
Decarbonisation is putting hot water strategy under a new spotlight in healthcare estates. As hospitals and healthcare facilities move toward heat pumps, heat networks and lower-carbon infrastructure, they still need to maintain safe water systems and demonstrate effective control of Legionella risk in line with healthcare guidance.
In healthcare premises, where temperature is used as the control strategy, hot water still needs to be stored at 60°C and distributed so that it reaches 55°C at outlets. That means hot water strategy is not just an energy decision, it is a patient safety, compliance and assurance decision.
We support healthcare organisations with practical, risk-led advice to help Estates teams assess decarbonisation proposals, understand water safety implications and maintain safe, compliant hot water systems in practice.
The healthcare hot water challenge
Healthcare estates are under growing pressure to decarbonise heating and hot water infrastructure through heat pumps, heat networks and wider low-carbon strategies.

Guidance aimed at healthcare estates teams has been clear that systems serving hospitals need to maintain high temperatures to mitigate Legionella risk, and that this can be more challenging with heat pump systems -with Legionella control identified as one of the primary concerns for estates and healthcare facilities when decarbonising hot water systems.
That means the real question for Estates teams isn’t simply “how do we decarbonise?” It’s “how do we decarbonise while still being confident in healthcare water safety, HTM 04-01 alignment, outlet temperatures, monitoring, governance and patient protection?”
How we can help
We support healthcare organisations in reviewing proposed hot water strategies against HTM 04-01 and healthcare water safety expectations, and in understanding where lower-carbon strategies could affect Legionella control, outlet temperatures, monitoring or governance. We also help Water Safety Groups and healthcare project teams assess whether supplementary or alternative controls may need to be considered where temperature-only control becomes harder to sustain, alongside the practical monitoring, compliance support and engineering assurance needed to maintain safe systems in live estates.
Because in healthcare, lower carbon cannot come at the expense of lower assurance.

Meet Paul Tolley – Healthcare Solutions Manager
If your team is reviewing hot water strategy or decarbonisation plans ahead of IHEEM, speak to Paul via Paul.Tolley@marlowe-es.com or 07899 791521 about practical support with risk-led implementation and assurance.
