Cutting emissions and strengthening NHS resilience in Wales
Swansea Bay Health Board proves that climate leadership and high quality care can go hand in hand
Patients are at the heart of climate change solutions driving the investment for Swansea Bay Health Board.
As the medical world progresses at speed with new technologies promising better diagnoses, quicker recoveries and improved outcomes – the solutions to our climate crisis are also key.
At Swansea Bay University Health Board, it is Des Keighan’s job to balance the need to tackle rising energy costs with the need to look at energy efficiencies as well as decarbonisation technologies.
For the NHS, where cost is aways a high priority and where patient care comes first, this is a significant challenge.
Swansea Bay University Health Board is the local health board within NHS Wales responsible for providing healthcare services in Swansea and Neath Port Talbot.
As assistant director of commercial and contract management - PFI, Des and his team is leading the challenge head on.
Des and his team made headlines in 2021 by delivering a UK-first with Morriston Hospital becoming the first acute hospital directly powered by its own dedicated solar farm.
Built at Brynwhillach Farm, the 4 MW facility initially met around 26% of the hospital’s electricity needs.
The project saw 10,000 solar panels installed and was and backed by a £5.7 million Welsh Government Invest to Save loan, delivered by our teams at Salix.
The ambitious project quickly proved its worth, powering the hospital for up to 50 consecutive hours in the winter months.
The Invest to Save scheme provides interest-free loans to public sector organisations to fund energy efficiency and carbon reduction projects that repay themselves through the savings they generate.
For Swansea, it created an opportunity for significant change.
Des said: “Morriston was our jewel in the crown.
“It demonstrated that the NHS doesn’t have to wait for change but rather we can lead it.”
The innovation continued in 2024, when the solar farm was expanded with an additional 1 MW of capacity and a new battery storage system, increasing the supply to about one-third of the hospital’s needs and enabling night-time use of stored energy.
Annual energy savings now exceed £900k, with an extra £325kanticipated from the latest upgrades. The carbon savings are equally impressive, with nearly 2,000 tonnes of carbon emissions avoided.
However, Des is clear-eyed about the realities. He said: “We’re all tempted to go for the low-hanging fruit, like LED upgrades, which are vital of course, but we recognise the importance of taking a holistic and long-term approach.
“Our team assessed the full Morriston site to consider what it would really take to decarbonise and it is a significant cost. Funding schemes help make these ambitions a reality when otherwise strained.”
As hospitals look toward heat decarbonisation, Des understands that the challenges can multiply, especially as electrifying heat can be costly.
Des is also keen to clear up a common misconception: that investing in low carbon upgrades comes at the cost of paying for nurses, doctors or patient care.
He added: “These projects are funded from entirely different budgets – they’re not taking money away from staff. But we have to do a better job of explaining that to the public. It’s not one or the other. It’s not mutually exclusive.”
In fact, by cutting wasted energy spend and reinvesting savings into the wider system, green technologies support the long-term resilience of the NHS, Des says.
Des himself has a hands-on approach. Starting as a fitter, he’s worked for the NHS since 1982 and has progressed his way through the ranks. He understands the realities on the ground as well as the pressures at the top.
Over the past few years, Swansea Bay University Health Board has delivered a series of strategic energy efficiency upgrades across its estate, including the replacement of thousands of light fittings, enhanced insulation, modernised Heating, Ventilation and Air Conditioning or HVAC systems, and the installation of local solar arrays.
These upgrades are not just about reducing utility bills as they help create safer, more comfortable environments for patients and staff alike. Brighter, well-lit wards, improved air quality, and more stable indoor temperatures all contribute to better clinical settings and overall staff wellbeing.
The benefits also extend beyond the building fabric. The financial savings achieved through reduced energy consumption are reinvested into other areas of hospital care, helping to protect services, support innovation, and strengthen resilience across the health board.
Des said: “Communication has been key throughout these projects, with videos created to bring staff and stakeholders along the journey.
“We find that the visual is the most effective when conveying the impact and importance of the projects.”
The team also relied on shared services to support planning and logistics, ensuring smooth delivery across multiple departments and governance layers.
However, Des noted that technically, the challenges have been considerable. Integrating modern systems like air source heat pumps into older hospital infrastructure exposed issues with legacy controls and compatibility.
Des said: “You need to consider these elements when introducing new innovative technologies. Retrofitting requires time, coordination and expertise.
“It is possible and necessary but make sure you have scoped out the scale of the project before you undertake it.”
Des expressed his pride for the grassroots movement within the health board. Green teams, patient-led sustainability initiatives, and even inhaler recycling schemes have all played a role in engaging staff and patients.
Swansea Bay Health Board also embraced a creative approach to culture change, launching a Bridgerton-inspired sustainability campaign titled Lady Turnitdown which engaged more than 2,000 people.
Developed in partnership with Swansea University and Vital Energi, the initiative re-energised staff engagement through humour, competition and accessible messaging on energy-saving behaviour.
“We’re building a culture,” Des said. “We’ve got a Green Council and a Sustainability Board with staff, clinicians, estates teams and it’s undoubtedly a collective effort.”
However, the challenge of aligning priorities within a healthcare setting is an ongoing and task.
Clinical teams rightly focus on delivering the best possible outcomes for patients, often through the use of highly specialised, energy-intensive technologies.
The estates and sustainability teams, meanwhile, are focused on creating an environment that is not only efficient and resilient but also supports long-term care delivery.
“Surgeons want the best for their patients - do we. But we all have different lenses,” he added.
These perspectives are not in conflict, but rather reflect the diverse expertise needed to keep a hospital running.
Des said: “The key lies in maintaining an open conversation and fostering a shared understanding.”
Furthermore, ensuring that sustainability considerations are embedded in decision-making without compromising clinical excellence.
By working collaboratively, the health board is finding ways to balance immediate clinical needs with the responsibility to safeguard future care through sustainable practices.
Funding bodies are another key aspect of this collaborative effort according to Des. He said: “When Salix announced funding, I saw it as a massive opportunity. When the money is tight, saving energy becomes essential.”
Fellow public sector bodies also have a part to play in the success of this project and many like it.
Des said: “In terms of lessons learned and knowledge, we’ve built strong networks across Wales, spoken to other health boards and shared lessons in order to deliver the project to the best of our ability.
“We know how to do this. The capability is there - but now we need to scale.”
Looking to the future, Des is particularly interested in unlocking the potential of deep geothermal energy.
He said: “We know there are geological surveys identifying opportunities across Wales. It’s not a guaranteed solution and it’s not cheap, but we have to start exploring these technologies seriously.
“Someone has to go first, and I believe the public sector has a responsibility to lead.”
For Des, this isn’t just about carbon. It’s about the future of patient care. “Every saving we make, every kilowatt we cut, can be reinvested into care. That’s what drives us to lead and deliver.”