Supported by Ferguson Brown Consultants, Chelsea and Westminster obtained funding to upgrade to LED lighting based on predicted energy and CO2 reductions through the life of each installation. The need to replace existing fixtures point for point with minimal construction work was essential to the project as all areas were live environments so patient care and consideration was paramount.

Additionally, the timeline to design, manufacture and install a solution was a critical factor to be considered as deadlines were in place to access the funding of the project.

Thorn were selected to provide the product solution based on a mix of standard, modified and bespoke fixtures, carefully selected to meet the stringent requirements of the project. Standard products included Chalice LED downlights for circulation areas, College LED for corridors and Omega LED for the patient wards. Local controls were also built into the project, helping to maximise the energy savings and provide additional functionality of the spaces.

Bespoke architectural solutions were used in more challenging areas such as the atria and staircases. The existing indirect reflector fixtures and suspended circular fixtures in these spaces were originally designed to complement the building architecture and are an important feature for the trust to keep and maintain the building identity. Therefore the refurbishment and upgrade exercise was required to replace the existing compact fluorescent sources with LED. With the timescales being so stringent on the project, the additional prototyping and testing of these bespoke solutions had to be built into the programme.

The upgrades completed in this phase of the project resulted in a 42% reduction in energy consumption with a payback of less than 5 years with the additional benefit of reduced maintenance not only a financial benefit for the Trust but also playing a major part in minimised disruption in the 24 hour care they provide and maximising safety through low maintenance lit environment.

Based on the success of this first phase, Chelsea and Westminster are now planning the remaining 60% of the refurbishment programme.

Visit www.novelenergylighting.com today to explore Thorn LED lighting options for your facility.

NHS Trusts are in the midst of a period of huge technological change. The rise of LEDs and controls are enabling Trusts to benefit from huge energy savings and improved quality of light, with paybacks of under five years. At the same time, there is a growing awareness of the potential health benefits of biodynamic and circadian lighting, yet there are still very few examples of this cutting-edge thinking appearing on patient wards. Is this because there is a reluctance to innovate within Trusts or is it because the science behind circadian lighting is still not fully understood?

Lux, in association with Aurora, invited a panel of industry experts, with participants including facilities managers and engineers from NHS Trusts, lighting designers and consultants, to its Healthcare Forum to discuss the issues in a roundtable discussion. Key areas covered included:

Lack of investment

Trusts face wide-ranging challenges, from aging buildings, with lack of investment in lighting over the years, through to tough financial constraints. “We have buildings with a diverse age – from the 1920s and 1930s through to new build,” said Rob Hocking, electrical team leader at Southend University Hospital NHS Trust. “We need to standardise lighting systems so that we can reduce stock and react quicker to call-outs.”

“The funding is starting to come through now, but there has been a lack of investment in new technology,” said Kevin Tinson, estates operations manager at Oxford University Hospitals NHS Trust. “We have one hospital using T12 lamps, with two shipping containers full of T12 replacements. We are faced with a lot of work to catch up.”

Damian Oatway, senior sustainability engineer at Manchester Royal Infirmary said there was a resistance to anything new. “Unless the technology is proven and you can justify investment in terms of energy savings, it’s difficult. Exiting PFI contracts are also a problem because they often stipulate like-for-like replacement.”

Quality of LED lamps had also been an issue for Trusts in the past. “We have had to replace a batch of 250 LEDs, despite them being CE-marked,” said Ehsan Sattar, assistant director of projects and estates energy manager at Royal Marsden Hospital. “It’s a challenge when there are so many different products, colour rendering capabilities, lifetimes and lead times. How can we ensure the quality?”

Shyel Stark, product manager at Aurora, called on Trusts to pick the right partner and look for those suppliers that can offer back-up support and warranties.

“The quality of LEDs is much improved,” said Dina Chowdury, senior lighting designer at Lighting Design House. “You can get LEDs with 2700K colour temperatures now and CRIs of 90 which perform like halogens. But whereas halogens can all run on the same transformers, every LED lamp has a different driver. Standardisation is needed because otherwise the NHS will be left with an inventory problem.”

Not just about energy

While energy savings may be the initial driver for upgrading to LED, with typically 45% of a hospital’s electrical load coming from the lighting, the Forum highlighted a range of other issues. “The improved product life means that there is less likely to be an impact on operations, there is greater awareness of the effect of lighting on seasonal affective disorder and dementia and the role of flicker in patients with autism,” said Paul Davidson, Aurora’s group technical and project manager.

Lighting Design House is a big advocate of biodynamic lighting and has introduced the technology into its own offices with positive results. “In hospitals, the ideal is to have LED panels to achieve general lighting of 150 lux on wards, which can be automated with manual override at the nurse station,” says Chowdury. “Patients would then have local task lighting via a bedside light, with colour options that they can control. The perfect formula is a pinch of blue to kickstart activity, a dollop of sunlight, some swirls of visual delight, a pinch of amber red later in the day and a big dollop of darkness to aid sleep.”

Damian Oatway felt that lighting has such a big influence in hospitals that there was a role for a lighting manager within Trusts. “There also needs to be better guidance on what works and what doesn’t and what is considered best practice. This would help me to convince people further up the chain and get funding.”

There was generally a lack of lighting expertise within Trusts. “It’s up to me to advise and get the estates team to buy into improvements and install them. It can be a slow process,” said David Willey, energy manager at Whittington Hospital NHS Trust.

Where’s the money coming from?

Funding will always be an issue within the NHS, and experiences differed around the table. “The money is there if we can get a payback of four-and-a-half years or less,” said Oatway. Others were finding funds difficult to come by, with expenditure on new buildings meaning less money for lighting upgrades.

Funds for energy improvements are available through Government-backed organisation Salix Finance as interest-free loans. “A new NHS funding team has been created this year and LED installations account for the greatest number of projects so far,” said Sameen Khan, client support officer at Salix. “Savings can be achieved with paybacks of less than five years.”

I would say the biggest challenge we face is upgrading in areas that are quite sensitive, for example patient areas. Also making sure that we don’t get in the way. The exciting thing is that there are lots of opportunities, so if we can improve lighting in patient areas, that can only improve the healing process.

Our budget can accommodate change

We have a pretty comprehensive lighting upgrade programme across our two main acute care sites. We are investing upwards of £1 million ($1.5 million) in lighting at those hospitals. What we’ve done is to have an audit on their current lighting, and identified savings opportunities for a like-for-like change. But when we tender for the work – which we’ll be doing shortly – the idea is that we’ll be looking at everything, including biodynamic lighting.

We obviously have to see how we can work within the budget, but the wonderful thing about Guy’s and St Thomas’ is that it’s an organisation that thinks beyond direct paybacks.

Interestingly, the lighting project that we’re doing is part of a big energy-saving project that the trust is undertaking, so it’s about a £12 million ($17.8 million) overall investment in energy efficiency, and lighting comprises about a £1 million of that. What we’ve done is present the business case to the trust with a certain level of guaranteed savings. We’re doing an energy performance contract, so we have a partner that underwrites the savings. If it works within that budget and we get the savings back in, then they’re happy.

We want our patients to have control

I would love to do something creative in our patient areas, particularly on the care wards. We have a lot of patients that are in our wards for a significant amount of time, and lighting can be such an amazing healing factor. Conversely, the wrong lighting can be quite difficult for people, so it’s important that we get it right.

It gets exciting and interesting when you start to see how patients interact with light and how they can control it themselves and improve their stay while in hospital.

LEDs are our default choice now

We do all our own internal maintenance, and we are very strapped for resources. We have an in-house engineering team and they’ve got lots to do. We’re a quite complex, variously aged estate, so the more that we can remove from them maintaining the basics, the better. If we can put in lighting that’s going to stand the test of time, that’s so helpful for us and gives us resources to do other projects.

The guidance we have is: ‘If not LED, justify why not.’ In some areas, we’ve upgraded to T5 so the payback is quite slow. But for the most part, we are moving to LED where we can.

We want our patients to be involved

My proudest moment will be giving our patients the control to make sure that, whether they’re in their own room or whether they’re in a ward, they have the ability to control lighting to give them the best experience possible. And that it actually works, because if the light switch is on and it’s right above the bed and it’s shining right in their eyes, that’s not going to do anyone any good.

The other thing is that we really ought to involve our patients in the process. We want to do some trials and get people to say: ‘I like this, I don’t like this.’ We’ve got the funding, which is the big thing, and we’re tendering for lighting in the next couple of months. My job is to make sure it doesn’t become a like-for-like switch-out, which it could. In some areas it will. That’s the sensible thing to do in some areas, but in others we need to be more creative.

One of the things I really am pleased about is that we’ve introduced photocell-controlled lighting almost across the board. We’ve eliminated the areas where we have lights on and bright sunshine at the same time.

I’d like to see more transparency and standards

One thing that would be really helpful with LEDs is more transparency in the way they’re manufactured and the quality. There’s still an element of having to go to the right supplier, the right manufacturer, the right… and that, I think, adds a premium to the likes of Philips.

But I also think that manufacturers could really help standardise. When we build a new ward, there’s a standard set-up for a hospital bed. It’s the number of plugs around the bed. It’s where the table goes, it’s where the lighting goes to a certain extent. It’s where the patient entertainment system is, and it’s a kind of standard thing, so we don’t recreate it every single time we do a new ward. It would be really good if there were a sort of standard set of principles that we could apply to patient areas. That would help us reduce the design costs, and to just get things done.

Novel Energy Lighting has supplied LED lighting for several NHS trust lighting upgrades. We have the expertise to work with hospital specifiers, survey buildings, and deliver quality LED goods with 5 year warranties. Call us today to discuss: Tel: 0208-540-8287