are emission figures through to 2020. With the realignment of carbon reporting the NHS carbon footprint rose from 18 million tonnes of CO2e to 21 million tonnes of CO2e.

Figure 5 NHS England CO2e emissions from 1990 to 2020 with Climate Change Act targets REF

The main reasons for this increase are due to three key changes:

1.NHS now reports on greenhouse gas (GHG) emissions, displayed in CO2e (CO2 equivalent). This means that CO2 is not the only GHG measured. This is consistent with the 2008 Climate Change Act;

2.The procurement data has also been updated from 2004 to 2007. It confirms an increase in emissions over this period. This is composed of 59% procurement, 24% building energy and 17% travel sector emissions;

3.The 2020 target has aligned with the amendment (May 2009) to the Climate Change Act. The target is a reduction of 34% rather than 26% from the 1990 baseline.

The government estimates that the NHS is responsible for 3% of the UK's total CO2 emissions. For an organisation set up to improve the nation's health, it is some paradox that it may be contributing untold damage to people's future health.

To give direction to NHS organisations, the Department of Health published Health Technical Memorandum, (HTM) 07-02 in 2006, entitled EnCO2de - Making Energy Work in Healthcare. This HTM was developed by the British Research Establishment, (BRE), to deliver best practice guidance on Environmental and sustainability for healthcare facilities.

"Electricity and carbon based fuels have been used in the delivery of healthcare for more than 100 years, and reliance on energy has grown to a point where only the most basic healthcare can be delivered without it. The challenge for the twenty-first century is to continue to deliver world-class healthcare without compromising the global environment."

Ref HTM 07-02

The NHS Carbon reduction strategy 2009 was developed by the Sustainable Development Unit (SDU), to complement and support the Climate Change Act (2008); stating that all NHS trusts must have carbon reduction strategies in place by 31 March 2010. In addition to the Carbon reduction strategy, Fit for the Future was published in 2009 being designed to assist the NHS in producing long-term strategic plans with the emphasis on taking action immediately. Fit for the Future offers a novel approach, by challenging the current views of sustainable development within the strategic teams of NHS establishments. By developing scenarios based in 2030 the work package promotes the steams to, '…encourage people with a stake in the future of healthcare to think about, discuss and plan for, radical change.'


To successfully reduce carbon emissions within the UK, the government has recently implemented the Carbon Reduction Commitment Energy Efficiency Scheme (CRC), This scheme became a mandatory undertaking for energy users across the UK. It is aimed at improving energy efficiency and cutting emissions in large public and private sector organisations. As the NHS falls into this catchment and being one of the largest employers in the world, NHS trusts all around the country will have to be part of the CRC.

Although the government has developed policies mapping out changes in service delivery there will always be a need for local and central healthcare presence. If in the future quality care can be delivered closer to patient's homes this may cut down on the carbon emissions related to the patient journey, but the need will still remain for centres of specialist activities within the acute setting (REF to Transforming Community Services, DH 2008 (check year). Cole (2010) labelled these policy changes as 'radical' but with the emerging clinical technologies such as proton therapy, higher energy loads and thus increasing emissions may not be far away for certain large healthcare providers. Continuing to deliver healthcare becomes harder with these huge energy constraints and government targets to increase activity could result in more CO2 being released into the atmosphere and carbon targets slipping.

By referring to figures realised in 2004, (figure 6), we can see that the division of carbon emissions is heavily weighted to procurement (59%), but the second largest emitter is building energy with 24%.

Figure 6. 2004 NHS CO2 emissions: primary breakdown.

Building utility supplies are the life blood to all healthcare facilities, without them nothing would be able to function; no water being pumped or heated, no ventilation systems cleaning and conditioning the air, no power for imaging equipment for diagnosis. Just by examining the Estates Return Information Collection (ERIC), for 2009/2010 shown in figure 7, we can see that 69% of the fuel (gas, oil and coal), used by NHS establishments across the UK is carbon based, with only 1% being reported as energy supplied from a renewable source.

Figure 7. ERIC 2009/2010 Energy Break down.

With over 30% of building energy being consumed by the use of electrical energy, (figure 7), NHS organisations need to control its use throughout facilities by the users. But controlling how people use electricity in the work place is a common problem, from leaving computers switched on to bringing their own electrical devices into work for their own benefit; mobile phone chargers, fridges, toasters etc.., all these loads on the electrical infrastructure increase the energy consumption of the building.

It is also apparent that the electrical demand in the NHS is a factor that is constantly growing (Figure 7). With this growing demand the NHS faces tough times in relation to carbon emissions and the curtailment of energy usage. Knight (2010) forecasts the growth of electrical consumption within the NHS to be 17% over the next 5 years and goes on to cite old buildings as '...a mill chain around Trust's necks.'

NEED TO CHECK HOW TO REF Electrical presentation from CPA

Figure 8. NHS Electrical growth, figures derived from ERIC data. (recorded in Gigajoules)

Many NHS Estates', consist of buildings dating back to pre-war, with only 29% being constructed within the last 16 years. As building regulations have developed over the previous decade, buildings prior to this have suffered from poor thermal efficiency, old technology and poor energy efficiency. As NHS clinical needs become more demanding, strains are placed on this aged infrastructure, which in turn struggles to support the service delivery. We can see that at least 56% of current healthcare buildings were constructed pre-1975 (figure 9), construction methods and building regulations have changed hugely over the years which leaves certain NHS facilities attempting to deliver quality care in substandard facilities.

Figure 9. ERIC Estate age data 2009/2010

Pencheon (2008) argues that the knowledge to implement sustainable design changes in healthcare facilities lies deep with the construction industry already, citing 'some healthcare buildings are already functioning with one quarter the average carbon foot print.' He goes on to point out that all proven sustainable technologies should be used in new construction projects, routinely.

Within the hospital environment there are many opportunities in the design of a new building or refurbishment of facilities, which would allow the integration of many energy saving systems and installations, one of these being lighting. Figures released in 2005 show that the global electricity consumption for lighting was to 2650TWh worldwide, which equates to approximately 19% of the total global electricity used. REF IEA (2006)

Issues surrounding legacy buildings and the introduction of new technologies being retrofitted within, for the reduction of carbon emissions, without detriment to the patient environment is challenging to say the least. As lighting technology progresses, new opportunities are emerging in relation to light sources, which may offer huge savings over conventional lighting applications.

McKinsey (2008) illustrates the cost effectiveness of lighting systems (amongst other options) in the reduction of CO2 emissions. The carbon abatement curve shown in figure 10 depicts technology options that mitigate or reduce carbon emissions. As the width of the bars on the diagram increase, so does the amount of CO2 abated, with the lowest cost opportunities, 'low hanging fruit', to the left of the curve.

2.1.5 Summary


2.1.6 References


2.2 Lighting Theory

2.2.1 Introduction

This Section will give an outline of lighting theory and a brief history of electrical light sources and lighting technology………………

2.2.2 Light Theory

Our ability to see depends upon the presence of light and the various effects light can produce. Being able to provide and to control light from natural and artificial light sources is therefore an important feature of the built environment and our comfort. As light hits an object some of the light is absorbed and some reflected, this reflected light is what allows us to see objects.

Vision is one of our most important human senses. We use sight to understand the environment, to move about and to carry out our tasks. Our vision also plays a major role in our sense of well-being. Ulrich (1984) conducted a study that stimulated the development of evidence-based design. Ulrich evaluated patients who were randomly assigned to different rooms on the same corridor; these rooms were the same in configuration apart from the view from the window. Half of the patients look out on trees, while the others looked at a brick wall. The patients who had the view of nature left hospital on average three quarters of a day sooner.


2.2.3 Lighting Quality


2.2.4 Lighting Technologies

Electrical lighting was first discovered and demonstrated by Sir Humphry Davy in 1802, the carbon arc discharge lamp soon gave birth to the incandescent lamp that has been commercially available since the late 1870's, since that point the evolution of light sources to current day has seen the efficiency's increase steadily, (shown in figure 9, and measured in Lumens per Watt). It is also plain to see that there are many types of light source, from the daylight supplied by the sun through the artificial sources shown below.

Figure 10 Light output over the years of different light sources.

(Courtesy, Robus lighting)

The main two light sources of the past century are the incandescent lamp and the fluorescent lamp (gas discharge lamps). The life cycle of the incandescent lamp is now drawing to a close. Under recent legislation (1st September 2009), the incandescent lamp is now classed as inefficient in comparison to the compact fluorescent lamp (CFL) as such it is being phased out. Low energy compact fluorescent lamps can currently out perform up to nine times the life of a normal incandescent lamp.

Commercial development of the fluorescent tube has allowed mass marketing and installations throughout the world, which in turn has meant the fluorescent tube has become an item we utilise in our everyday lives within the healthcare environment. Lighting our offices, corridors, receptions clinical treatment rooms, right through to the back of house areas such as the plant rooms, energy centre, catering departments, fluorescent tubes have been lighting our darkness. It's estimated that 80% of artificial light is produced by this type of light source. Over the years the technology within the fluorescent lamp has had minor changes, of which the most significant being diameter of the tubes decreased, this has lead to the lamp efficiency increasing.

The CFL uses the same technology as linear fluorescent lamps where light is emitted due to gases being excited by an electrical charge; this is then allowed to shine through a phosphor coating producing white light. As with all fluorescent lamps they do need time to warm up and they contain Mercury, due to the highly toxic nature of Mercury CFL's may provide a more economical way to light our lives but it leaves a bitter after taste environmentally for waste.

The above diagram shows the impact on the environment that fluorescent lamps have throughout their life. Using Mercury as part of the lighting process leaves this hazardous material and lamp costly to dispose of.

When comparing LEDs to fluorescent tubes, here are four key specifications that should be reviewed:

Lumens - This is the unit of measurement for strength of light. Look for tubes with 1500 lumens or more.

Watts - This is a unit of measurement for power consumption. Four-foot LED tubes typically use 15 to 25 watts, while fluorescent tubes of this size use more than 30 watts.

Lifespan - This is how long the bulb will last. It's measured in hours. 50,000 hours is common for LED's.

Colour temperature - The temperature of the light is the colour of the light. It is measured in units of absolute temperature, or Kelvin (K). 3000K is considered warm (redder), 4100K is considered neutral, and 5800 K is cool (bluer).

2.2.5 Lighting Controls


2.2.6 Day lighting


2.2.7 Light and the healthcare need

The care environment for patients needs to not only be functional, but also show careful consideration to the requirements of different patient categories. McCloskey (2004), outlines issues with conventional, institutional, fluorescent light fittings as being, "helpful to staff, problematic for older adults," these type of light fittings are the standard compliment of any healthcare facility that has had little thought centred around lighting design for differing care groups.

Some specific care groups have benefited from research that shows that bouts of clinical depression can have a reduced length of stay if they are allocated a sunny room rather than a dreary one. Beauchemin and Hays (1996) concluded that patient length of stay could be reduced by on average by 2.6 days. This type of research has also been applied to the dementia patient groups where light can not only assist in consolidating the sleep patterns of patients but also reduce the agitated behaviour that carers and staff are confronted with.

Ulrich (1984) conducted a study that stimulated the development of evidence-based design. Ulrich evaluated patients who were randomly assigned to different rooms on the same corridor; these rooms were the same in configuration apart from the view from the window. Half of the patients look out on trees, while the others looked at a brick wall. The patients who had the view of nature left hospital on average three quarter's of a day sooner.

Benedetti et al (1999), expands the work carried out by Beauchemin and Hays by not only taking artificial lighting into account but also the room orientation, which in turn allowed for a greater and longer exposure to natural lighting in harmony with circadian rhythms, giving positive results for patient outcomes.

More recent research by Bommel in 2006 examined the connections between lighting, health, well-being, and alertness. His findings drive home the synergy that needs to take place between architects, interior designers, the mechanical and electrical design team and even the lighting designer; citing that, " is not sufficient for future 'healthy' lighting installations to specify only the luminance..."

Lighting affects humans in different ways; it enables us to see, it regulates our body rhythms such as the sleep/wake cycle (circadian cycle) and there has been various documentation which suggests that differing types of lighting can aid or speed up the healing process; and subsequently giving a shorter length of stay in a healthcare environment.

2.2.8 Summary

Low energy lighting solutions would not only offer 'function' but, of 'interest' and 'benefit' to the users of the building. Lighting must meet these numerous requirements from several differing perspectives, staff, patient and visitors along with delivering benefits aligned with energy efficiency, allowing Trusts' to progress carbon savings in line with the NHS directive of carbon reduction.

Under the green agenda incandescent lamps are slowly being phased out with new technologies lighting the way; the revival of induction lighting and solid state lighting in the form of LED's (Light Emitting Diodes), are currently pushing forward to show that they can shine and be the new lighting solution for healthcare environment's. It is with these developed technologies that the NHS can make significant headway into the reduction of set targets.

With carbon reduction and energy usage under such close scrutiny can the NHS take lighting design to not only enhance the patient environment but also reduce its carbon footprint. Acute hospitals by there own nature have areas which function 24 hours a day all year round. Carrying out just a simple 'drive by' of any hospital and its blatantly obvious that not all empty areas are in darkness, lights being left on are just wasting energy and thus increasing the carbon footprint of the NHS.

Lighting has many rolls to fill but can it bring light to patients and also lessen the burden on the, financially challenged NHS.

Trying to balance the need for light while reducing the carbon emissions of a healthcare facility is not an easy task. With developments in technology changing on a daily basis, designers, architects, consultants, specifiers and the end client have a hard job to keep up with this progress. For example, LED lighting technology is currently experiencing such rapid fortune, according to market research firm Strategies Unlimited, demand for LED lighting will exceed $5 billion in 2012.

With this large growth in the lighting markets are the new solutions able to deliver energy saving of such proportions that would assist a healthcare facility to reduce its carbon footprint?

As lighting energy is estimated to be in the region of 58000 GWh per year within the UK, any form of low energy systems that mitigate this huge amount should put any adopter in good stead with meeting carbon reduction targets.


2.2.9 References


3. Research Methods

3.1 Introduction

3.2 Literature Review

3.3 Case Study Research


3.5 Summary

3.6 References

4. Case study at Birmingham Women's Hospital NHS Foundation Trust.

4.1 Summary.

To be completed once study finished.

4.2 Introduction

Lighting technology has remained fairly constant since the invention of the incandescent and fluorescent lamps in the 1800's. But the incandescent lamp is gradually being phased out of production and fluorescent lamps remain, not very eco-friendly due to the levels of mercury within. Original fluorescent tubes contained up to 45mg of mercury, this is absorbed gradually by the glass over time. As tubes have developed the amount of mercury has reduced to 5mg, just enough for the calculated life of the tube. When the fluorescent tube is no longer serviceable the tubes have to be disposed of via a recycling specialist, as the mercury content is toxic,

Light sources of today need to show that they can be as energy efficient as possible within healthcare facilities. This drive comes from many directions but recently the QIPP agenda (Quality, Innovation, Productivity, Prevention), has developed work streams within national, regional and local organisations to improve the quality of care delivered whilst making efficiency savings which can then be reinvested to service delivery.

Whilst producing light and visual interest for the users of the space, 30% of the energy consumed in healthcare buildings is attributed to electricity, to mitigate carbon emissions we need to focus on being as energy efficient as possible where lighting is concerned.

Since the early 1960's another source of light was discovered; the Light Emitting Diode (LED). Initially being used for indication status the LED has seen huge development, breaking into the domestic and commercial markets for energy efficient general lighting sources. LED's have properties such as, life expectancies of 50000 hours or more, whilst consuming low power in relation to light output, fluorescent lamps in comparison have less light output after 20-30000 hours. Light fittings and lamps with LED sources are now being developed to such an extent that fluorescent lamp technology could be in the twilight of its years.

The site selected for the case study installation was Birmingham Women's NHS Trust (BWHCT). The Trust was formed in 1994 and in 1995 the former Women's Hospital Sparkhill, and Sorrento Maternity Hospital were moved to the Birmingham Maternity Hospital site, continuing the 125 year history of a hospital dedicated to women's healthcare in Birmingham; in February 2008 the Trust was granted NHS Foundation status.

Based in Edgbaston, adjacent to the University Hospital Birmingham NHS Foundation Trust, the site consists of approximately 150 adult beds with 40-50 neonatal cots. On average, the Trust look after 50,000 patients a year, carry out approximately 3000 operations and deliver over 7200 babies. This generates an annual income of approx £85 million. On an annual basis approximately £700,000 of this income is attributed directly to energy costs. With the introduction of this trial it is hoped that the electrical energy consumed for lighting BWCHT can be reduced.

The lighting installation process is supported by the Trust board, with a view to improve the patient and staff environment and assist in the reduction of energy usage and thus carbon emissions. The installation itself will consist of the removal of the currently installed fluorescent luminaries and replace them with a different type of technology for producing light, the LED. If this installation proves successful in the reduction of energy consumption and enhances the patient environment, the installation process would be rolled out to all areas of the trust.

4.3 Structure of the trial

A site survey was carried out by the author to select a suitable environment for the trial. The area needed to have a general lighting requirement, but also needed to be used by a cross section of users. Once the area had been selected as the M1 corridor the selection of a suitable luminaire was carried out from a range of different suppliers. (Appendix A criteria for sample selection).

It was observed early on within the sample selection that many lighting manufactures were offering replacement LED tube solutions for installation into existing fluorescent luminaries. These were trialled initially, but with high failure rates and issues concerning possible electrical shock hazards, this retrofit solution was quickly discarded from the trial on general Health & Safety grounds. Photo CS1 shows an early replacement LED tube installed within a standard fluorescent luminaire. As can be seen, the tube itself has bent during normal usage. It was at this point a decision was made to move away from retro-fitting the LED light source into a luminaire designed for fluorescent tubes. An LED designed luminaire was selected from the samples and was trialled within a 'live' test installation.

Photo CS1, Image of LED fluorescent tube replacement.

The area selected for the trial was highlighted as the M1 corridor. This is the main hospital thoroughfare, leading to departments such as Ultrasound, Neonatal, Outpatients, and Genetics forming a link between the main hospital building and Norton Court (administration, finance, procurement and accommodation). As such the users of the space could be staff, visitors, patients or contractors.

With the area carrying such heavy footfall, the installation would have to be done outside normal working hours, but does give exposure to a diverse range of users. This user perception would help assess the suitability of the installation from responses to questionnaires (Appendix B) prior to, and after the installation. The questionnaire takes the format of an anonymous hand out - hand in selection of questions to all types of users of the space

These responses in conjunction with the energy reduction calculation will allow the Trust to make an informed decision on the site-wide implementation of LED technology as a general lighting solution

4.4 Design & Installation considerations

Following the site survey and selection of the M1 corridor as the trial area site drawings and dimensions were checked to carry out a lighting design calculation using a piece of software call 'Relux.' This software has the capability to replicate the proposed lighting scheme within a three dimensional view. This allows for lighting calculations to be proven before the installation takes place.

The existing installation consists of linear fluorescent luminaries with clear prismatic diffusers. Due to the age and type of material the diffusers are constructed from, coupled with fluorescent light sources emitting ultraviolet radiation (UVR), these diffusers have aged from the exposure to the UVR which in turn allows the luminaries give off a very yellow light. (approx 2000K). The light source within the luminaire is made up of, twin T8 36w/840 fluorescent tubes. Due to the age of these luminaries the control equipment for starting and running the lights also needs to be factored into energy usage calculations, this gives a total connected load of 95watts.

The selected test LED luminaire is constructed of three separate panels built into a chassis, which is designed to be installed within a standard false ceiling grid with 595mm x 595mm formation. Performance of the panel was specified as total connected load of 39.4watts with a rated output of 2700lumens.

Lighting requirements of spaces within a hospital environment vary dependant on the proposed use of the space, some theatre lights offer up to 100000 lux while night-lights in a ward environment are no more than 1-5 lux. As the chosen installation area is classed as the main 'hospital Street' or main corridor, the installation needs to achieve at least 200 lux at floor level, but no more than 350 lux. The lighting requirements for this space have been taken from the Chartered Institute of Building Services Engineers (CIBSE) Lighting guide for Hospitals (LG2).

4.5 Performance of the installation

The original installation consisted of 17 luminaries each with 2 x 36w fluorescent tubes, as previously mentioned this age of luminaire has old technology for the start up and running of the light source

4.6 Survey Results

4.7 Life Cycle Costs

4.8 Summary

4.9 References

Appendix CS1

Luminaire Selection
















4x18w Flourescent
























4x14w T16








4x14w T16

















































Shaded areas are waiting for information from manufacturers, table needs to be reformatted.

Appendix CS2

Site drawings and dimensions of test area.

Appendix CS3

Case Study Questionnaire.

Birmingham Women's NHS Foundation Trust currently spend over £700,000 on utilities per year, with a view to reduce these costs and become more energy efficient we are assessing various energy saving technologies, one of these being lighting.

Your views on the current lighting installation on the M1 corridor will be used to draw up a lighting solution for the whole of site, with a view to reduce our energy usage and carbon missions.

We would be grateful if you could complete this quick questionnaire by ticking the relevant boxes. â-¡

Are you a; â-¡ Member of Staff

â-¡ Patient

â-¡ Visitor

â-¡ Contractor

Are you aware of energy reduction solutions the Trust are trialling?

â-¡ Yes

â-¡ No

Do you think that lighting contributes to creating a welcoming patient environment?

â-¡ Yes

â-¡ No

Do you think this corridor has;

â-¡ Too much light?

â-¡ Just the right amount of light?

â-¡ Not enough light?

Do you think the light installation creates;

â-¡ An excellent patient environment?

â-¡ An above average patient environment?

â-¡ An average patient environment?

â-¡ A below average patient environment?

Appendix CS4

Software results

Appendix CS5

Results of surveys

Appendix CS6

Energy monitoring results

Appendix CS7

Photographic results of installation.