Health Technical Memorandum 07-07: Sustainable health and social care buildings – Planning, design, construction and refurbishment
Health Technical Memorandum 07-07 (HTM 07-07) is a technical guidance document issued by the Department of Health in the United Kingdom. It provides a structured framework for the design, installation, and operation of specialised healthcare buildings and engineering technology. As part of the core suite of nine Health Technical Memoranda, this document outlines the policies and established best practices required for both new-build projects and the refurbishment of existing healthcare estates. It operates within the wider legal framework of the Climate Change Act 2008 and the Building Regulations, focusing on the delivery of sustainable healthcare infrastructure.
The scope of HTM 07-07 encompasses the entire building lifecycle, from the initial concept to eventual disposal or reuse. It identifies thirteen core issues that must be addressed at every stage: Community, Local environment, Design quality, Flood risk and SuDS, Future-proofing, Health and well-being, Energy and carbon emissions, Transport, Water use, Materials, Waste, Land use and ecology, and Pollution. The memorandum defines sustainability through the Brundtland Report principles and mandates the use of specific assessment tools, such as BREEAM Healthcare, which superseded the earlier NHS Environmental Assessment Tool (NEAT).
The following sections detail the regulatory requirements for project stages, the responsibilities of various stakeholders, and the specific technical benchmarks for energy, waste, and environmental performance required in the healthcare sector.
Project Lifecycle Stages
The memorandum organises the development process into eight distinct stages, identified by alphanumeric values from 'a' to 'h'. Each stage requires specific commitments and recommended actions to ensure sustainability targets are integrated rather than treated as an additional requirement.
- Justification (a): Development of the Strategic Outline Case (SOC) to establish sustainability as a key project driver.
- Scoping (b): Completion of the Outline Business Case (OBC) and initial concept designs.
- Procurement (c): Finalisation of the Full Business Case (FBC) and selection of the project team.
- Commitment (d): Signing off finalised information and securing sustainability accreditation.
- Construction (e): Site mobilisation and mitigation of environmental impacts through a Construction Environmental Management Plan (CEMP).
- Post-construction (f): Commissioning and the creation of a Building User Manual.
- Operation (g): Ongoing monitoring, reporting, and post-project evaluation.
- End of life (h): Evaluation of property for conversion, reuse, or sustainable demolition.
BREEAM Healthcare and Design Assessment
All new healthcare development projects and major refurbishments must undergo assessment via the BREEAM Healthcare methodology. This system awards credits across nine categories to produce an overall score.
- Excellent: The target score for all new healthcare development projects.
- Very Good: The minimum acceptable score for refurbishment projects.
- AEDET Evolution: The Achieving Excellence Design Evaluation Toolkit used to specify and evaluate design quality for healthcare environments.
- ASPECT: The Staff and Patient Environment Calibration Tool used to assess the impact of design on staff performance and patient health outcomes.
Energy, Waste, and Carbon Targets
The document establishes concrete performance benchmarks to comply with national energy efficiency and carbon reduction strategies, including the UK Climate Change Programme (UKCCP).
- Energy Performance: New capital developments must target 35–55 GJ/100 m³, while existing facilities target 55–65 GJ/100 m³.
- Carbon Reduction: A mandatory target to reduce primary energy consumption by 15% or 0.15 million tonnes of carbon emissions (relative to the March 2000 base year).
- Site Waste Management Plans (SWMP): A legal requirement for all construction projects with a value exceeding £300,000.
- Energy Performance Certificates (EPC): Mandatory for all non-domestic buildings when constructed, leased, or sold.
- Display Energy Certificates (DEC): Required for buildings over 1000 m² occupied by public authorities.
Future-proofing and Structural Lifespans
A sustainable building is defined as one that remains operationally useful throughout its structural life. The guidance sets out specific expected lifespans for different building components to guide investment and design.
- Structure and vertical circulation: Expected life of 30–60 years.
- Engineering services: Expected life of 15 years.
- Internal layout: Expected life of 2–3 years before requiring flexibility for change.
- Low-to-zero carbon approach: The public sector aspired to be zero carbon by 2018, with all buildings reaching this status by 2019.
Frequently Asked Questions
What is the minimum BREEAM rating for new NHS buildings?
All new healthcare development projects are required to achieve a BREEAM Healthcare score of Excellent.
At what project value is a Site Waste Management Plan (SWMP) legally required?
A Site Waste Management Plan is a legal requirement for all construction projects valued at over £300,000.
What are the specific energy performance targets for new healthcare developments?
New capital developments and major redevelopments should achieve an energy performance of 35–55 GJ/100 m³.
Which tool replaced the NHS Environmental Assessment Tool (NEAT)?
The BREEAM Healthcare methodology superseded the earlier NHS Environmental Assessment Tool (NEAT) in 2008.
What is the expected lifespan for internal healthcare building layouts?
Healthcare buildings are designed for high flexibility, with the internal layout having an expected life of only 2–3 years before needing modification.
What are the two types of green electricity tariffs identified in the memorandum?
The memorandum identifies the Renewable energy tariff, where the supplier buys units from renewable sources, and the Eco-funds tariff, where a premium is invested in new renewable energy projects.
What is the role of a Sustainability Champion?
The Sustainability Champion acts as a catalyst to ensure that sustainability is addressed continuously throughout the capital development programme, often serving as the project's design champion.
What is the maximum walking distance recommended for new healthcare site bus stops?
The guidance recommends a walking distance of 400 m from the nearest bus stop and 800 m from the nearest railway station.
