Prof Alan Short

University of Cambridge

October 2009 to October 2012

AIM: The project aims to investigate the design and delivery of economical and practical strategies for the adaptation of the NHS Retained Estate to increase its resilience to climate change whilst meeting the challenging carbon reduction goals and performance requirements of the NHS.


  • The meaning of resilience will be refined and methods for its evaluation will be devised through consultation with DoH, NHS and Trust level policy-makers and other stakeholders, patients and staff.
  • Building types occurring frequently within the 4 stakeholder NHS Trust estates will be identified, yielding ‘typical’ case study buildings. For each type the services strategies, internal condition and energy use will be determined through a combination of field measurement and site survey.
  • Through a combination of modelling and critical appraisal, the resilience of the existing case study buildings will be established using current and future weather data for different geographical locations.
  • Robust refurbishment strategies will be developed for the case-study buildings. The likely future internal environmental conditions, including the prospects for effective airborne pathogen control will be predicted, energy use and capital and lifecycle costs estimated, and stakeholder responses to these scenarios tested.
  • The barriers to adaptive refurbishment will be diagnosed. A Re-Design Decision-making Process for managing and delivering the refurbishment pathway will be evolved through the adaptation of engineering design change prediction tools.
  • Finally, what the Project Team has come to call a ‘catalogue’ of viable refurbishment options will be developed. The principles of delivering sustainable, low-energy refurbishment to enhance resilience will be distilled for incorporation into current DH and NHS guidelines. Decision-making protocols will be developed. The Project outcomes will be disseminated widely through the health, construction and research communities in part through the medium of film.

Main messages

DeDeRHECC has shown that:

  • refurbishment can significantly lower the energy use of hospital buildings in the present day, essential for the NHS to meet its carbon reduction targets whilst also saving money;
  • that refurbishment, including naturally ventilated options, can deliver buildings that perform well in extreme summers in future climates;
  • that refurbishment does not cost in excess of new-build construction.

Policy briefing

The DeDeRHECC and BIOPICCC (Built Infrastructure for Older People in Conditions of Climate Change) projects have produced a briefing paper for policymakers summarising key findings to date relating to Community Resilience.