Cardiff and Vale energy lead highlights ‘Rubik’s cube’ challenge of NHS decarbonisation
Wales health board faces ageing infrastructure, rising costs and net zero targets as data, technology and teamwork drive progress: listen to The Decarbonisation Dialogue podcast
Delivering energy efficiency and carbon reduction across a large, complex healthcare estate is akin to solving a “Rubik’s cube”, according to Jon McGarrigle, head of energy and performance at Cardiff and Vale University Health Board.
Speaking on episode 42 of The Decarbonisation Dialogue podcast, Jon outlined the interconnected challenges facing NHS organisations as they work to cut emissions while maintaining critical services.
With more than 30 years’ experience in energy management and engineering, Jon leads strategic programmes aimed at reducing both carbon and cost across the Welsh health estate. His work spans policy development, infrastructure upgrades and performance improvement initiatives, underpinned by a long-standing commitment to efficiency and sustainability.
At the heart of the challenge, he says is the complexity of the NHS estate itself.
In episode 42 he explains how the issues are all interdependent and describes the six key pressures that must be balanced simultaneously. These include ageing infrastructure, the scale and geography of sites, the 24/7 operational demands of healthcare, changing clinical activity, financial constraints and national decarbonisation targets.
Much of the health board’s estate dates back to the 1960s. While upgrades have been made over time, legacy systems still present limitations.
Jon says: “They were well designed for their time, but they cannot match the efficiency levels of modern systems.”
The scale of operations adds further complexity. Cardiff and Vale University Health Board manages 48 sites, including two major hospitals, alongside thousands of energy-intensive assets - from ventilation systems to boilers and combined heat and power units.
“All of these systems must function continuously,” he says. “We never close, so reliability is critical.”
At the same time, he says decarbonisation introduces new tensions. Electrification of heating systems, for example, can reduce carbon emissions but increase operational costs due to higher electricity prices. “Energy and carbon reduction generally align,” he says, “but not always without trade-offs.”
Let the data be the DNA of your technical solution
If you can’t measure it, you can’t manage it.
Structured response and strategic programmes
To address these challenges, the health board has developed both management and technical responses. On the management side, this includes an environmental policy, clear objectives alongside action plans approved at board level. Progress is reviewed annually to ensure strategies remain effective.
Technically, the approach is three-tiered. The first focuses on data-driven monitoring. An energy monitoring and targeting system analyses consumption patterns and flags anomalies. This has led to simple but impactful changes, such as correcting control settings or identifying equipment left running unnecessarily.
Jon says: “Many improvements are low or no cost, but they deliver significant benefits.”
The second tier involves smaller-scale projects, including boiler upgrades, insulation improvements and control system enhancements.
The third tier is a large-scale strategic programme delivered through the Refit framework, which enables major energy conservation measures to be funded and implemented with support from external partners. The programme is financed through savings generated over time, allowing for investment without upfront capital pressure.
Refit has also facilitated the introduction of newer technologies, including renewable energy systems, while providing access to specialist expertise.
The role of people and culture
Despite the importance of infrastructure and investment, Jon stressed that people remain central to success. With around 17,000 staff across the health board, employee behaviour has a significant impact on energy use. Engagement initiatives have been introduced to raise awareness and encourage more sustainable practices.
“Staff understand how their departments operate,” he says. “Their input is invaluable.”
Many ideas for improvement originate at departmental level and can often be implemented quickly. Strengthening this culture of collaboration is seen as key to long-term progress.
Blending old and new technologies
Looking ahead, Jon believes the future of healthcare decarbonisation will depend on a hybrid approach. However, he believes that no single solution will deliver results at scale. Instead, a combination of established energy conservation measures and emerging technologies will be required.
Recent projects reflect this blended approach. These include large-scale LED lighting upgrades, high-efficiency ventilation systems and solar photovoltaic installations across multiple sites, including car parks.
Data as the foundation
Central to all efforts is the use of data.
“Let the data be the DNA of your technical solution,” Jon says. Half-hourly metering and real-time monitoring allow teams to identify issues early and respond before they escalate.
This data is increasingly shared across the organisation, with plans to expand access and improve visibility for staff.
“If you can’t measure it, you can’t manage it.”
Advice for others
For organisations beginning their decarbonisation journey, Jon emphasises the importance of establishing a clear baseline, setting achievable goals and maintaining strong communication.
Collaboration across the sector is also vital. “We share many of the same challenges, learning from each other is essential.”
Ultimately, he says the goal is to ensure that sustainability supports, rather than competes with, patient care. “Reducing energy costs allows more investment in clinical services, and protecting the environment is part of protecting public health.”
As NHS organisations continue to navigate the path to net zero, Jon’s message is clear: success will depend on aligning people, technology and data - one turn of the cube at a time.
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