Ageing infrastructure presents healthcare providers with a growing challenge when it comes to energy management.

Many estates operate out of buildings that were never designed for today’s demands. Round-the-clock use, the presence of more energy-intensive equipment, and greater digitisation of services all combine to create increased energy demand, against a backdrop of ageing buildings, outdated heating systems, limited insulation, legacy control systems, and decades-old lighting and ventilation.

This all adds up to one thing: spiralling energy demand and greater inefficiency. But it’s not just a cost issue. When infrastructure fails, it can affect patient safety, comfort, and the continuity of care.

But there is an answer. Here are five practical ways healthcare providers can overcome the energy challenges of aging infrastructure; all grounded in a more effective approach to energy strategy.

  1. Map your energy usage to understand where inefficiencies lie

In older estates, energy inefficiency is often baked into the fabric of the building. Without accurate visibility of where and how energy is being used, it’s nearly impossible to tackle the problem effectively. Installing sub-metering and using real-time monitoring tools enables estate and FM teams to identify high-consumption areas, detect anomalies, and benchmark building performance. This data creates a foundation for targeted improvements, even if budgets for major upgrades are limited.

  1. Use data to detect faults before they disrupt care

A key risk in aging buildings is the sudden failure of critical systems like HVAC or hot water. However, these failures often give off warning signs in the form of energy spikes or irregular patterns. With continuous monitoring in place, teams can spot unusual energy behaviour that may indicate equipment degradation, leaks, or systems running outside of operational hours. This allows maintenance to be planned proactively, reducing the risk of emergency repairs that can impact clinical operations, and increasing the efficiency of systems and equipment, which may also result in reduced energy consumption.

  1. Deploy phased, building-specific energy strategies

Healthcare estates are rarely uniform, especially those that have grown over time. Different buildings may have different heating systems, insulation levels, usage patterns, and retrofit potential. That’s why generic carbon reduction plans often fail to deliver, because they don’t consider these site-by-site differences. A more effective approach is to develop phased, building-level energy strategies. This means prioritising high-consumption or high-impact areas first, and building momentum with achievable, cost-effective improvements before moving to larger capital upgrades.

  1. Offset grid dependency with on-site generation

In many older facilities, energy costs are compounded by total reliance on the grid. This makes healthcare providers vulnerable to market volatility and limits opportunities for decarbonisation. While structural limitations may prevent full-scale generation in some sites, others may be suitable for solar, combined heat and power, or other technologies. Even partial on-site generation can help flatten cost curves and support sustainability goals, provided it’s integrated into a wider energy strategy.

  1. Make energy management a central and permanent part of estates planning

One-off energy audits or retrofit projects will only go so far in an estate where systems are ageing and usage is constantly evolving. But by embedding energy management into everyday decision-making, from procurement to maintenance scheduling, healthcare providers can build a more resilient and responsive estates function. This includes upskilling teams, engaging stakeholders across clinical and operational departments, and working with expert partners who understand both the complexities of infrastructure and the demands of the care environment.

 

Ageing infrastructure is a reality for many in healthcare. But with the right energy strategy, rooted in visibility, planning, and incremental action, providers can reduce energy waste and cost, progress towards Net Zero, and most importantly protect care continuity, even in the most challenging estates.