Scotland’s ageing population, rise in chronic conditions and climate change risks are putting health infrastructure under growing pressure. To combat these challenges, Scotland must deliver sustainable, future-proofed healthcare infrastructure that can adapt to changing demand while reducing environmental impact.
This challenge sits alongside a shifting investment landscape. The Scottish Government’s infrastructure strategy and capital investment pipeline are increasingly geared towards delivering resilient, net zero-aligned public assets, with healthcare identified as a key priority area for transformation.
Recent spending plans point to significant opportunities to modernise the healthcare estate, including over £500m committed to primary and community care infrastructure and a growing pipeline of capital projects across NHS Scotland. These programmes signal a move towards more localised, community-based models of care, requiring a new generation of flexible, low carbon facilities.
Unlocking the full value of this investment will depend on how effectively funding is aligned with long term sustainability objectives. With NHS Scotland targeting net zero emissions by 2040 and undertaking large scale estate decarbonisation, capital funding must address backlog maintenance and capacity pressures and enable innovation in design, delivery and whole life performance.
What is sustainable infrastructure?
Sustainable health infrastructure is the planning, design, construction and operation of buildings and assets which deliver environmental, financial, clinical and social value. It strengthens local communities, supports wellbeing, and helps services stay available when they are needed most.
In practice, this means designing infrastructure with a focus on:
- Reducing emissions and resource use, supporting Net Zero
- Driving cost‑effectiveness in operations and maintenance, with whole‑life value built in
- Supporting modern models of care and multidisciplinary working, with flexibility to adapt as services evolve
- Improving equality, accessibility and dignity to create facilities which work for all.
Why does sustainable health infrastructure matter?
Sustainable health infrastructure is crucial in responding to today’s realities which shape demand, risk and affordability. The following factors are influencing the future needs of Scottish infrastructure:
- Demand rising and changing: Scotland’s population is ageing, with people aged 65+ increasing by 27% over the last 20 years
- Chronic conditions increasing: Over half of all adults now have at least one long‑term condition, demonstrating an upward trend
- Climate change risks: 22 NHS boards recently completed Climate Change Risk Assessments which highlighted risks to their operations including flooding, storm surge and coastal inundation, heavy downpours and extended hot weather
- Net zero commitments: NHS Scotland has committed to achieving net zero emissions by 2040 and aims for a net zero supply chain by 2045
- Rising digital care: Scotland’s national video consultation service expanded rapidly during COVID‑19, increasing from around 330 to 17,000 consultations per week within four months (March–June 2020).
How is this being delivered in Scotland?
Scotland’s capital pipeline increasingly links investment to outcomes such as prevention, resilience and the transition to net zero. For healthcare, the direction of travel is clear: more care delivered closer to home, supported by modern, efficient and adaptable buildings.
A key commitment is a national programme of new primary and community health centres which are intended to shift activity from acute hospitals into local, joined‑up care settings. The Scottish Government’s Infrastructure Delivery Pipeline 2026 highlights over £500 million of planned investment in primary and community care infrastructure. Pilot schemes include Port Glasgow, East Calder and East Livingston, Cowdenbeath and Lochgelly with a further first tranche of 12 schemes identified elsewhere throughout the country.
Another emerging opportunity is the £50 Barra and Vatersay Community Campus. This integrated, multi‑use campus intended to replace the current school and St Brendan’s Hospital, will bring together education, health, social care housing and community facilities, creating sustainable infrastructure.
What are the benefits of sustainable health infrastructure?
Sustainable infrastructure will improve health and wider-societal by facilitating:
- Better access and experience: inclusive design supporting dignity and accessibility
- Adaptability over asset life: spaces which can be reconfigured as services, technology and workforce models evolve, reducing disruptive retrofits
- Integrated care delivery: facilities designed for co‑location of health, social care and community services, creating continuity and comprehensive care
- Climate resilience: risk‑informed site planning limiting disruption from flooding, storms and overheating
- Lower emissions and whole‑life cost: energy‑efficient buildings, low‑carbon heating and durable materials to cut running costs and carbon together
- Better value for public investment: fewer unplanned closures and reactive repairs, and long‑term protection of asset value.
What’s next?
Over the next few years, Scotland’s pipeline points to sustained procurement activity focused on community-based health infrastructure, net zero and resilience. For organisations across design, construction, digital and estates management, this will create opportunities to help deliver sustainable infrastructure in Scotland.
Need support on your next tender?
At EiB, we have a dedicated strategic work winning team in Scotland, who are up-to-date with the latest sustainable healthcare opportunities through market engagement and local events.
Our win rate in the health sector currently stands at 95%, demonstrating how our strategic advice and guidance develop winning healthcare bids. With a local Scotland team, we are poised and ready to support organisations secure contracts to deliver in Scotland’s journey to preventative, community-based and sustainable care.
