Nigel Thomas, national specification and project sales manager, ABB Electrification looks at how hospitals need to stay powered up at all times.

In a modern hospital, power is the invisible lifeline connecting every vital function, from life-support equipment in intensive care units to the HVAC systems that prevent infection spread. Continuous electrical supply underpins every aspect of patient care.

ABB research shows that hospital power outages can cost estates managers upwards of £6,000 per minute, but the true cost cannot be measured in pounds alone. When power fails, surgeries are cancelled, and dialysis treatments are delayed, it’s lives which hang in the balance.

The triple challenge

Healthcare estates face three converging pressures that make power security both more critical and more difficult to achieve.

Demographics are shifting dramatically. The Centre for Ageing Better predicts the number of people aged 65-79 will increase by nearly a third to 10 million over the next 40 years, while those aged 80 and over will more than double to six million. These patients are highly sensitive to environmental conditions and significantly more vulnerable during power disruptions.

Energy intensity compounds this challenge. With an average consumption of approximately 74 kWh per square foot, hospitals use 2.5-3 times more energy than commercial buildings. The NHS alone consumed 11.3 billion kWh in 2020. HVAC systems account for around 50% of hospital energy use, and research has directly linked faulty HVAC systems to disease outbreaks.

Decarbonisation adds a third dimension. Healthcare accounts for nearly 5% of global greenhouse gas emissions. For the NHS, meeting Net Zero 2045 targets requires wholesale transformation: integration of renewable sources, intelligent load management, battery storage, and comprehensive energy monitoring. The government's £180 million investment in rooftop solar across 200 NHS sites signals this scale. But upgrades need to be practical and avoid causing downtime.

The key question: faced with these pressures, how can hospitals continue to deliver 24/7 reliability?

Knocked out power

Recent incidents illustrate the current vulnerabilities of the grid. In early 2025, Storm Eowyn forced Forth Valley Royal Hospital to rely on emergency batteries for 70 minutes after backup generators failed to engage immediately. In 2024, a blackout at Queen Alexandra Hospital forced procedure cancellations and Emergency Department closure. Europe's largest recent blackout had widespread effects in Spain and Portugal, leaving hospitals scrambling to maintain emergency departments and protect temperature-sensitive vaccines.

These weren't prolonged disasters, but they exposed how quickly modern hospitals become vulnerable when power stability is compromised. As intermittent renewables also become a larger share of the energy mix, hospitals need sophisticated infrastructure to manage this reality.

Active rather than reactive

Traditional hospital electrical systems were largely passive. Circuit breakers tripped during faults. Generators kicked in during outages. Boiler houses contained aging equipment requiring round-the-clock monitoring. These systems were inefficient, with inflexible wiring, difficult fault isolation, and undetected fire hazards.

Modern smart building systems anticipate, rather than simply react. Sensors continuously monitor power quality, equipment performance, and energy consumption. Building management systems aggregate data and optimise operations in real time. Predictive analytics flag potential failures before they cause downtime.

Royal Preston Hospital in Lancashire implemented a unified control system managing ventilation, boiler plants, heating, and lighting across its estate serving 1.2 million patients annually. The system provides granular visibility and occupancy sensing by zone, enabling targeted optimisation for a lower carbon footprint, reduced costs, improved comfort, and enhanced reliability through early fault detection.

Intelligent power protection

Modern circuit breakers exemplify how electrical protection has evolved. The SACE Emax 3, for example, combines lightning-fast breaking with built-in intelligence, continuously monitoring temperature, wear, voltage, and current — which allows proactive maintenance instead of emergency fixes during crises. It’s also the first air circuit breaker to achieve IEC 62443 Security Level 2 certification.

In the interconnected digital age of smart buildings — when cybercriminals have more potential access points than ever before — this level of protection is paramount. Especially in critical infrastructure like hospitals.

UPS systems form the critical bridge between primary power loss and backup generator activation. The MegaFlex DPA UPS, based on decentralised parallel architecture, allows each module to function independently. If one requires maintenance, others continue operating. This prevents single points of failure while maintaining continuous protection for intensive care units and operating theatres, where momentary interruption is unacceptable. In 2024, Haapsalu and Narva hospitals in Estonia implemented MegaFlex DPA infrastructure within 12 weeks, with systems tested before deployment and slotted neatly into existing electrical rooms.

Comprehensive energy visibility

Smart electrification creates what amounts to a hospital's central nervous system. Cloud-based platforms provide continuous visibility into transformer systems, UPS performance, and power distribution across entire estates. Remote monitoring identifies temperature anomalies and electrical faults before they escalate.

Felix Bulnes Hospital in Santiago, Chile, deployed a full suite of advanced circuit breakers and power monitoring tools safeguarding every level of power distribution. The system's real-time monitoring allows facilities managers to anticipate issues well before they cause downtime. The space-saving design also reduced the electrical room footprint by 25%, freeing vital capacity.

Managing renewable integration

As hospitals install solar panels and prepare for increasingly renewable-heavy grid supply, particularly given National Grid’s Great Grid Upgrade, intelligent energy management becomes essential. Health estate managers need tools to monitor and adjust energy consumption in real time, making faster and better decisions based on data insights.

Energy Performance Index (EnPI) functionality allows hospitals to configure specific performance trends, tracking both energy use and cost, while group peak monitoring ensures facilities don't exceed contracted power levels. This is critical when managing variable renewable input.

Power factor monitoring across all assets also helps optimise efficiency. Customisable reporting delivers scheduled insights with relevant information by device group and time, supporting both operational decision-making and regulatory compliance for sustainability directives.

Crucially, open protocol architectures using standards like KNX, Modbus, or BACNet allow integration with diverse equipment from multiple vendors. Hospitals can select optimal solutions for specific needs without vendor lock-in, incorporating technologies as they become available. This flexibility is essential as energy technology continues evolving.

A practical implementation

Few hospitals can shut down for major infrastructure overhauls. Phased approaches work best, prioritising critical systems for immediate attention while upgrading secondary systems progressively. Modern systems' backward compatibility enables this incremental approach.

An integrated eye care centre opening in 2027 installed ABB Electrification technology through a £1.5 million contract delivering distribution boards, automatic transfer switch units, and circuit breakers. These provide seamless connectivity while enabling retrofitting of future technologies. Open protocol platforms allow multiple systems to work in tandem — if one requires maintenance, it doesn't cascade failures.

ABB research indicates proper energy and asset management can reduce energy bills by 20% and cut maintenance costs by up to 40%, helping justify investments while delivering sustainability benefits alongside improved reliability.

The path forward

Hospital energy infrastructure has reached an inflection point. Aging passive systems cannot meet the demands of an aging population, integrate renewables, or deliver Net Zero efficiency. But wholesale replacement isn't an option when continuous operation is literally a matter of life and death.

Smart building infrastructure offers the solution: intelligent systems that predict rather than react, optimise rather than simply operate, and adapt rather than require replacement. The technologies exist — predictive circuit breakers, modular UPS systems, cloud-based monitoring platforms, and open protocol architectures.

In healthcare, power reliability and sustainability are not competing priorities. Modern intelligent infrastructure delivers fully on both. With millions of lives on the line, there is no compromise.