You're listening to the Decarbonisation Dialogue,
a podcast from Salix. Welcome to Delivering on
Climate Change, our collective challenge. Welcome
to the Decarbonisation Dialogue. I'm Hannah Walker
and I believe that the best way to communicate
a message is by being passionate about what you
are talking about. Through that passion, I believe
you use your influence and take people with you
to create action and make a difference. Our task
today is to turn our actions into a positive
legacy and make our impact count. My guest today
is John McGarrigle who is Head of Energy and
Performance for Cardiff and Vale University Health
Board and is responsible for energy management.
He is the project manager for strategic energy
schemes for carbon and cost reduction and other
engineering programs and is the author of a range
of policies and procedures for the health board.
He has more than 30 years energy management experience
and engineering experience. During his career,
he's been Energy Manager of the Year finalist,
a part -time lecturer, and is a fellow of the
Institute of Mechanical Engineers. Today, he
plays a crucial role in driving forward the organization's
carbon reduction initiatives, energy efficiency
projects, and performance improvement programs
across the Welsh health estate. John's background
is in engineering, facilities management, and
strategic planning. Welcome to John. Hello Hannah,
and thank you so much for this great opportunity.
That's really kind, thank you. It's a real privilege.
Thank you. Now John, let's start by telling us
please a little bit about your career and how
you came eventually to combine health, engineering,
energy and of course climate. Thank you for the
question Hannah. Well I originally trained as
a mechanical building services engineer for heating,
ventilation and air conditioning systems. And
I was always interested in making systems more
efficient and more economical to run. And also
in college I was drawn to energy and fuel related
subjects. And then an opportunity arose where
I then moved into the manufacturing industry,
undertaking various energy and environmental
research projects. for a major international
cosmetics organization. This included aerosol
waste minimization, steam distribution system
optimization, and effluent treatments, and I
really enjoyed my experience there. And at that
same time, I also had the privilege of being
a part -time lecturer at a local university.
As I had developed a good background in engineering
and also energy management, I really then wanted
to use this knowledge and experience complex
and diverse organization. And when the opportunity
within Cardiff and Vale Health Board came along,
it seemed to be a perfect fit for my career.
Also, as the NHS has so many differing areas
of expertise, I've had the privilege of gaining
experience in a range of other disciplines as
well, including transport and travel and environmental
management systems. I've now been responsible
for energy management for Cardiff and Vale University
Health Board and other roles as well for over
20 years now and the NHS is an amazing organisation
and I'm very privileged to contribute in a small
humble way to the healthcare and wellbeing of
our patients and I always do my best to follow
the principle that patients come first, they
are our priority. So that's really a bit of a
very quick summary of my career pathway to date.
Thank you. Thank you for putting such passion
into that. Now, let's talk about Wales for a
moment, because Wales' primary net zero target
is to achieve net zero greenhouse gas emissions
by 2050. And I think there's legally binding
five -yearly annual carbon budgets to guide that
transition. And I think the government also has
a collective target for the public sector to
achieve net zero by 2030. Now, all things health.
Tell us a little bit for a moment about what
the biggest challenge is in aligning health service
delivery with ambitious carbon reduction targets.
Energy management within Cardiff and Vale University
Healthwood has a range of challenges, risks or
opportunities depending on how we look at them
and there are a number of recurring themes and
I like to describe them really in the form of
a Rubik's Cube because I find that they're generally
related in some way. and have some form of interdependency,
so they need the various faces to align in some
way. So the first challenge we have is the age
of our estate. Our largest site, University Hospital
of Wales, and others, were designed and constructed
before or whilst the Beatles were still together
in the 1960s. Yes, they've been upgraded, but
much of the original building and engineering
infrastructure is still operational. And these
designs, as good as they were and still are,
do present energy management challenges, for
example, building U -values and insulation levels,
heating and ventilation system designs and controllability,
they realistically will not be able to be as
efficient as the latest systems. That's the first
thing, really, is the age of our estate. Secondly,
we have got the size and the geography of our
estate. We have 48 sites, including two major
acute hospitals, and we have hundreds of thousands
of energy -consuming pieces of plant and equipment.
just for estates and facilities alone. And this
includes over two and a half thousand air conditioning
and ventilation systems, nearly 300 boilers,
and we operate a 4 .4 megawatt CHP plant combined
with our system. And there are many other complex
engineering networks and systems all consuming
energy, and these also present any challenges
to us. Thirdly, the NHS is a high -risk, high
-dependency organization. We're always open 24
-7. Therefore, we never close. So all of the
engineering systems and technologies must always
work. Then we've got health care activity and
associated requirements. These will always change.
And we must keep up to date with that and must
understand how it impacts on energy usage. And
then we've got cost and resource pressures and
energy market volatility. It continues to be
a challenge for the health board and other organizations
as well. And capital funding is required to invest
in energy and decarbonization. So there's cost
and resource to pressures. And finally we've
got decarbonisation. In 2021 the Welsh Government
issued the NHS Wales decarbonisation strategy
and that gives key objectives that we're trying
to adhere to. and decarbonisation and energy
generally they travel well together but sometimes
there is a little bit of a tension between the
two because when you are trying to, let's say,
reduce our carbon impact for heating systems
by electrifying them, there'll be a corresponding
cost increase because the electricity tariffs
are so much higher than gas. There can be a little
bit of a tension there. So those are just some
of the six factors that I've pulled out and in
order to... really develop our energy management
strategy and a decarbonisation strategy, but
also ensuring we have the optimum healthcare.
We have to make sure that all those six factors
and those six faces are aligned. So it's really
running that healthcare and making sure that
people get the services they need. whilst facing
all those other pressures that you've talked
about, like the historic systems. I mean, when
you mentioned the beetles, that puts it into
a little bit of time context. And of course,
all the cost and the pressures around that. And
of course, the Wales health boards aim to achieve
34 % reduction, I believe, in carbon emissions
by 2030. And I think that involves new ambulances
running on low carbon, et cetera, and lead lighting,
et cetera. So thank you for explaining those
challenges because it is no small feat. Is it
ready to get on top of that and understand that
and actually create action from all of those
challenges? Which energy management strategies
do you think have proven most effective in reducing
both the carbon emissions and the operational
costs in your experience with the work that you've
been doing? Well firstly we have a management
response which has been we've developed an environmental
policy, we operate an environmental management
policy. This details the aims and the objectives
and themes that we want to achieve and the various
responsibilities. We've adapted other policies
to include decarbonisation and sustainability
themes. From this we've developed action plans
agreed by the health board which have then been
developed and approved and then implemented.
And also we have a review process whereby we
review what we've achieved in the last year to
make sure that our program and our strategy is
still fit for purpose. That's kind of our management
response. We've also had a technical response
as well. And for our technical response, we've
had like a three tier approach to that. Firstly,
we have an energy monitoring and targeting bureau
system. whereby we've identified and targeted
uncharacteristic energy usage and profiles through
the data, we've identified and addressed the
issues with our estate's colleagues, and the
findings have been really constructive, as areas
of good practice have been highlighted, in addition
to opportunities for improvement. Many of the
improvements have been made by simple adjustments
or changes, but have resulted in big benefits,
for example, equipment left on overnight or at
weekends. control panels left in hand instead
of automatic control, and heating and cooling
set points needing correction. That's the first
stage of our technical response. It's really
monitoring and targeting the data and finding
out where anomalies are present there. Next thing,
we have projects. These are generally standalone
projects or smaller projects where we've sought
funding within the health board. And these include
things like re -burnering our boilers, addressing
the control systems where they've needed replacement
and also installing pipework and fabric insulation.
And so that's a second stage of the tier process.
And then finally, we've got a major strategic
program and this is called Refit. And in 2016,
the Health Board wanted to significantly reduce
energy usage, costs and carbon emissions on a
strategic scale. And in 2017, we were introduced
to the Refit framework. And in summary, Refit
is a government framework whereby large scale
energy conservation measures are developed, they're
designed and delivered via a third party. Funding
is provided through the SALEX program and is
paid back from the energy savings over an agreed
time scale. Our service provider was selected
after a mini competition exercise in 2018 -19
and works commenced in 2020. And Refit has enabled
Cardiff and Vale Health Board to really deliver
the scale of the energy conservation measures
needed to achieve the magnitude of the benefits
we wanted to realise. Refit also gave us access
to resources and expertise through the service
provider to implement newer renewable technologies
and systems in a healthcare setting within the
Health Board. That's been really, really helpful
to us. And then... Refit has also given us access
to the expertise of SALECS and we're so grateful
to the SALECS team and the SALECS program for
the funding mechanism to fund the Refit program.
So those are our three sort of technical approaches
of how we've implemented our energy conservation
measures. They have been proved to be successful.
So firstly, management response but we've also
had a technical response as well. And thank you
for explaining that and I think you touched there
on a little bit of technological advance and
obviously the data which I'm going to talk, hopefully
we'll talk about in a moment. So we've got all
of this, it's exceptionally ambitious and driven
and especially when you talk about the technical
and then the management advancements there. But
let's talk a moment for about people because
you've got a large number of staff, you've got
teams, um across the organization and you've
got something called organizational culture what
what part do teams and people play in achieving
your energy and carbon targets and and how interested
are they in terms of why are we doing this is
it in in their investment in active kind of climate
change measures well the team approach is vital
to the success of any energy and decarbonisation
management programme. Within Cardiff and Vale
University Health Board there are approximately
17 ,000 employees and they will have a significant
impact on energy usage as they will know how
their departments operate and how their departments
use energy and we are so grateful for their support
and their enthusiasm and their encouragement.
We've operated a range of initiatives regarding
staff awareness and staff encouragement and this
is an area that we wish to develop further as
it closes the loop between how we import and
distribute energy in the health board and how
it is used in practice for patient care. Furthermore,
many of the ideas are readily available to trial
and to implement. with no or low cost. So there
really are readily available projects out there.
Again, we're so grateful to the staff and teams
who help us with that. So let's go turn our attention
to the emerging technologies and innovations
happening in the sector, specifically obviously
in engineering and energy. What do you think
has had the biggest impact, particularly on reducing
healthcare carbon footprint? I believe that we're
currently living through history from a technology
and energy aspect. There are many new ideas and
technologies which are now available such as
electric vehicles, electric heat pumps, hybrid
systems, improvements in controls and new controls
technology and it may take a little longer to
see how these systems develop in the next few
years including their success in practical applications.
But the biggest impact in reducing the carbon
footprint on healthcare will probably be a blend
of differing approaches and technologies, a hybrid
solution, which will include existing proven
tech technologies and conservation ideas, but
blending these with new emerging systems. So
we'll see a range of systems and methodologies,
but working together to deliver a common goal.
Firstly, that we've seen, as I've mentioned earlier,
staff engagement has a key role in reducing energy
and carbon emissions. And by working together,
we will ensure that there is a positive and encouraging
culture in ensuring that local initiatives and
sustainable daily practices are being adopted.
And we really do have an encouraging culture.
It really, really is excellent. Next, we have
our monitoring and targeting bureau and exception
reporting process, as I mentioned earlier, including
the automated metering and data collection. We've,
again, trialed new technology in that area, which
has proved very successful. And this is fed into
an energy database. And monitoring and targeting
systems with half hourly data helps us understand
in flight how our systems are performing and
help us identify and address control problems.
Again, in flight and not after a problem has
arisen and then developed. Early identification
and intervention can prevent much bigger issues
from rising and that's been really successful
for us. Thirdly, and we've been doing small to
medium scale projects including building fabric
and engineering infrastructure improvements,
for example controls for our heating, ventilating
and air conditioning systems, our steam and compressed
air systems and processes, and many improvements
can be low and no cost measures that can provide
quick wins and savings. But finally our strategic
schemes including existing system optimization
and traditional energy conservation measures
and the traditional conservation measures includes
pipework insulation and double glazing. These
have been blended with new technologies including
solar PV schemes and these include a solar PV
roof for one of our main multi -story car parks,
two solar car ports at other sites and other
solar PV systems as well. We've invested very
heavily in replacing a lot of our traditional
lighting systems with LED and we replaced over
100 ventilation systems with direct drive high
efficiency fan unit motors which is again proved
very very successful. So again in conclusion
for the question really I just feel it's going
to be a blend of traditional technologies with
newer technologies working together to achieve
that common goal and that's what we found most
successful in our programme. You mentioned obviously
the solar PV, the LED lighting but of course
that important issue of data collection and monitoring
and making sure that you're seeing what's happening
as a result so presumably you can be flexible
and change things where needed. Absolutely, I
mean the data is key and what I always say is
let the data be the anatomy or the DNA around
which you build your technical solution because
it really will guide you into where there are
all those opportunities. Yes, do you think that
because you've got those you mentioned I think
17 ,000 employees across yes it's quite a large
number how is that data if it is at all being
shared with those people and is there much interest
in that wider from the team that's operating
it? A lot of the data is shared through various
management meetings and management reports as
well and we are looking at pioneering more of
that onto our intranet side and other mechanisms
as well for our staff to engage in, but also
we're keen to learn from our staff and obviously
learn from departments to see what they would
like to see in the information that they would
like us to develop for them. So we're kind of
currently working on that. Yes, thank you. Now,
you've got a huge, as I said, I alluded to your
experience when I did the intro, you've got about
30 years of experience. What drives your commitment
to sustainability and carbon reduction? in healthcare
for you personally? I've always been interested
in making systems more efficient and economical
to run and also in college again drawn into those
subjects of energy and fuel related aspects.
I have a pattern to protect and reduce the use
of our fossil fuels where possible and reduce
costs as well as because when we reduce costs
this can be invested in the clinical needs of
the health board and patient care. Finally, we
have a beautiful world and we need to protect
and reduce the impact of climate change and reduce
our environmental impacts. And again, finally
though, just again, another final comment. I'll
go back to a previous comment. It's a real privilege
that I can contribute in a small, humble way
to healthcare of our patients and ensuring that
healthcare is being delivered in the most sustainable
and environmental manner. And this is a huge
driver for me. And my final question, John. is
what advice would you give to other healthcare
leaders trying to implement impactful climate
change initiatives? We've got a long way to go,
haven't we, and a lot to achieve in relatively
short periods. Absolutely. I think firstly it's
to determine what your baseline is and what your
energy usage is and you have to get the data
or as much of it as possible and also understand
your estate and clinical requirements for energy
usage because as the saying goes if you can't
measure it you really can't manage it. This will
show you where you are from the aspect of performance
and also where the potential opportunities that
are available to you. From this you can then
develop your outline strategy for your organization.
so that you can get senior management and board
approval with a targeted approach and contact
other health boards and trust for their advice
as we will have a range of common opportunities
and challenges and we can assist others as others
can assist us. Thirdly, then develop the actions
that you're going to be undertaken. Please ensure
that they are achievable and deliverable. There's
nothing more encouraging than when you set an
objective and you achieve it. So make sure they
are achievable and deliverable. So you need to
have smart objectives. Try where possible to
keep the action simple as they can yield really
really strong benefits communication communicate
the strategies and plans, the length and breadth
of your organisation and identify and recruit
the champions and resources you need to deliver
it as many great ideas can be birthed through
discussion and we're so grateful for all the
encouragement within Cardiff and Vale from all
the staff and all the management and the total
health board as well because it really really
is a massive program for us and I'm very grateful
to our director who leads capital estates and
facilities for all his enthusiasm and encouragement
and then finally just go for it. and implement
the planned projects and measures and capture
and monitor the results of the actions. Again,
if you can't measure it, you can't manage it.
So also capture any lessons learned, which can
be helpful when you come to replicate any initiatives
in other sites as well. So that will be my advice
going forward for anybody else. Thank you very
much John and I do love that idea of finding
the champions because they will lead the way,
as well as all that good communication. Thank
you very much to John today for joining me. from
the Cardiff and Vale University Health Board.
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the biggest challenge of our time. Today we must
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us know what you think and also any ideas for
future guests. Thank you very much and thank
you very much again to John. Thank you so much,
Hannah, for the privilege. It's been a privilege
to be here and talk to you. Thank you so much.
Thank you. You've been listening to the Decarbonisation
Dialogue, a podcast from Salix. For more information
about our work and to find more content, please
visit salixfinance .co .uk forward slash podcasts.