Energy efficiency is unlikely to be the most crucial priority for every practice planning to have their premises rebuilt.
For our surgery, the Mile Oak Medical Centre in Brighton, however, the partners started discussions with the property developer and architect with this high on the agenda. Also on our ‘wish list’ was a warm, welcoming and calm building full of natural light.
The agreed specification was for a timber-frame building with brick cladding to blend with the surrounding urban architecture. This method of building was relatively quick, only eight months between moving out into temporary buildings in the local park while the old surgery was demolished until opening the doors of the new medical centre to patients.
The brick cladding meant that insulation is to a high standard. Along with double-glazing, this gives us a building which is always warm. The central heating is turned on much later in the year than in our homes. Even at the coldest times it is only necessary to turn on the radiators for an hour in the morning and in the evening. Insulation against heat-loss provides sound insulation too, giving a calm atmosphere.
We didn’t stop at being energy efficient. The members of the practice team have responsibility for various activities.
For example, we recycle glass, paper and card. At present we have to pay a recycling company £30 a month to collect recyclable refuse. In time we hope that the Brighton and Hove Council will extend domestic recycling collections to businesses.
Promoting a green life
We encourage staff to leave their cars at home. Cycle racks are provided. There is a shower that staff can use before starting work. Although the practice is on a fairly steep hill, more staff members are cycling and getting fitter.
Our lighting is energy saving and is switched off when not needed. Some parts of the building, particularly the corridors have no natural light so need artificial lighting continuously. Using high-specification energy-saving lighting makes these areas still feel light, bright and airy.
In other areas, natural light is used to maximum effect. The waiting room is like a giant conservatory. This could make the area noisy, but sound-absorbing ceiling tiles mean it is tranquil and quiet.
Velux roof windows in the waiting room and first-floor consulting rooms give light and ventilation. Sensors close them automatically if it rains.
Special surge-protectors are connected to computer supplies and when computers are turned off at night, the supply is automatically cut to other devices such as printers.
We have encountered one unforeseen problem. For 11 months of the year the building is at a comfortable temperature, but during last summer’s very hot weather, rooms on the lower floor became unbearably hot. Heat that had built up during the day was not being dissipated overnight.
In the morning, temperatures in consulting rooms were the same as at the hottest time of the previous day. Since doors to consulting rooms are shut for confidentiality reasons during the day, natural airflow cannot be used to make the rooms more comfortable.
In contrast, in the first floor administration area, where there is cross-flow of air across the building, the temperature was pleasant.
We are reluctant to solve the problem by installing energy-wasting air conditioning and are seeking a more ecological alternative.
One system we are looking into involves building up a heat differential to take heat from one part of the building to another. To make that happen, requires a certain amount of energy.
However, we want the energy to come from a renewable source so that the remedy is carbon neutral.
A wind turbine might be a possibility given that the surgery is on a hill and there is nothing to block the wind between it and the sea.
One concern though is whether there will be enough wind at the hottest time of the year. We are also looking into solar panels. Whatever the remedy, we will have to fund the installation ourselves.
The whole team loves the building: it is a really pleasant working environment. More importantly there is a sense that it is ‘owned’ by each person who works there and by the community it serves.
Rather than having a politician cut the ribbon on opening day, this service was performed by five patients; two newborn babies and three centenarians.
The Portslade Green Gym planted the gardens with bulbs. (Green gym members do environmental conservation or gardening during ‘gym’ sessions.)
Making the switch
In future we might be able to increase the use of bikes rather than cars, use ‘pool cars’ or alter our on-call duties so that we do not need to use our cars every day.
We could also use an electricity supplier that guarantees to put electricity into the national grid from renewable sources such as wind or wave power equal to the amount the practice consumes.
Other steps will be more incremental: recycling of batteries is a new addition and it would be easy to change to using recycled paper for letters, photocopying and toilet rolls.
Mile Oak Medical Centre is a conventional building in a conventional suburb of Brighton. We hope that by becoming a deeper shade or two of green we can make a difference and be an example to others.