Extreme Heat: Resilience of NHS Infrastructure

Question

Asked by

To ask His Majesty’s Government what assessment they have made of the resilience of NHS infrastructure to extreme heat; and what steps they are taking to ensure that NHS buildings are adequately equipped to withstand prolonged periods of extreme heat.

My Lords, extreme heat does pose a serious risk to NHS buildings and services. All NHS organisations are required to have effective arrangements in place for adverse weather. We are supporting trusts to target the most critical estates risks with £6.75 billion over nine years, including risks that need to be dealt with in respect of cooling and ventilation; and we are ensuring that new hospitals and new-build neighbourhood health centres have climate resilience embedded in their design from the outset.

I welcome the Answer from the noble Baroness. Last Wednesday was the London Ambulance Service’s busiest ever day for life-threatening emergencies, and at least six NHS trusts declared critical incidents. Nine in ten of our NHS buildings are ill-equipped to handle heat. The Climate Change Committee’s report, A Well-Adapted UK, argues urgently for solar batteries and cooling across all public buildings, yet Great British Energy’s programme covers only 200 out of 1,200 NHS sites. Therefore, will the Minister commit to ensuring that every hospital has solar battery storage and air-source heat pumps by 2035?

The Government are indeed providing trusts with substantial investment—I mentioned just some of it—in these measures, and that is very much in line with the Government’s net-zero ambitions and intent. We are investing £155 million in solar projects and £400 million in heat decarbonisation grants across the NHS. I emphasise that, looking forward, all NHS new builds and major upgrades will align with the net-zero building standard.

My Lords, following the Question from the noble Earl, Lord Russell, before we have all those solar systems in place, I urge the Minister to audit major hospital trusts on their back-up power systems, and in particular to ensure that the refrigeration facilities are available continuously for the storage of medicines, life support systems and all the other essential elements that require electricity.

Yes indeed, and I go back to my point about the £6.75 billion estates safety fund, the whole intention of which is to target the most serious risks, such as those the noble Baroness refers to. Vital projects will attract that funding. They include overheating risks such as broken chillers, outdated air-handling units and, if needed, refrigeration—in other words, where there is a need for urgent upgrades.

My Lords, last night, here in the House, the Parliamentary and Scientific Committee, of which I am president, held a meeting on the effects of extreme heat in the workplace. During that meeting, reference was made to the fact that, during last week’s heatwave, several MRI machines failed. Will my noble friend extend an invitation to the Physiological Society, which has done a great deal of work on the effects of heat on the human body, and consult it on possible ways these types of events can be avoided?

My noble friend raises an important point. It is important to note that extreme heat particularly affects buildings with poor insulation and limited natural ventilation, which, by their very nature—I am describing many health settings—heavily rely on such measures if there is heat-generating equipment like imaging suites and IT systems. Also, 11% of buildings in the NHS estate are older than the NHS itself, which gives some sense of the scale. We have committed £10.5 million in research funding to develop effective cooling solutions that can be used across the whole system. It may well be that the organisation to which my noble friend refers is part of that, but I will take his suggestion back to the department.

My Lords, I am grateful to the Minister for answering the Question of the noble Earl, Lord Russell, on new-build hospitals, but there is clearly a question about existing hospitals and facilities. I wonder what plan or strategy there is, and whether it is written down, to identify hospitals that do critical and time-sensitive procedures, to make sure that they are prioritised when there are extreme heat conditions, and to commission independent hospitals with the appropriate cooling and ventilation systems to allow those critical operations to go ahead.

We are already investing some £30 billion of capital across the NHS estate. I have mentioned the most serious infrastructure risks, which the noble Lord rightly refers to. While we accept the age of the estate and its size—I noted in preparing for this Question that we are talking about the equivalent of 4,000 football pitches—we also have a backlog of maintenance issues, which have grown and grown. We estimate that some £15.9 billion is needed. While there are no easy solutions, we do have a resilience plan not just for overheating but for all threats to resilience arising from temperature. We are also providing the funding—although, to the point the noble Lord makes, it is down to local decision-making—and ensuring that we are assisting the estate across the country to meet the challenges, the priority being those areas that need it most.

My Lords, aside from the estate, patients on medications known to cause issues in extreme heat are not always being given specific advice on adjusting use of these during extreme weather and, as a result, have been admitted to hospital. What work is the department doing, particularly given that we have further hot weather coming, to ensure that patients receive the right advice and support to avoid hospital admissions as a result of such hot weather?

The recent heat health alert was the first alert since July 2022. Importantly, the UK Health Security Agency has updated its weather health alert system in order that action can be taken and preparations put in place. It has also expanded its guidance, communications and the training of staff across the health and social care sector, so they can better deal with the challenges.

My Lords, I was very pleased to hear the Minister say in response to the Question of the noble Earl, Lord Russell, that all new hospitals and hospital projects in the pipeline will be climate-proofed, and that that will include resistance to extreme heat. However, I would like to ask about care homes. The most vulnerable in society include the elderly—a category to which I admit I belong, along with a number of other noble Lords—and care homes are therefore an important element of protection against extreme heat. What plans do the Government have to ensure that care homes are as well protected from extreme heat as the Minister says hospitals will be in future?

Clearly it is a different situation, in terms not of climate but of the estate. I know the noble Lord is aware of this, but it is worth pointing out that the social care sector is rather more fragmented and includes the private sector. However, for social care, advice is available about what measures to put in place, along with training.

My Lords, many workers across many sectors are suffering unbearable temperatures that they are expected to work in, and that is increasing demand on the NHS and its services. Does the Minister agree with the principle that health and safety laws can drive adaptations in workplaces necessary for the health and safety of the workforce, as happened with the introduction of a minimum working temperature? Is it time that we had a maximum working temperature, as the TUC has called for?